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Many alternatives to the industry standard of urine drug testing have emerged over the last few years and at least one of these alternatives is beginning to gain acceptance.
Blood
Although blood drug testing is as accurate as urine drug testing, and it is difficult to alter results, the major concern is the invasive nature of the collection process. Also the cost of collection and analysis is greater.
Saliva
Many experts indicate that they would prefer the analysis of saliva to that of urine. Saliva collection is thought to be less objectionable in nature, and parent drug detection is higher than in urine. Currently, an unfortunate disadvantage to saliva drug testing is the high risk of contamination and false positives by oral and nasal routes. Also, drugs are only detectable for one to two days.
Sweat
The sweat patch, although accurate in the testing for drug use, has one major flaw. The collection process is quite lengthy, in that the donor must have the patch applied, wear the patch for 10 days to two weeks, and then have the patch removed and sent to a laboratory for analysis. Many consider this approach too invasive and others agree that the potential for adulteration is very high.
Fingernail
Although fingernail specimens can accurately detect drugs of abuse, the overwhelming disadvantage is the inability to detect recent drug use. Most fingernail clippings are between five and six months old by the time they can be obtained and would give very little insight as to recent use of drugs. Fingernail use is, however, gaining acceptance in the postmortem setting.
Hair
Unlike urine testing, hair testing can detect drug use for a much longer period. The standard hair test will detect drug use for up to three months. Hair testing's greatest advantage is the ability to create a permanent record of drug use in the strand (shaft) of the hair. All positive screening tests are confirmed using special GC/MS (gas chromatography/mass spectrometry) or MS/MS (tandem mass spectrometry). The collection process involves clipping a specimen from the crown of the head and preparing the specimen through precise chain-of-custody and packaging for shipment to the laboratory for analysis. The appropriate use of the hair test has traditionally been for pre-employment and follow-up situations. The primary reason for this is the fact that it is not possible to get the most recent drug use from a hair specimen since it takes several days for hair to grow out enough to obtain a specimen. The perfect combination is both urine and hair analysis. Such a program will incorporate the testing of both at one laboratory to provide recent and long term use of the five primary drugs of abuse: marijuana, cocaine, amphetamines, opiates and PCP (Phencyclidine).
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