Occurs when a foreign substance is added to the urine specimen in order to interfere with the testing. Adulteration of the specimen has been attempted by some donors for years. Early on, substances like bleach, acids, Drano, salt and Visine were used to adulterate specimens. In recent years, commercial products are sold specifically to adulterate urine specimens. Brand names include Klear, Urine Luck, Whizzies and THC Free. These products are advertised on the Internet and in magazines such as High Times. The most common adulterants today are oxidants, acids and bases.
A normal metabolic waste product of muscle activity that a person excretes into their urine all the time. A person produces and excretes about the same amount of creatinine each day. A person that produces a lot of urine will spread that creatinine over a high volume of urine, and the creatinine concentration will be low. A person that does not produce much urine will have a more concentrated urine and the creatinine concentration will be high. Creatinine is measured in units of milligrams per deciliter or mg/dl. For drug testing purposes, the expected concentration of creatinine is equal to or greater than 20 mg/dl. It can be as high as 300 to 400 mg/dl in a very concentrated urine, which will be a deep yellow-brown color. If the creatinine is less than 20 mg/dl, we do a second test for dilution called specific gravity.
Performed by Gas Chromatography with Mass Spectrometry detection (GC/MS). This test is based on the physical and chemical properties of the specific drug or metabolite to be measured. Drug identification is achieved BOTH by chromatographic retention time and by Mass Spectrum, which is the "drug fingerprint." This test is very specific and robust with respect to interference. This confirmation test is legally defensible evidence of drug use. GC/MS Confirmation Reporting. Results are reported as POSITIVE according to SAMHSA cut-off levels. GC/MS results can be reported in as a qualitative result in ng/mL.
The multi-copy document that is completed by the certified collector at the time of the specimen collection. This document when correctly completed provides legal defensibility and ties the urine specimen to the document. Multiple copies are designed to: 1) accompany the specimen to the laboratory 2) sent to employer 3) sent to MRO 4) retained by collector 5) provided to donor as a receipt.
Classification: Stimulant Street Names: Blow, Coke, Crack, Flake, Snow Mode of Use: Snorting, intravenous injection, free-base (crack) smoking Physiological Effects: Desirable effects of cocaine include euphoria, anorexia, and sexual stimulation. Direct cardiotoxic effects may be the contributory factor in cocaine-induced deaths. Psychological Effects: Prolonged and intense use can lead to paranoia, hallucinations and violent behavior. The central nervous system stimulation (rush) is followed by depression (crash). This rush and crash cycle is the principle reaqson for the development of chronic cocaine abuse. Legally Obtained as: Cocaine is still used as a local anesthetic. Medicinal cocaine use is rarely found outside hospital settings because of the high potential for abuse, the difficulty maintaining the license to store cocaine and the availability of suitable substitutes. Cocaine is not contained in any prescription medications from a pharmacy or in any over-the-counter medications. As late as 1986 an herbal tea sold under the name of Health Inca Tea contained enough cocaine to cause positive urine test. The DEA continues to seize herbal teas containing cocaine. Metabolism: Cocaine is metabolized to benzoylecgonine. The presence of Benzoylecgonine is accepted evidence of cocaine use and can be detected in the urine for as long as 2-5 days. Summary: Commonly used local topical anesthetics such as lidocaine, novocaine and benzocaine are structurally unrelated to cocaine and its metabolites and do not result in a positive screen or confirmation. There are no known medications that cause a false positive screen or confirmation. Studies have shown that although cocaine can be absorbed through the skin, even intense exposure is insufficient to cause a positive urine test result.
Classification: Hallucinogen Street Names: Weed, Doobie, Grass Mode of Use: Smoking & ingestion Physiological Effects: Munchies after use. Psychological Effects: Euphoria Legally Obtained as: Dronabinol and Marinol. Metabolism: THC in marijuana is broken down into at least 5 different compounds (metabolites) that are excreted in the urine. The metabolite commonly in the greatest abundance (accounting for greater than 30% of all the metabolites) is carboxy-THC (THCC). The parent drug (THC) does not pass into the urine. The presence of marijuana metabolites in urine is accepted evidence of marijuana use. Summary: There are no known drugs that cause false positive results wither on the screen or confirmation test.
Medical Review Officer (MRO). A Physician (Medical Doctor or Osteopath) who has special training and expertise is drugs of abuse. All MRO's must have additional training and certification from a DHHS approved organization that provides training, written & oral testing, and continuing education. The most recognized certifying body is the American Association of Medical Review Officers (AAMRO).
These have been the most common oxidant used over the last five years. New oxidants are packaged and sold as adulterants each year. It is very difficult for laboratories to keep up with these new oxidant products. Acids and bases drastically change the pH of the urine. Acids cause a low pH and bases cause a high pH value. In both cases, the drug test may not work properly. Specimens are considered adulterated if the pH is too low (less than or equal to 3.0) or if the pH is too high (greater than or equal to 11.0).
Classification: Narcotics Street Names: Heroin: Horse, H, Smack, White Lady and Skag. Morphine: Junk, Morphai, Morphium and Morpho. Mode of Use: Heroin: Smoked, snorted, or injected. Morphine: Oral ingestion, injected, suppositories, liquid Codeine: Oral ingestion, elixirs. Hydrocodone: Oral ingestion. Hydromorphone: Oral ingestion, elixirs, injection and uppositories. Oxycodone: Oral ingestion and elixirs. Physiological Effects: Analgesia (pain relief), respiratory slowing and constipation are common effects for most users. Respiratory slowing, or even complete cessation, presents the greatest immediate risk associated with opiate abuse. Death due to complete respiratory arrest is common with overdoses. There is also the long-term risk of AIDS and other infectious diseases associated with illicit intravenous drug use. Tolerance is the property by which a dramatic increase in the dose is necessary to achieve the same effect. Tolerance begins to build after the initial dose, but is usually significant only after the second week of chronic use. Up to a 35 fold increase in dose may be necessary. Withdrawal symptoms begin 6-8 hours after the last dose and reach a peak at 36-72 hours. Psychological Effects: Mental alterations are primarily sedation and euphoria, the heightened feeling of well being. Long-term use leads to dependence (addiction) and tolerance. Legally Obtained as: The following table contains commonly used opiates and opiate-like drugs. Metabolism: In the body, heroin is converted to 6-Acetylmorphine (6-AM) within a few minutes. 6-AM is further metabolized to morphine within a few hours. Heroin usually contains 5-10% codeine because it is manufactured from opium, which contains morphine and codeine. Heroin itself is so rrely detected in the urine following use that laboratories do not normally test for it. 6-AM is a unique metabolite of heroin and is usually only detected during the first 12 hours after use. When present it is evidence of heroin use. Summary: The terms narcotics and opiates are often used interchangeably but are not exactly the same. Narcotics are drugs that numb the senses and induce sleepiness. Some non-opiate drugs also have narcotic properties. Opiates are compounds derived from opium, the milky residue of the opium poppy plant. Opium contains morphine and codeine. The naturally occurring morphine and codeine can be altered in the laboratory to produce semi-synthetic opiates, of which there are many. The most notable semi-synthetics are heroin, hydrocodone, hydromorphone and oxycodone. Poppy seeds contain enough codeine and morphine so that their consumption can cause both morphine and codeine to be detected in the urine. Poppy seed consumption rarely results in a morphine levelgreater than 2000 ng/mL, whereas use of heroin or morphine usually leaqds to much higher levels.
Classification: Hallucinogen Background: Phencyclidine was fist synthesized in 1926 and was used as an anesthetic for humans and animals. A number of toxic central nervous system effects were discovered over time and production was completely discontinued in 1978 due to the high rate of toxicity. It is currently only produced for research purposes and as a laboratory drug standard. Legally Prescribed forms: There are currently no legal forms of the drug which are accepted for medical or veterinary use. Illicit Use: PCP is usually snorted as a white powder or injected. It may also be smoked, often as a mixture with marijuana. Intravenous use and oral consumption are also possible. Street names: are "angel dust", "hog" and "loveboat". It may be misrepresented by drug dealers as another hallucinogen, i.e. mescaline or THC. Effects on the User: PCP is a strong hallucinogen. Auditory or visual illusions may develop. The drug may induce altered perception of time and distance. Desired effects may be exciting and dreamy. Toxic Side Effects: Like dreams, there may also be terrifying nightmares of unpredictable duration. Flashbacks have been reported. The hallucinations may lead to irrational acts, which place the user in grave danger. Episodes of uncontrollable violence may develop. Long-lasting mental alterations may persist after the drug has been completely metabolized. Most commonly these take the form of depression, suicidal ideation, speech impairment and social withdrawal. Actual physical addiction has not been proven with certainty. Drug Testing Results: PCP is readily absorbed into the body's fat stores and may be detected for prolonged periods. Detection interval may be as long as two weeks following brief use and as long as 30 days for chronic abuse. High doses of the cough suppressant, dextromethorphan, may produce false positive screen results. However, confirmation by GC/MS will rule out this compound.
Are performed by Immunoassay. This test is based on the biological interaction of an antibody with a drug and/or its metabolite. This test is sensitive to drug groups as opposed to a specific drug or its metabolite. Immunoassay can provide qualitative results only and is only relied upon to give NEGATIVE results.
Specimen validity testing is checking a urine specimen to make sure it is not too dilute or that it has been adulterated by the addition of a chemical substance that can interfere with the testing. Testing for dilution and adulteration of the urine specimens is known as specimen validity testing, i.e. making sure the specimen is valid for testing.