Urine specimen validity test for drug abuse testing in workplace and court settings

Abstract

In recent decades, urine drug testing in the workplace has become common in many countries in the world. There have been several studies concerning the use of the urine specimen validity test (SVT) for drug abuse testing administered in the workplace. However, very little data exists concerning the urine SVT on drug abuse tests from court specimens, including dilute, substituted, adulterated, and invalid tests. We investigated 21,696 submitted urine drug test samples for SVT from workplace and court settings in southern Taiwan over 5 years. All immunoassay screen-positive urine specimen drug tests were confirmed by gas chromatography/mass spectrometry. We found that the mean 5-year prevalence of tampering (dilute, substituted, or invalid tests) in urine specimens from the workplace and court settings were 1.09% and 3.81%, respectively. The mean 5-year percentage of dilute, substituted, and invalid urine specimens from the workplace were 89.2%, 6.8%, and 4.1%, respectively. The mean 5-year percentage of dilute, substituted, and invalid urine specimens from the court were 94.8%, 1.4%, and 3.8%, respectively. No adulterated cases were found among the workplace or court samples. The most common drug identified from the workplace specimens was amphetamine, followed by opiates. The most common drug identified from the court specimens was ketamine, followed by amphetamine. We suggest that all urine specimens taken for drug testing from both the workplace and court settings need to be tested for validity.

Determining the effects of adulterants on drug detection via enzyme‐linked immunosorbent assay and adulterant tests strips

“…35 The addition of liquids to a urine sample can possibly decrease the amount of sample antigens that are available for competitive binding, therefore leading to a decrease of metabolite concentration to below cut-off threshold levels. 35 The addition of liquids to a urine sample can possibly decrease the amount of sample antigens that are available for competitive binding, therefore leading to a decrease of metabolite concentration to below cut-off threshold levels.…”

Suitability evaluation of new endogenous biomarkers for the identification of nitrite‐based urine adulteration in mass spectrometry methods

“…Abstinence control of ethanol, drugs of abuse (DOA), or highly addictive prescription drugs in the context of regaining driver's license or workplace drug testing are of increasing interest. Due to the opioid crisis and the upcoming legalization of recreational marijuana in the United States and other countries, the concern about clean drug tests, too, has significantly increased …”

“…11 Systematic studies on the prevalence of adulteration attempts are scarce and it can be assumed that such attempts are detected only in rare cases. 1,12 With recent intentions in several US states to ban artificial urine products, chemical adulteration attempts might become of higher interest. 13 On a mechanistic basis, adulterants may interfere with components of the immunoassay principle or degrade drugs or their metabolites through oxidation unreliable for any analytical detection.…”

Evaluation of endogenous urinary biomarkers for indirect detection of urine adulteration attempts by five different chemical adulterants in mass spectrometry methods

“…6 Urine tampering methods range from urine substitution through artificial urine to dilution or chemical adulteration. 4,9,10 With recent intentions in several US states to ban artificial urine products, chemical adulteration attempts might become of higher interest. Integrity testing, spot and dipstick tests, or integrated sample checks to commercially available immunoassay systems are often performed as a time-and cost-effective alternative but are associated with high rates of false positives or false negatives 3,7,8 Today, the extent of urine tampering remains largely unknown.…”