A comparison between instant and laboratory oral fluid analysis among arrestees

Research studies that collect biological measures of drug use have traditionally utilized laboratory urinalysis. Several recent studies have also documented the utility of laboratory oral fluid (OF) analysis. A new method of drug testing-instant OF technology--may offer a quicker, equally accurate alternative to laboratory OF assays. To date, however, no field studies have compared the two methods. In the current study, an instant OF test (ORALscreen) was administered to 65 adult arrestees surveyed through Maryland's Substance Abuse Need for Treatment among Arrestees (SANTA) study. Following a research interview, a second OF sample was collected (ORALconfirm) and shipped to the manufacturer's laboratory for analysis. The instant OF test was 96% sensitive and 83% specific for cocaine, 100% sensitive and 75% specific for opiates, and 100% sensitive and 94% specific for marijuana. Kappa statistics were low for all three drugs, suggesting poor agreement between the two tests. Moreover, while the marijuana sensitivity and specificity coefficients in the current study were high, a growing body of research has indicated that OF analysis is not as accurate as the gold standard of urinalysis in detecting recent marijuana use. Implications for these findings are discussed.