The International Paruresis Association (IPA) to US Federal Government: “When?”

Catonsville, MD USA (March 24, 2026) –The International Paruresis Association (IPA), the leading nonprofit advocating for individuals with Shy Bladder Syndrome (paruresis), issued a public call today urging federal officials to answer one long overdue question regarding workplace drug testing modernization: “When?”

In October 2023, the federal government adopted new Mandatory Guidelines for Federal Workplace Drug Testing Programs authorizing oral fluid drug testing—a scientifically reliable alternative to urine collection. The reform was a major step forward for the thousands of federal employees who live with paruresis, a DSM 5 recognized social anxiety disorder that can make urine sample provision physically impossible.

But more than two and a half years later, not a single laboratory has been certified to perform the authorized oral fluid tests. As a result, the option that was supposed to provide relief, fairness, and equal access to employment remains unavailable.

“Every month that passes without certified oral fluid testing is another month when federal workers with paruresis face anxiety, discrimination, and career barriers,” said Dr. Steven Soifer, PhD, MSW, co-founder of the IPA which celebrates its 30th Anniversary this year. “We’ve been working on this issue since our founding. Our members ask the same question every day: When will the federal government complete the work it already approved?”

The IPA formally contacted the Substance Abuse and Mental Health Services Administration (SAMHSA) earlier this month to request a status update on laboratory certification and has notified key members of Congress whose committees have oversight responsibility for public health and workplace testing policy. No response has been received to date.

“Congress authorized an alternative. The Administration adopted it. Workers need it. The only missing piece is implementation,” Dr. Soifer said. “We are asking SAMHSA and federal leadership for a straightforward answer—When?”

Paruresis affects an estimated 24 million Americans and is especially harmful in environments with mandatory observed or timed urine collection, including federal employment, security clearance procedures, and law enforcement recruitment. Without access to oral fluid testing, many individuals experience unnecessary suffering, job insecurity, or exclusion from positions they are otherwise fully qualified to hold.

The IPA calls on SAMHSA to provide:
• A clear timeline for certifying oral fluid laboratories;
• Interim guidance for agencies and employees;
• A commitment to ensure fairness and medical accommodation for workers with documented conditions such as paruresis.

“The question is no longer whether the federal government supports oral fluid testing,” said Dr. Soifer. “That has already been decided. The only question left—the one our community is asking—is simply: When?”

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[March 24, 2026: Three years later and we are still waiting for the promised approval of labs for oral fluid testing. Shame on you U.S. Government. Check here to see if your senator is on the pertinent committee. Email executive director, Tim Pyle, tim@paruresis.org, for sample info you can share with them on our behalf.

When the Approved Lab list is released, you’ll find the labs here. We continue to work with our industry contacts to stay on top of this situation. Stay tuned for more. If you are subject to Department of Transportation drug testing rules, and your employment is in jeopardy, reach out to us here.]

Our original update on new rules
from May 2, 2023: