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When a user of illegal drugs is sent for a urine drug test, many times the donor will attempt to alter his/her urine, either internally or externally, in order to avoid the detection by a laboratory of an illegal substance in the urine. The three methods used to alter or change a urine specimen are:
- Adulteration
- The addition of a substance to the urine at the time of the collection is generally how adulteration is done; however, there are some commercially available products that are sold specifically as adulterants to add substances to one's urine to interfere with the testing process. There is also potential health risk to such internal adulterant; however, the actual risk is unknown. All SAMHSA-certified laboratories test for adulterants in urine.
- Substitution
- Using a urine specimen that is known to be free of any illegal drug is the most successful method of altering test results. However, the donor must be able to conceal the specimen from the collector, keep it at body temperature and transfer it into the collection container within a very short time. One of the more common practices used by drug users in the medical field is the reverse catheter. A donor will empty his/her own bladder, insert a catheter, and insert someone else's drug-free urine through the catheter into his/her own bladder. There are also expensive devices that may be purchased for this very purpose. Although there is no test to determine if a substituted specimen has been used, collectors are well trained to detect the substitution of specimens.
- Dilution
- Adding a dilutant (water) to a specimen is the most common form of alteration. The collection process, along with the need to keep the dilutant at body temperature, has greatly reduced this practice. All SAMHSA-certified laboratories test specific gravity and creatinine levels for evidence of dilution.
Drug Altering Products
Tests for pH and creatinine can aid in the detection of common methods for defeating urine drug tests, including dilution or adulteration of the sample with bleach, vinegar, Visine, sodium bicarbonate, Drano, soft drinks or hydrogen peroxide.
Commercially available adulterants such as UrinAid and Instant Clean Add-it-ive produce glutaraldehyde. Glutaraldehyde is not normally in urine and detection generally indicates use of an adulterant.
Other commercially available products, Klear and Whizzies, produce the presence of nitrate in the urine, which is not normally present. If nitrate is detected in the urine specimen, it is an indicator of adulteration.
The Urinator is a device that the donor wears, allowing him/her to carry a drug-free specimen, unnoticed, into the collection area. The donor maintains body temperature via a self-contained, battery-operated, thermostatically controlled heater.
Urine specific gravity and creatinine values are useful in detecting in vitro (within the body) and in vitro (from outside the body) dilution of urine samples.
The products below are used primarily to keep laboratories from detecting drugs in urine. Most are commercially available.
Adulterant Shows Method of Detection Golden Seal; water Change in specific gravity and creatinine; Indicates dilution Specific gravity and creatinine levels Klear; Whizzies Nitrate in urine Nitrate levels Urine Luck;
THC-Free; Amber 13Abnormal pH levels pH levels Instant Clean;
Add-it-ivePresence of glutaraldehyde in the urine Glutaraldehyde levels PASSIVE INHALATION, POPPY SEEDS AND SECOND HAND SMOKE
Passive inhalation, poppy seeds and second hand smoke are all reasons that donors who test positive cite to dismiss their illegal drug use-even though many studies indicate they cannot cause a positive reading. However, the most devastating argument against all of these excuses is the ever-increasing cutoff levels established by federal regulations and adopted by non-federally regulated industry.
DRUG TEST CUTOFF LEVELS
Those who established cutoff levels for drug testing have gone through some tough times trying to prove to the doubting public, politicians, unions and employers that the drug cutoff levels were already too high. Therefore, it has always been easier to raise the limits to eliminate the passive inhalation, poppy seeds, and second hand smoke excuses than to fight the many opposing studies conducted by questionable research groups.
The following cutoff levels are currently being used by all SAMHSA- certified laboratories:
Drug Screen Confirmation THC 50 ng/ml 25 ng/ml Opiates 2000 ng/ml 2000 ng/ml PCP 25 ng/ml 25 ng/ml Cocaine 300 ng/ml 150 ng/ml Amphetamines 1000 ng/ml 500 ng/ml The screen cutoff is the highest level of drugs detected in the urine that will still report as negative. The confirmation test is only done when the screen test results exceed the screen cutoff levels. Confirmation cutoff levels indicate the highest level of drugs detected in the urine that will report as negative. Ng/ml equals nanograms per milliliter, indicating the weight of drug detected to the volume of specimen.
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