Written and maintained by CASRAI Editorial Board
Last updated
General information only, not medical or legal advice. It describes federal workplace program rules as published in 2023 and does not address any individual test result.
Short answer
A saliva drug test, also called an oral fluid drug test, analyzes a specimen collected from the mouth with a single-use collection device. Under the HHS federal workplace guidelines published in October 2023, a collector watches the donor throughout, and each oral fluid specimen is at least 1 mL of undiluted fluid, collected as a primary tube (A) and a split tube (B).
Definition and scope
The HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs Using Oral Fluid (OFMG) describe an oral fluid specimen as one collected from the donor’s oral cavity, made up of a combination of physiological fluids. The guidelines were effective October 10, 2023. They govern federal workplace drug testing programs and the laboratories certified by HHS to support them; they are not a rule for every employer, clinic or consumer device. At the time of that notice, HHS stated that no Federal agencies were testing hair or oral fluid specimens, so the text is best read as the published framework rather than a description of current agency volume.
For how point-of-care and laboratory diagnostics are regulated more broadly, see what an in vitro diagnostic is and the CLIA-waived test definition.
How oral fluid collection works in the federal framework
Collection device and volume
Section 7.1 of the OFMG requires that a single-use collection device intended to collect an oral fluid specimen be used. Section 2.4 requires at least 1 mL of undiluted (neat) oral fluid for each specimen, designated Tube A and Tube B. If a device uses a diluent or another component that modifies the volume of the testable specimen, it must still collect at least 1 mL of undiluted oral fluid.
Observation by the collector
Section 8.5(a) states that the collector must be present and maintain visual contact with the donor during the collection procedures. The donor positions the collection device under the collector’s observation. In its response to comments, HHS notes that the guidelines also require the collector to go over the manufacturer’s instructions for use with the donor and to observe the donor washing their hands before handling the device.
Split specimen
The guidelines describe a primary specimen (A) and a split specimen (B), collected concurrently or serially, or one specimen from a single device subdivided into A and B.
Saliva drug test vs urine drug test: sourced initial cutoffs
The two HHS documents publish initial test cutoffs for their own specimen type. The panels below are as published in the 2023 guidelines (oral fluid: 88 FR 70814; urine: 88 FR 70768); the documents state that the Secretary publishes the current panels each year in the Federal Register, so this table is not a current panel. Note that the analytes differ: oral fluid testing for marijuana targets THC itself, while urine testing targets the metabolite THCA.
| Initial test analyte | Oral fluid initial cutoff | Urine initial cutoff |
|---|---|---|
| Marijuana (THC in oral fluid; THCA metabolite in urine) | 4 ng/mL | 50 ng/mL |
| Cocaine / benzoylecgonine (urine: benzoylecgonine) | 15 ng/mL | 150 ng/mL |
| Codeine / morphine | 30 ng/mL | 2,000 ng/mL |
| Hydrocodone / hydromorphone | 30 ng/mL | 300 ng/mL |
| Oxycodone / oxymorphone | 30 ng/mL | 100 ng/mL |
The numbers are not interchangeable: a cutoff belongs to one specimen type, one analyte and one published panel. The urine guidelines (effective February 1, 2024) also describe observed urine collections for specific circumstances, whereas the oral fluid guidelines build visual contact into every collection.
Where it matters for labs, clinics and supply decisions
- A collection device for a federal program must be single-use and must yield at least 1 mL of undiluted oral fluid for each of two tubes (Sections 7.1 and 2.4).
- The program expects a trained collector and a documented split specimen, so a device is one part of a collection process rather than the whole of it.
- Cutoffs and analytes are set by annual HHS notice, so a program should check the current panel on the SAMHSA workplace page instead of relying on a figure printed in a guide.
Clinics that handle employment-related testing can compare their own workflow against the occupational medicine clinic supply checklist and the pre-employment physical exam supply checklist. For the urine side of the same topic, see the urine HAT guide.
Common misunderstandings
- “The cutoff numbers are universal.” They are published per specimen type and panel for federal programs, and the 2023 panels are replaced by annual notices.
- “Oral fluid and urine tests look for the same molecule.” For marijuana they do not: the oral fluid panel lists THC, the urine panel lists THCA.
- “Saliva collection is unobserved because it is simple.” The federal oral fluid framework requires the collector to keep visual contact with the donor.
FAQ
What is an oral fluid drug test?
It is a drug test performed on a specimen collected from the donor’s oral cavity. In the HHS guidelines effective October 10, 2023, the specimen is a combination of physiological fluids collected with a single-use device.
Is a saliva drug test the same as an oral fluid drug test?
The federal guidelines use the term oral fluid; saliva drug test is the common name for the same kind of test.
What is the difference between a saliva drug test and a urine drug test?
The specimen type differs, and so do the published analytes and initial cutoffs (see the table above). The HHS oral fluid guidelines also require the collector to maintain visual contact with the donor during collection.
Sources
- HHS, Mandatory Guidelines for Federal Workplace Drug Testing Programs Using Oral Fluid, 88 FR 70814 (October 12, 2023), govinfo.gov, date checked October 30, 2026.
- HHS, Mandatory Guidelines for Federal Workplace Drug Testing Programs Using Urine, 88 FR 70768 (October 12, 2023), govinfo.gov, date checked October 30, 2026.
