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Drugs Testing Book
- Table of Contents
- Introduction
- Immunoassays and Their Screening
- An Overview Regarding the History of Immunoassays
- Basic Immunoassay Principles and Guidelines
- Variety of Immunoassays Used for Illicit Drug Testing Programs for workplaces
- Characteristics of an Immunoassay’s Performance
- Methodology Limitations
- Types and Mechanisms of Interference of Assays
- Sources of Interference
- Immunoassays and Their Application Regarding Workplace Drug Testing Programs
- Cutoff Ranges and Result Interpretation
- Selection and Troubleshooting of Immunoassays
- Summary
- Confirmation via Contemporary and Latest Techniques
- Conventional Confirmatory methods
- Gas Chromatography
- Liquid Chromatography (High Performance)
- Mass Spectrometry
- Basic Theory
- Ionization Of Electrons
- Chemical Ionization
- Full Scan Analysis
- Selected Ion Monitoring
- Quadruple Mass Spectrometer
- Quadruple ion Trap MS
- Modern Method Of Drug Confirmation
- Additional Mass Analyzers
- Time Of Flight – Mass Spectrometers
- Fticr-MS – Fourier Transform Ion Cyclotron Resonance – Mass Spectrometry
- Capillary Electrophoresis
- Summary
- Quality Assurance
- Organization Employee Assistance Programs
- Chain of Custody
- Specimen Collection
- Standard Operation Procedures
- Personnel
- Accessioning/Specimen Processing
- Security
- Internal Proficiency Testing
- External Proficiency Testing
- Inspection
- Initial and Confirmation Testing
- Equipment and Maintenance
- Laboratory Information Management System
- Records
- Specimen Validity Testing
- Quality Assurance Oversight
- Lean Six Sigma
- Summary
- Supervision of Regulated Workplace
- Historical Overview
- The Responses Of Laboratory and Regulatory Agency to the Problem
- US Federal Regulations/Criteria
- Scope of Adulterant/Substitution Products
- The HHS-Certified Laboratories Experience
- Effects of Adulterants on Analytical Tests
- Governmental Responses to the Problem
- Alternate Specimen Matrices
- Summary
- Drugs of Abuse in Hair
- Drug of Abuse in Oral Fluid
- Sweat Testing
- Amphetamines
- Opoids
- Phencyclidine
- Cocaine
- Cannabinoids
- Stability of Drugs of Abuse in Biological Fluids
- Interpretation of Workplace Drug Test Results by Medical Review Officer
- Federal Drug-Testing Programs
- Amphetamines
- Cocaine
- Marijuana
- Opiates
- Phencyclidine
- Other Drugs Tested For in Workplace Programs
- Benzodiazepines
- Barbiturates
- Methadone, Methaqualone, and Propoxyphene
- Ethyl Alcohol
- Dot-Mandated Alcohol Testing
- Specimen Validity Testing
- Additional MRO Functions Under the Federal Drug-Testing Programs
- Summary
- Laboratory Accreditation & Regulation
Scope of Adulterant/Substitution Products
Since the late 1980s, coincident with the advent of federally regulated workplace testing, several product types have evolved and have been developed specificity to “beat urine drug testing”. These subversion products can be classified as products/adulterants used to destroy the drug in the urine specimen or interfere with the initial (immunoassay) and/or confirmatory (GC-MS) drug tests, liquids added to a urine specimen to dilute (i.e., in vitro dilution) the drug concentration below its administrative cutoff, diuretic or cleansing products that are ingested to flush drugs from the body or to dilute the urine (ie., in vivo dilution), and products that can substitute for a donor’s urine, some being supplied with reservoirs, catheters, and life like prosthetic delivery devices.
Chemical Adulterants
Some products have been developed and openly offered for sale containing highly caustic and corrosive chemicals, such as acids, aldehydes, and chemical oxidants. These products include nitrite, chromium VI (a carcinogen), and bleach. These products are routinely packaged in small, easily concealable vials and tubes, allowing them to be readily added to a donor’s urine in the privacy of a restroom.
Dilution Products
Efforts to dilute urine include those that add water to a small volume of the donor’s urine and natural diuretics, such as caffeine, that expedite the elimination of urine from the body. Simply try to dilute the concentration of drug below the testing administrative cutoff can be done by drinking very large quantities of water, on the order of 96 to 120 ounces (3 quarts to 1 gallon) of fluid. Water-loading may be a very effective (but sometimes dangerous) method for beating a drug test, especially if the donor knows when the drug test is scheduled.
Cleansing Products
Cleansing kits, such as internal colonies, goldenseal, psyllium husks, and specially formulated cleansing drinks, are marketed to cleanse the body of toxins: more specifically, illicit drugs. These products are often marketed as dietary supplements, guaranteed to “work” in 60 min or less. These cleansing products work primarily along the same lines as products advertised to dilute in vivid the urine.
Synthetic or Drug-Free Human Urine With and Without Prosthetic Delivery Devices
The most cumbersome, yet highly effective, way to beat a urine drug test is to use a concealed physical device which contains a reservoir holding drug-free human urine. The drug-free urine is then either poured into or delivered into the collection container through a tube or prosthetic device. Synthetic urine can be used in the place of drug-free human urine. As with the adulterants, containers of clean urine specimens can sometimes be successfully carried into the collection area by donors.
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