Alternate Specimen Matrices

As noted previously, urine is currently the only specimen allowed for US federal workplace drug-testing programs. There are laboratories routinely testing for drugs of abuse in other biological specimen matrices e.g., hair oral fluid, sweaty and employers in the private sector may choose to use these alternate specimen matrices in their workplace programs.

Compared to urine, these alternate specimen matrices are less susceptible to donor attempts at specimen tampering. In contrast to unobserved urine collections, hair and oral fluid specimen collections are observed in that the specimens are obtained by the collector. Sweat specimens are collected using a patch worn by the donor for a period of time. The patch is tamper-evident, so attempts by the donor to alter the drug test results should be discernible by the collector when the patch is removed for testing.

As noted above, in 2004, HHS published proposed revisions to the Mandatory Guidelines and requested public comments concerning the proposed revisions. The process is continuing at this time. These proposed Guidelines allow for the use of alternate specimen matrices i.e., hair, oral fluid, and sweaty for federal employee testing. The Preamble for the proposed revisions to the Mandatory Guidelines states that Addition of these specimens to the federal Workplace Drug Testing Program would complement urine drug testing and aid in combating the threat from industries devoted to suborning drug testing through adulteration substitution, and dilutions

There are commercial products advertised to remove drugs from hair. Many of the companies selling urine adulterant products also offer shampoos claiming to detoxify the hair. Although some cosmetic treatments E.g. bleaching, permanent waves have been shown to decrease the concentration of drugs in hair, it is extremely unlikely that any shampoos would be effective in removing drug analytes from hair. A 2005 study evaluated 8 commercial products purporting to remove drugs from hair. The authors concluded that the products were ineffective using the testing procedures in effect at their laboratory. At least 1 study has shown that even vigorous washing techniques used by hair-testing laboratories do not remove all drug analyte from hair.

There are also commercial adulterant products advertised to defeat oral fluid drug tests. A 2005 study evaluated 2 such products, along with a mouthwash. The study showed that the oral fluid adulterants could be used to clear residual drug compounds from the mouth, but did not destroy the drug compounds. The authors concluded that these products were no more effective than mouthwash in cleansing the mouth. It appears that observation of the donor for a period of time before oral fluid specimen collection would counter any cleansing effects of these products. The proposed HHS Guidelines outline procedures for collecting each specimen types including an observation period before collection of oral fluid specimens.

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