Urine testing has been increasingly used as a screening tool for drug use in the workplace. According to Mary Jo Wakeman, M.D., medical director of OccNet, "As the number of these tests has increased, so have the attempts of individuals to beat the test." OccNet is the occupational health service of the Health Alliance. Easy access to the Internet has provided a means of spreading information, and the production of products which change the urine sample, called "adulterants," has become a big business.

Urine samples are adulterated in order to attempt to produce a negative result from a sample that contains drugs or drug metabolites (chemical products that are the result of the drug being broken down). Adulteration may also produce an invalid test result so that a follow-up test is required, "buying time" for the drugs to clear the donor's system naturally. 

The three primary means of adulteration are dilution, substitution and in-vitro adulteration.

Dilution is the process of reducing the concentration of drug or drug metabolites in the sample. This is accomplished by adding fluid to the sample or by drinking large amounts of fluid to dilute the specimen, called "internal dilution." If the amount of the natural substance creatinine in the urine is abnormally low, internal dilution may be the cause. Drug testing laboratories all routinely test samples to detect dilution.

Substitution occurs when the donor switches his or her own urine sample for a drug-free specimen at some time during the collection process. Sometimes the donor may submit something other than urine. All samples are screened for parameters that indicate samples that are not human urine. Other tests are done at the time of collection to catch substitution with someone else’s urine.

In-vitro adulteration is the addition of a foreign substance to a urine sample that either disrupts the testing process or destroys the actual drug present. Some products on the market "guarantee" a negative test result.

Such products pose a threat to the integrity of urine drug testing programs, but sophisticated detection technology is keeping pace with this market. "Testing methods are continually being updated to keep one step ahead of those who are trying to alter the tests," says Dr. Wakeman.

For information about how your company can be assured of high quality drug testing results, call OccNet at 1-513-585-9400.

The occupational health specialists of Alliance Health for Business, working with other Health Alliance network providers, place a strong emphasis on prompt and appropriate return-to-work. To find out more about Alliance Health for Business services, call 513-585-9400.