“A month that goes by without an oral fluid test is another month when federal employees with paruresis face anxiety, discrimination, and barriers.”
By Kastalia Medrano, Filter
The Department of Transportation will require “directly observed” urine drug testing in federal employment situations where saliva testing is required but not possible. The clarification of DOT drug and alcohol testing procedures is the latest development in a years-long push by the trucking industry. oral fluid testing as an alternative to urine testing.
The new rule was published in the Federal Register on May 11, and will go into effect on June 10.
Truck drivers, who are subject to a large number of federal regulations, do not choose the method of drug testing, while DOT-regulated employers do. The campaign to implement oral fluid testing has been led by the American Trucking Association (ATA), which believes it is necessary to “keep drivers with disabilities off the road and maintain the trucking industry’s commitment to safety.”
The Substance Abuse and Mental Health Services Administration (SAMHSA) approved lab-based oral fluid testing in 2019, and the DOT finalized its regulations in 2023 allowing employers to choose this as an alternative to urine testing. But the actual implementation requires at least. Two laboratories approved by the Food and Drug Administration to process tests—one for the initial analysis and another to confirm the results. There are currently zero.
Oral fluid testing is attractive to many employers for a number of reasons, one of which is its effectiveness in detecting drug use within hours compared to urine drug testing. While the trucking industry has become the public face of the campaign, the regulations also affect federal workers in the commercial aviation, railroad, public transportation and pipeline sectors.
One of the main concerns expressed by the trucking industry has been that urine drug screens are not visible, making it easier to avoid oral fluid testing. Another concern is paruresis, commonly referred to as “shy bladder” syndrome: if a driver can’t urinate when they need to, they’re stuck for a three-hour wait, which obviously affects their arrival time. And if they still cannot produce urine during this period, they are considered to have refused to take the test and are removed from their duties. To return, they must “pass” a urine test watched by a same-sex observer.
New DOT the rule also updates existing terminology by replacing the word “gender” with the word “sex” in accordance with President Donald Trump’s January 2025 executive order “Defending Women from Gender Ideological Extremism and Restoring Biological Truth to the Federal Government.”
“A month that goes without an oral fluid test is another month when federal employees with paruresis face anxiety, discrimination and professional barriers,” Dr. Steven Soifer, co-founder of the International Paruresis Society, said in March. “We have been working on this issue since our inception (30 years ago). Our members ask the same question every day: When will the federal government finish the work it has already approved?”
In April, at the request of ATA, six members of Congress he wrote Robert F. Kennedy Jr. to the Secretary of the Department of Health and Human Services citing FDA regulatory hurdles as the reason why laboratories in the United States are not certified to process oral fluid tests.
They cited an analysis by Quest Diagnostics that showed a 370 percent increase in “replaced” urine specimens from 2022 to 2023. Quest has its own laboratory-based oral fluid collection method, Quantisal™, and has therefore been an ardent supporter of the campaign.
On May 1, the FDA a notice with the intention of considering revising the requirements for toxicology studies. That same day SAMHSA a the list It confirms that currently certified laboratories, which will probably be updated in the future, but are not available at the moment.
However, at the end of the day, HHS handles oral fluid testing in a similar scenario to hair follicle testing. The department promised to create guidelines for hair testing in 2015, but has yet to do so.
This the article originally posted by The filteran online magazine that deals with drug use, drug policy and human rights from a harm reduction perspective. Follow Filter on Bluesky, X or Facebookand sign up for their newsletter.