A comparison of saliva testing to urinalysis in an arrestee population

Past studies have concluded that individuals under criminal justice supervi sion often underreport their recent use of illicit drugs. To address this u nderreporting, objective biological measures, such as urine, saliva, and ha ir testing, have been used to gain better estimates of illegal drug use. Wh ile urinalysis is generally recognized as the reference standard, a method recently introduced in nonlaboratory settings for ascertaining drug use-sal iva testing-may offer an alternative to urinalysis. To date, however, no st udies have compared saliva testing to urinalysis among criminal justice pop ulations. In the current study, urine and saliva specimens were collected f rom 114 adult arrestees interviewed as part of Maryland's Substance Abuse N eed for Treatment among Arrestees (SANTA) project. With urinalysis as the r eference standard, analysis of the saliva test results indicated sensitivit y of 100% and specificity of 99% for cocaine and sensitivity of 88% and spe cificity of 100% for heroin. For marijuana, however, the saliva results ind icated a sensitivity of only 5%. Anecdotal reports from the field suggest t hat saliva may have some advantages over urine because of the case of colle ction, invulnerability to adulteration, and minimal personal invasiveness. These findings suggest that a more comprehensive study to evaluate the effi cacy of saliva testing in field research may be warranted.