Need and utility of a polyethylene glycol marker to ensure against urine falsification among heroin users

Abstract

Background Deceptive methods of falsifying urine samples are of concern for anyone who relies on accurate urine toxicology results. A novel method to combat these efforts utilizes polyethylene glycol (PEG) markers administered orally prior to providing a urine sample. By using various PEG combinations to create a tracer capsule of unique composition, each urine sample can be matched to that individual. The goal of this study was to determine the effectiveness of using the PEG marker system among active heroin users screening for research studies. Methods Upon each screening visit, participants (N=55) were randomized to provide an unobserved urine sample, or the PEG tracer procedure was used. LCMS analysis was used to distinguish the PEG combinations, and allowed us to provide a unique qualitative analysis of patterns of drug use (N=168, total urine specimens). Results The unique composition of the tracer capsules was accurately detected in 83.5% of the urine specimens. Analyses of inconsistencies implicated a number of possible attempts at fraudulence (11.4%) and investigator/lab error (5.1%). Among this sample, the concurrent use of multiple classes of psychoactive drugs was more common than not, though concomitant drug use was often underreported. Conclusion Urine drug testing should be the minimum standard for obtaining information about drug use as self-report was unreliable even in a situation where there were no perceived adverse consequences for full disclosure. In cases where there are significant pressures for individuals to falsify these data, more protective collection methods such as the PEG marker system should be considered.

No evidence of compensatory drug use risk behavior among heroin users after receiving take-home naloxone

“…Though it is made clear to participants that information concerning their drug use will not affect their participation in the study nor be shared with anyone outside of research staff, it has been shown that users may misrepresent drug use, even when there are no perceived adverse consequences (Jones et al, 2015). Despite these limitations, the data are encouraging given the staggering increases in opioid overdoses across the county.…”

Hair analysis for the detection of drug use—is there potential for evasion?

“…Other studies have addressed how bleaching and other cosmetic treatments can affect the quality of hair samples, and the degree to which analytes can be detected, although this might not be done deliberately (American Society of Addiction Medicine (ASAM), ; Martins, Yegles, Thieme, & Wennig, ; Yegles, ). Most of the emerging evidence on circumvention focused on other specimen types, such as urine and blood (Cody & Valtier, ; Dasgupta ; Jaffee et al, ; Jones et al, ). The range and sophistication of some of those evasion methods (including even the use of a fake penis which delivers warm artificial urine) lends support to the assumption that substance users will seek to evade detection on the hair analysis also.…”

“…Other studies have addressed how bleaching and other cosmetic treatments can affect the quality of hair samples, and the degree to which analytes can be detected, although this might not be done deliberately (American Society of Addiction Medicine (ASAM), 2013; Martins, Yegles, Thieme, & Wennig, 2008;Yegles, 2005). Most of the emerging evidence on circumvention focused on other specimen types, such as urine and blood (Cody & Valtier, 2001;Dasgupta 2007;Jaffee et al, 2007;Jones et al, 2015).…”

“…Evasion is a common issue on other types of drug test. Urine samples, which are often provided in private by the testee, can be easily adulterated, substituted, or diluted (Beard, 2016;Cody & Valtier, 2001;Dasgupta, 2007;Jaffee, Trucco, Levy, & Weiss, 2007;Jones, Atchinson, Madera, Metz, & Comer, 2015). Blood tests are generally considered tamper-proof (due to the sample being obtained by a professional), but samples must be acquired within much shorter timeframes than urine or hair, especially for drugs which exhibit a short plasma half-life.…”

Urine Samples Tampering Pattern for Drugs of Abuse Testing: Experience of the Saudi Arabia Poison Control Centers

“…To the best of our knowledge, there were a few researches concerning further urine sample validity tests for urine sample of suspected substance of abuse criminal cases, including substituted, invalid, or adulterated procedures. For pre-employment/workplace drug testing of urine samples, there have been several reports concerning urine specimen validity tests for substances abuse tests [10][11][12]. The aim of this article was to clarify our findings from urine samples adulteration attempts detected from specimen validity tests results, involving the pattern adulteration; the rates of dilution, substitution, adulteration, and finally invalid samples prevalence, in cases of pre-employment/workplace and suspected drug of abuse testing for urine samples in Saudi Arabia over one years.…”