Summary

The National Survey on Drug Use and Health NSDUH, conducted by the Office of Applied Studies OAS in SAMHSA, provides evidence of the continuing problem of drug abuse in the workplace. This nationwide survey has shown that most illegal drug users are employed. Moreover, many ways of passing drug tests illegally have been counteracted by the Federal agencies. The 2004 NSDUH showed that, of the 16.4 million respondents aged 18 or older who reported current illegal drug use, 12.3 million (75.2%) were employed either full or part time. Similar numbers were identified in the 2005 NSDUH. In that survey, of the 17.2 million respondents aged 18 or older who reported current illegal drug use 12.8 million (74.8%) reported that they were employed either full or part time.

These statistics emphasize the importance of workplace drug testing as a means of identifying employees who are drug users. An effective, comprehensive drug-free workplace program that includes drug testing and employee assistance programs facilitating drug rehabilitation can benefit both the employer and employees. Throughout the history of workplace drug testing, employees using illegal drugs have attempted to mask their drug use by altering drug test results. The ready availability of commercial products for diluting, adulterating, or substituting urine drug test specimens continues to cause problems for the drug-testing industry and for those employers using drug testing, including federal agencies.

APPENDIX: HHS MANDATORY GUIDELINES’ REQUIREMENTS FOR SPECIMEN VALIDITY TESTING AND REPORTING (1, 687)

Dilute:

A laboratory will report a urine specimen as dilute in conjunction with a positive or negative drug test when on a single aliquot

· The creatinine concentration is greater than or equal to 2 mg/dL and less than 20 mg/dL, and

· The specific gravity is greater than 1.0010 but less than 1.0030.

Substituted

A laboratory will report a urine specimen as substituted when both the initial and confirmatory tests (i.e., tests on separate aliquots) document that:

· The creatinine concentration is less than 2 mg/dL, and

· The specific gravity is less than or equal to 1.0010 or greater than or equal to 1.0200.

Adulterated

A laboratory will report a urine specimen as adulterated when both the initial and confirmatory test results (i.e., tests on separate aliquots) meet one of the following criteria:

· The pH is less than 3,

· The pH is greater than or equal to 11,

· The nitrite concentration is greater than or equal to 500 mcg/mL,

. Chromium (V1) is present, verified by a specific confirmatory test,

· A halogen E.g., bleach, iodine, fluorides is present, verified by a specific confirmatory test

· Glutaraldehyde is present (verified by GC-MS confirmatory test),

· Pyridine (pyridinium chlorochromate} is present (verified by a GC-MS confirmatory test),

A surfactant is present (i.e., dodecylbenzene sulfonate-equivalent concentration is greater than or equal to 100 mcg/mL},

· The specimen contains a substance that is not a normal constituent of human urine (verified by a confirmatory test for the specific substance), or

· The specimen contains an endogenous substance at a concentration that is not a normal physiological concentration (verified by a confirmatory test for the specific substance).

Invalid Result

A laboratory will report an invalid result for a urine specimen when results for 2 separate aliquots meet one of the following criteria.

1. Creatinine concentration and specific gravity results are discrepant.

· The creatinine concentration is less than 2 mg/dL on both the initial and confirmatory creak ne tests and the specific gravity is greater than 1.0010 but less than 1.0200 on either or both the initial and confirmatory specific gravity tests, or

· The specific gravity is less than or equal to 1.0010 on both the initial and confirmatory specific gravity tests and the creatinine concentration is greater than or equal to 2 mg/dL on either or both the initial and confirmatory creatinine tests;

2. The pH is outside the acceptable range:

– The pH result is greater than or equal to 3 and less than 4.6 using either a colorimetric pH test or pH meter for the initial test and a pH meter for the confirmatory test or

– The pH result is greater than or equal to 9 and less than 11 using either a calorimetric pH test or pH meter for the initial test and a pH meter for the confirmatory test;

3. Nitrite is present, but below the program cutoff for adulteration:

· Nitrite is greater than or equal to 200 mcg/mL using a nitrite colorimetric test for both the initial and confirmatory tests,

· Nitrite is greater than or equal to the equivalent of 200 mcg/mL nitrite using a general oxidant calorimetric test for both the initial and confirmatory tests, or

· Nitrite is greater than or equal to 200 mcg/mL using a nitrite colorimetric test or a general oxidant calorimetric test and is greater than or equal to 200 mcg/mL but less than 500 mcg/mL for a confirmatory test using a different method;

4. The possible presence of chromium VI is determined using the same chromium VI calorimetric test with a cutoff greater than or equal to 50 mcg/mL chromium  for both the initial and confirmatory tests;

5. The possible presence of a halogen Berg., bleach, iodine, fluorides is determined using the same halogen calorimetric test with a cutoff greater than or equal to the LOD for both the initial and confirmatory tests, or relying on the odor of the specimen as the initial test;

6. The possible presence of glutaraldehyde is determined by using the same aldehyde test, aldehyde presents or characteristic immunoassay response on one or more drug immunoassay tests for both the initial and confirmatory tests;

7. The possible presence of an oxidizing adulterant is determined by using the same general oxidant calorimetric test (with a greater than or equal to 200 mcg/mL nitrite equivalent cutoff, a greater than or equal to 50 mcg/mL chromium (VI)-equivalent cutoff, or a halogen concentration greater than or equal to the LOD for both the initial and confirmatory tests;

8. The possible presence of a surfactant is determined by using the same surfactant calorimetric test with a greater than or equal to 100 mcg/mL dodecylhenzene sulfonate-equivalent cutoff for both the initial and confirmatory tests, or using a foam/shake test for the initial test;

9. Interference occurs on the immunoassay drug tests on two separate aliquots (i.e., valid immunoassay drug test results cannot be obtained);

10. Interference with the MOMS drug confirmation assay occurs on 2 separate aliquots of the specimen and the laboratory is unable to identify the interfering substance;

11. The physical appearance of the specimen is such that testing the system may damage the laboratory’s instruments; or

12. If the physical appearances of Bottles A and B are clearly different, the test result for Bottle A is one of the reasons stated in 1 through 10 above anchor the specimen was negative for drugs upon initial testing.

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