2. Quest Diagnostics
Agenda
• Overview
• History of Oral Fluid Drug Testing
• Future of Oral Fluid Drug Testing
• 10 Benefits of Oral Fluid testing for Employers
• Summary
• Questions
| 2Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
3. Quest Diagnostics | 3
Oral Fluid Testing Overview
• The oral fluid drug testing market is worth
about $45MM annually.
• Quest Diagnostics introduced Oral-Eze® to
the market in 2011.
• In oral fluid drug testing, the oral fluid is
typically collected on a cotton pad. The
pad is then placed in a transport tube
containing a buffer preservative solution. A
chain of custody process is completed and
then the specimen is transported to a
laboratory for screening and confirmation
(if required).
• Oral fluid testing is popular in retail,
grocery, staffing, manufacturing and other
industries.
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
4. Quest Diagnostics
History of Oral Fluid Drug Testing
• Started in the early 1990s
• Began in the retail space
• Retail, Staffing, Manufacturing
| 4Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
5. Quest Diagnostics
Future of Oral Fluid Drug Testing
September 2011, DTAB unanimously recommends
– Adding oral fluid as a permitted specimen type in Federal drug testing programs
– HHS consider adding prescription Schedule II Drugs (e.g. oxycodone) to Federal
drug testing programs
January 2012
– SAMHSA administrator accepts DTAB’s recommendations
– DOT endorses the opportunity to improve transportation safety by addressing illicit
use and abuse of the prescription drugs
– Start of Process – Neither HHS nor DOT have changed their requirements.
State Regulations
• For workplace drug testing, there are only two states and one territory that prohibit the
use of oral fluid testing – Hawaii, Maine, Vermont and Puerto Rico.
• Some voluntary worker’s compensation programs only permit urine testing – Check
your state!
| 5Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
7. Quest Diagnostics | 7
1. Detects Recent Drug Use
• Oral fluid testing
– Detects recent use (previous 24-48 hours)
– Suited for pre-employment, random, post-accident, reasonable suspicion testing and
return-to-duty drug testing
• Urine testing
– Detects recent use (previous 24-72 hours)
• Hair testing
– Detects a pattern of repetitive use (up to 90 days, based on testing proximal 1.5” head hair)
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
8. Quest Diagnostics | 8
2. Excellent Drug Detection (Especially for Marijuana)
• Oral fluid collections are observed
– Curbs evasive donor behavior
• New Oral-Eze® collection and testing technology
– Sample adequacy window tells you when the correct
amount of oral fluid has been collected
• Oral fluid detecting more marijuana positives
– Oral fluid positives increased 26% in the first-half of 2012
– 70% more positives in oral fluid than in urine in the first-half
of 2012
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
9. Quest Diagnostics | 9
Positivity Rates By Testing Category
Oral Fluid Drug Tests for U.S. General Workforce
0%
1%
2%
3%
4%
5%
6%
2008 2009 2010 2011 Jan-Jun 2012
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
Source: 03/13 Quest Diagnostics Drug Testing Index™
10. Quest Diagnostics | 10
Overall Positivity Rates
(U.S. General Workforce)
0%
1%
2%
3%
4%
5%
6%
2003 2004 2005 2006 2007 2008 2009 2010 2011 Jan-Jun
2012
Urine
Oral fluid
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
Source: 03/13 Quest Diagnostics Drug Testing Index™
11. Quest Diagnostics | 11
Marijuana Positivity Rates
(U.S. General Workforce)
0%
1%
2%
3%
4%
5%
2003 2004 2005 2006 2007 2008 2009 2010 2011 Jan-Jun
2012
Urine
Oral fluid
Source: 03/13 Quest Diagnostics Drug Testing Index™
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
12. Quest Diagnostics | 12
3. Difficult Test to Cheat
“Can an oral fluid drug test be beaten?”
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
• We have not found any adulterants that can beat the test
• Observed collections curb evasive donor behavior making oral fluid testing
virtually adulteration proof
• Nothing in the donor’s mouth (gum, tobacco,
food, drink) for a minimum of ten minutes
before collecting the specimen
• Quest Diagnostics performs specimen validity
testing on every oral fluid specimen, yielding
the added assurance that the specimen
is appropriate for testing.
13. Quest Diagnostics | 13
4. Reduces Collection Fees and Downtime
• Collecting onsite eliminates the fees associated with urine and hair testing
collections
• Not having to travel to a collection site reduces lost productivity
• Simple and fast to collect
• We provide complimentary oral fluid collector training on our website
http://questdiagnostics.com/home/companies/employer/drug-screening/knowledge-center/online-training/specimen-collections.html
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
14. Quest Diagnostics | 14
5. Enables Remote Collections
• No access to a collection site? No problem!
• Flexibility of being able to test anytime, anywhere
• Remote geographies
• Off-hours collections
• Well-suited for retail, grocery,
staffing and construction workers
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
15. Quest Diagnostics | 15
6. Simplest Sample Type to Provide
• Easy on donors when compared with urine or hair
• Less invasive collection leads to
reduced donor anxiety and
enhanced donor dignity
• No shy bladder issues
• No taste on the collector pad
• 4 out of 5 collections are
completed in five minutes
or less
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
16. Quest Diagnostics | 16
7. Assurance of Valid Sample Collections
• Indicator window reduces repeat collections - the leading cause of employer
dissatisfaction
• Built-in indicator window turns blue when 1 mL of
oral fluid has been collected, reducing the likelihood
of the sample being rejected as “quantity not sufficient”
and thereby eliminating the time and expense
associated with a second collection
• Sample adequacy indicator likely required on oral fluid
collection devices
– Minimum volume collected
– Dilution assurance through known quantity collected
• Cutoffs expressed as original (“neat”) oral fluid
– Standardization across various devices
• Oral-Eze currently meets these requirements
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
17. Quest Diagnostics | 17
8. Lab-based Test Helps to Ensure Quality
• Screening and confirmation performed at a certified laboratory provides the
assurance of quality, consistency and results dependability
• Our oral fluid testing is performed at our Lenexa, Kansas laboratory
• This centralized laboratory and the logistics that support our specimen
transportation provides excellent test result turnaround time
• Negative results are typically reported within 24 hours
• Positive results typically report in 36-96 hours
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
18. Quest Diagnostics | 18
Oral Fluid THC Concentrations
• Data from nearly 30,000 Oral-Eze Oral Fluid THC Confirmations
• Lab-based (Oral-Eze) cutoff = 1.5 ng/mL
• >50% <15 ng/mL
• >75% <40 ng/mL
• POCT cutoff = 40-50 ng/mL
• Lab-based testing makes a
difference! or less
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
19. Quest Diagnostics | 19
9. Test for Common Drugs of Abuse
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
• Amphetamines
• Methamphetamines (including MDMA and its metabolite)
• Opiates (Codeine, Morphine, Hydrocodone, Hydromorphone,
6-monoacetylmorphine)
• Cocaine (metabolite)
• Marijuana (THC)
• Phencyclidine (PCP)
• Working to add additional
drugs to the Oral-Eze panel
20. Quest Diagnostics | 20
Oral-Eze Cutoffs (expressed as “neat” oral fluid)
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
21. Quest Diagnostics
Positivity Rates by Drug Category
Oral Fluid Drug Tests - For U.S. General Workforce, as a Percentage of All Such Tests
| 21Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
Source: 03/13 Quest Diagnostics Drug Testing Index™
22. Quest Diagnostics | 22
10. Widely Accepted Testing Modality
• Widely accepted testing modality – we performed nearly 700,000 oral fluid
drug screens from hundreds of clients in 2012
• Stand behind the accuracy and reliability of our
test results
• Assurance that lab-based oral fluid testing with
Oral-Eze will yield dependable results, helping
to create a drug-free workplace
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
24. Quest Diagnostics
Recap of Benefits
1. Detects recent drug use
2. Excellent drug detection
3. Difficult test to cheat
4. Reduces collection fees and downtime
5. Enables remote collections
6. Simplest sample type to provide
7. Assurance of valid sample collections
8. Lab-based test helps to ensure quality
9. Test for common drugs
10. Widely accepted testing modality
| 24Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
25. Quest Diagnostics
Questions
R. H. Barry Sample, Ph.D., D-FTCB
Director of Science and Technology
barry.x.sample@QuestDiagnostics.com
QuestDiagnostics.com/Oral-Eze
| 25
Aaron Atkinson, MBA
Product Manager
aaron.j.atkinson@QuestDiagnostics.com
Drug Users Need Not Apply: 10 Ways that Oral Fluid Testing Benefits Employers
26. Quest Diagnostics
Upcoming Webinars
Hair Testing with Randy Clouette
& Jared Rowland, Quest Diagnostics
May 2013
Instant Drug Testing with Bill Current
June 5, 2013
