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Drugs of Abuse Saliva Testing

Last updated May 1, 2019

Approved by: Krish Tangella MD, MBA, FCAP

PET Scan showing decreased brain metabolism in a drug abuser.

What are the other Names for this Test? (Equivalent Terms)

  • Saliva Drug Screening Test
  • Sports Doping Saliva Test
  • Substance Abuse Saliva Test

What is Drugs of Abuse Saliva Testing? (Background Information)

  • Ethanol (drinking alcohol) is the most commonly abused legal substance. Additionally, performance-enhancing drugs, such as steroids and erythropoietin, can be tested
  • To test for the presence of the above compounds, an initial screen is first performed. The initial screen detects the presence of a drug or its byproducts
  • However, the initial screen may detect compounds that are similar to illegal drugs and their byproducts. To differentiate between this and a legitimate drug abuse, a secondary test is performed, which is more sensitive
  • The Drugs of Abuse Saliva Testing is used to detect the presence of illegal drugs or their byproducts in saliva. The test is used to determine if an individual has taken illegal drugs. It is also used to diagnose a drug overdose

The National Institute for Drug Abuse (NIDA) has put together a list of the most commonly abused drugs. These include:

  • Amphetamines – stimulants (e.g. methamphetamine and Adderall®)
  • Barbiturates – depressants (e.g. phenobarbital)
  • Benzodiazepines – depressants (e.g. diazepam or Valium®)
  • Cannabinoids – hallucinogens (e.g. marijuana)
  • Cocaine
  • Opiates – depressants (e.g. codeine, morphine)
  • Phencyclidine (PCP)
  • Tricyclic antidepressants (TCAs)

What are the Clinical Indications for performing the Drugs of Abuse Saliva Testing?

Following are the clinical indications for performing the Drugs of Abuse Saliva Tests

  • Routine screening for medical, legal, forensic, or athletic (sports) purposes
  • Diagnosing a drug overdose that is marked by:
    • Nausea
    • Erratic behavior
    • Dilated pupils
    • Vomiting
    • Dizziness
    • Seizures
    • Abdominal cramps

How is the Specimen Collected for Drugs of Abuse Saliva Testing?

Following is the specimen collection process for Drugs of Abuse Saliva Testing:

Sample required: Saliva

Process: Spitting into a sterile container.

Preparation required: No special preparation is needed prior to the test.

What is the Significance of the Drugs of Abuse Saliva Testing Result?

  • Positive Drugs of Abuse Saliva Test indicate that an individual’s saliva contains significant levels of a drug of abuse.

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

  • Some drugs, such as methylenedioxy-methamphetamine (MDMA), are difficult to test because adequate procedures are not available, unlike for many other drugs
  • Furthermore, drugs like gamma-hydroxybutyrate (GHB) are quickly cleared from the body. Thus, by the time a test is performed, significant levels may not remain in the body

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

Please visit our Laboratory Procedures for more physician-approved health information:


References and Information Sources used for the Article:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 15, 2015
Last updated: May 1, 2019