State of practice on Oral Fluid Programs

Driving impaired by any drug, including alcohol, is illegal in all 50 states, the District of Columbia, and all U.S. Territories. This includes impairment from prescription and over-the-counter medications, cannabis, and illegal drugs. However, no commercially breath-based, or other detection technology is currently available to measure impairment from drugs other than alcohol. With the legalization of cannabis in many states and the opioid epidemic, law enforcement seeks on-site screening tools to aid in the detection of drug-impaired drivers.
Oral fluid testing for drugs is increasingly used by law enforcement officers at the roadside to test for drug use and establish probable cause and potential reimbursement for use of these devices is supported in the current NHTSA authorization (23 USC (d)(4)(B)(xi)(I)). Law enforcement state oral fluid sample collection can be more easily collected than blood and can be quickly collected before drug metabolites dissipate. Potential shortcomings of oral fluid include its ability to detect some metabolites but not all and detection of drug presence only and not impairment.

Several manufacturers have been developing portable on-site oral fluid drug-testing (screening) devices designed for use in the field. NHTSA (2021) evaluated five different devices commonly marketed to and used by law enforcement. The laboratory study assessed the screening devices’ accuracy, reliability and performance compared to manufacturer specifications. It also examined their susceptibility to interference and resistance to extremes of temperature and humidity (Buzby et al, 2021). The results indicated the five tested devices showed variability in performance across devices and across drugs on measures of sensitivity, specificity, and accuracy.
Use of oral fluid by states varies based on lab capability, legal framework, training, and other factors [1]AAA and the National Alliance to Stop Impaired Driving (NASID) have developed tools for implementing these programs.

Objective(s):
To ensure technical accuracy, relevancy, and consistency the Contractor shall create a working group. The Contractor, with assistance from the working group, will conduct a landscape and policy scan and report results to include 1) data, research, and resources related to active oral fluid screening and confirmatory testing programs; 2) a research review of and information on oral fluid devices; 3) a review of Federal, State, and local laws, protocols, regulations, trends, and information specific to oral fluids programs, and 4) a consolidation of stakeholder recommendations for oral fluid programs. Additionally, the Contractor and the working group will create a lesson learned document to assist states developing an oral fluid program. This document will include promising practices as well as the benefits and challenges of oral fluid programs. 

• TBD