Since March, as businesses and government agencies started closing and investigating safer alternative ways of testing procedures, more and more people have been inquiring about oral fluids testing for drugs of abuse. These are sometimes referred to as saliva tests or mouth swabs. So, let’s talk a little bit about what they are, how they work, and why the sudden spike in interest.
There are a couple of reasons for the impression that oral fluids testing allows for a safer collection protocol. Firstly, an oral fluids drug test can be performed remotely via video conferencing software. The administrator can watch the donor collect the specimen themselves, watch the collected specimen being inserted into the test, and watch the results develop without the device or donor leaving the camera view. Secondly, an oral fluids test can be performed in an outdoor setting while maintaining social distancing guidelines. Of course, the donor must remove their face covering to collect the specimen, but you should still be able to witness the entire process at a safe distance.
How They Work & Procedures
If you are unfamiliar with oral fluids test, there are basically two parts: the collector, which is a sponge attached to a plastic handle and the test device itself, where the collector (sponge) is inserted to direct the specimen into the well inside of the test where the test strips are located. The collection process can be a little tricky until you get the hang of it – for starters, an uncooperative donor can purposefully withhold collecting enough saliva to allow the test to function – but once the procedure is mastered, the test is as easy to perform and read as a urine drug test. One other tricky step with collecting a specimen is that the test requires more saliva than you might think. The instructions only mention the amount of time it should take until you have enough specimen, but it is not that black and white. The donor should compress the sponge against their cheek or tongue and allow the decompression to absorb the excess fluid. In the worst-case scenario, they can also expectorate directly into the test device, or into an external receptacle, which can then be poured into the test.
Oral fluids tests have come a long way in the past 12-15 years. If you had asked back then, I would have discouraged their use or at least give warning about their accuracy and other shortcomings. Today, however, they are just as accurate as the urine drug tests that we provide. Additionally, the number of substances that can be tested has significantly caught up to the options we have for urine testing. Add to this the fact that it is impossible to adulterate an oral fluids test, if the instructions are followed properly, making them an excellent tool to have at your disposal.
Shortcomings & Final Word
Perhaps the only shortcoming of oral fluids testing, especially for most of your purposes, would be the window of detection. As the toxicology of urine closely mirrors the toxicology of blood, drugs are only detectable while they are still in the bloodstream, much like a breathalyzer only detecting current intoxication as opposed to an EtG test offering detection for up to 80 hours after use. So, the best-case scenario for oral fluids testing would be detection of less than 24 hours after use. In some situations, such as injury at work, where the important factor is detecting current intoxication, oral fluids testing makes the most sense. However, this window of detection isn’t always as useful to someone when the need to detect recent and past drug use requires a detection window that goes back days or even weeks in some cases.
In summary, oral fluids testing is a great option for programs looking to detect recent drug use. Though there are some drawbacks with their window of detection, they can be administered safely and frequently, while adhering to COVID-19 guidelines. If you would like any additional information on this, or any other subject, please leave a comment below or reach out to us directly. Stay safe and be well.
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What is EDDP?
I often get asked about EDDP – primarily, “what is EDDP?”, and “should I care about EDDP?”. EDDP – the abbreviation for the chemical compound 2-ethylidene-1, 5-dimethyl-3, 3-diphenylpyrrolidine – is a major metabolite of methadone. While methadone is not a widespread drug of abuse these days, it is certainly something you would not want to not test for. Hopefully, the information about EDDP in this blog post will help you decide if testing for EDDP would be beneficial.
As you may know, some drug tests are designed to react to the parent substance: in other words, the substance that was ingested, while some panels are designed to detect the metabolite: what the body changes that substance into as the body’s metabolism processes it into waste. As for substances, some are (at least partially) excreted in the exact same form that was ingested. For example, with methadone, in most cases, the body will excrete at least some methadone in the urine. Also, as with most substances, the body will excrete at least some amount of metabolite in the urine – in this case, we mean EDDP.
Should I Care About EDDP?
There are 3 primary reasons to care about, and test for, EDDP. Before we get there, it is important to note that there is a non-trivial percentage of people in the world who are “extensive metabolizers” of methadone; this means that while most people will excrete the parent compound in their urine, some will almost completely metabolize the methadone into EDDP. Since a standard methadone panel does not react to the EDDP, it gives us three risky scenarios: 1) You have a patient/participant using methadone illicitly and a simple methadone test is not detecting this. 2) You have a patient/participant who is supposed to be taking their methadone, but suspect they are instead spiking their specimen with methadone to give the illusion they are taking it, and 3) Same scenario as number two, except the patient/participant is taking their methadone as prescribed, yet is causing suspicion by producing a negative methadone test.
Another, lesser, benefit of testing EDDP, is that all methadone instant tests currently available will cross-react with Doxylamine – a substance found in the over-the-counter medications Nyquil and Unisom (amongst others). The EDDP panel has a much higher threshold for cross-reactivity for Doxylamine than the methadone panel.
So, EDDP may not necessarily be crucial to all programs, but it is good to know what it is, and if you should care about it. As always, please fell free to comment here or reach out to us should you have any questions or would like any additional information on the subject.
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