Adulteration will be a continuing problem for the drug-testing industry and scientific community. Manufacturers of adulterants have successfully developed innovative means and chemical formulas to mask positive drug results. Although banning the sales of these adulterants may prevent their availability in some areas, the Internet would always ensure their availability. Both governmental agencies and adulteration test manufacturers should constantly update their test criteria to combat the continuous formulation change strategy of the adulterant companies. Laboratory reagents and on-site dipsticks have proven to be effective in detecting their presence in adulterated urine specimens. For convenience, manufacturers of drug screens have started to produce devices that test for drug and screen for adulteration simultaneously. In this way, the integrity of the specimen is assured while the drug screen is being performed. Examples include Monitect PC11A, ToxCup® PT15A, and QuickTox® 51A from Branan Medical Corporation. However, the self-destructive nature of the new generation of adulterants suggests that testing for them should be performed as soon after collection as possible and preferably on-site. Presently, owing to economic pressure, adulteration testing is not always performed on all specimens. In these cases, false negatives may result and the value of drug testing is compromised.
1. Winecker RE and Goldberger BA. Urine specimen suitability for drug testing, in Drug Abuse Handbook (Karch SB, ed), CRC, Boca Raton, FL: 1997; pp. 764-772.
2. Cody JT. Adulteration of urine specimens, in Handbook of Workplace Drug Testing (Liu RH and Goldberger BA, eds) AACC, Washington, D.C.: 1995; pp. 181-207.
3. Cody JT. Sample adulteration and on-site drug tests, in On-site Drug Testing (Jenkins AJ and Goldberger BA, eds), Humana, Totowa, NJ: 2002; pp. 253-264.
4. Mandatory Guidelines for Federal Workplace Drug Testing Programs, August 21, 2001 (66 FR 43876).
5. Quest Diagnostics, Inc. 2003 Drug Testing Index, July 22, 2004.
6. Warner A. Interference of common household chemicals in immunoassay methods for drugs of abuse. Clin Chem 1989;35:648-651.
7. Cone EJ, Lange R, and Darwin W. In vivo adulteration: excess fluid ingestion causes false-negative marijuana and cocaine urine test results. J Anal Toxicol 1998;22:460-473.
8. Paul BD, Martin KK, Maguilo J, and Smith ML. Effects of pyridinium chloro-chromate adulterant (Urine Luck) on testing drugs of abuse and a method for quantitative detection of chromium (VI) in urine. J Anal Toxicol 2000;24: 233-237.
9. Buddha DP and Aaron J. Effects of oxidizing adulterants on detection of 11-nor-A9-THC-9-carboxylic acid in urine. J Anal Toxicol 2002;26:460-463.
10. Cody J, Valtier S, and Kuhlman J. Analysis of morphine and codeine in samples adulterated with Stealth™. J Anal Toxicol 2001;25:572-575.
11. Tsai SC, ElSohly MA, Dubrovsky T, Twarowska B, Towt J, and Salamone SJ. Determination of five abused drugs in nitrite-adulterated urine by immuno-assays and gas chromatography-mass spectrometry. J Anal Toxicol 1998;22: 474-480.
12. Wu A, Bristol B, Sexton K, Cassella-McLane G, Holtman V, and Hill D. Adulteration of urine by "Urine Luck." Clin Chem 1999;45:1051-1057.
13. Procedures for Transportation Workplace Drug and Alcohol Testing Programs, Dec. 19, 2000 (65 FR 79526).
14. Mandatory Guidelines for Federal Workplace Drug Testing Programs, April 13, 2004 (69 FR 19644).
15. Edgell K, Caplan Y, Glass L, and Cook JD. The defined HHS/DOT substituted urine criteria validated through a controlled hydration study. J Anal Toxicol 2002; 26:419-423.
16. Chang SH, Guo H, Nguyen T, Tung KK, and Wei YF. Identification of human urine for drug testing. US patent number 6,368,873, April 9, 2002.
17. Peace M and Tarnai L. Performance evaluation of three on-site adulterant detection devices for urine specimens. J Anal Toxicol 2002;26:464-470.
18. Wong R. The effect of adulterants on urine screen for drugs of abuse: detection by an on-site dipstick device. American Clinical Laboratory 2002;21:37-39.
19. Wong RC, Chien BP, Her C, and Johnson CM. Effects of urine adulterants on Intect™ 7 adulterant test strip and Monitect™ abused Drug Screen. Clin Chem 2001;47:A75.
20. Tse HY and Bogema S. Kinetic studies on the detection of adulterants and on their effectiveness in urine screens for drugs of abuse. Clin Chem 2002;48:A58.
21. Wong RC, Chien BP, Nguyen PT, and Tse H. Adulterants: Its Detection and Effects on Urine Drug Screens. Presented at the Society of Forensic Toxicologists Meeting, Michigan, October, 2002.
Was this article helpful?