Adulterant Testing

ADULTERANT / SPECIMEN VALIDITY TESTING (SVT)

WHAT IS ADULTERATION?
Adulteration also referred to as Specimen Validity Testing (SVT) is the tampering of a urine specimen with the intention of altering the test results. The use of adulterants can cause false negative results in Drug Tests (Strip/Card/Device/Cup) by either interfering with the screening test and/or destroying the drugs present in the urine. Dilution may also be employed in an attempt to produce false negative drug test results. One of the best ways to test for adulteration or dilution is to determine certain urinary characteristics such as pH, specific gravity and creatinine and to detect the presence of oxidants/PCC, nitrites or glutaraldehyde in urine.

There are key factors that can be used to make this screening determination*:

pH Level

The pH level refers to the acidity or alkalinity of a urine sample. Monitoring the pH level is an essential aspect of drug testing procedures, as deviations from the expected pH range may indicate sample adulteration or manipulation. Here are key points regarding pH levels in drug testing:

  1. Normal Urine pH:
    • The normal pH range for urine is generally between 4.5 and 8.0. This range is influenced by various factors, including diet, hydration, and individual physiology.
  2. Adulteration Detection:
    • Monitoring pH is part of the adulteration testing process in drug screening. Adulteration involves the intentional manipulation of a urine sample to alter or mask the presence of drugs. Deviations from the normal pH range may be an indicator of adulteration.
  3. Impact on Drug Stability:
    • pH levels can affect the stability of drug compounds and their metabolites in urine. Extreme pH values can lead to degradation of certain substances, potentially resulting in false-negative or false-positive test results.
  4. Common Adulterants Affecting pH:
    • Substances added to urine samples as adulterants, such as acidic or alkaline agents, can influence the pH. For example, adding acidic substances like vinegar or alkaline substances like baking soda can alter the pH.
  5. Laboratory Procedures:
    • Laboratories routinely measure the pH of urine samples as part of the initial testing process. Any unusual pH values may prompt further investigation or additional testing to ensure result accuracy.
  6. Validity Testing:
    • Drug testing kits often include validity parameters, including pH measurement, to identify potential sample tampering. Abnormal pH levels may lead to the rejection of the sample or the need for additional testing.
  7. Quality Control:
    • Maintaining quality control measures is crucial in drug testing laboratories. Calibration of equipment and regular monitoring of testing conditions help ensure accurate pH measurements.
  8. Regulatory Guidelines:
    • Regulatory bodies, such as the Substance Abuse and Mental Health Services Administration (SAMHSA) in the United States, provide guidelines and standards for drug testing procedures, including considerations for pH monitoring.

In summary, monitoring the pH level in drug testing is a critical aspect of ensuring the integrity and reliability of test results. Deviations from the expected pH range can signal potential issues with the sample and may prompt additional measures to maintain the accuracy of drug testing outcomes.

Normal urine range from 6.0 to 7.0, but can vary from 4.5 to 8.0. High pH urines can be seen in UTIs or from diets high in vegetables and diary products. Low pH urines result from uremia, severe diarrhea, starvation and diets high in ascorbic acid or citric fruits.

Specific Gravity (SG)

Measures urine concentration, or the amount of dissolved substances present in urine compared to distilled water. Normal range is from 1.002 to 1.030. High values are caused by dehydration, glycosuria, and radio-opaque dyes. Low values occur in diabetes insipidus, renal disease and diuretic use.

Specific gravity is a measurement used in drug testing to assess the concentration of solutes (substances dissolved in a solution) in a urine sample. It is an important parameter in the evaluation of urine specimen validity during drug testing procedures. Here are key points related to specific gravity in the drug testing realm:

  1. Definition:
    • Specific gravity is a measure of the density of a liquid compared to the density of water. In the context of drug testing, it indicates the concentration of dissolved substances in urine.
  2. Normal Urine Specific Gravity:
    • The normal range for specific gravity in urine is typically between 1.005 and 1.030. This range accounts for variations in individual hydration levels.
  3. Adulteration Detection:
    • Monitoring specific gravity is part of the adulteration testing process in drug screening. Abnormal specific gravity values may suggest sample dilution or manipulation.
  4. Impact on Drug Metabolites:
    • Specific gravity can affect the stability of drug metabolites in urine. Extremely high or low specific gravity values may lead to inaccurate drug test results.
  5. Dilution and Adulteration:
    • Low specific gravity values may indicate sample dilution, which can be an attempt to mask the presence of drugs. High values may suggest the addition of substances to the urine to manipulate test results.
  6. Laboratory Procedures:
    • Laboratories routinely measure the specific gravity of urine samples during the initial drug testing process. Deviations from the expected range may trigger further investigation or additional testing.
  7. Validity Testing:
    • Drug testing kits often include specific gravity measurements as a parameter for sample validity. Values outside the normal range may lead to the rejection of the sample or the need for additional testing.
  8. Quality Control:
    • Maintaining quality control measures is crucial in drug testing laboratories. Calibration of equipment and regular monitoring of testing conditions help ensure accurate specific gravity measurements.
  9. Regulatory Guidelines:
    • Regulatory bodies, such as the Substance Abuse and Mental Health Services Administration (SAMHSA) in the United States, provide guidelines and standards for drug testing procedures, including considerations for specific gravity monitoring.

In summary, specific gravity is a vital parameter in drug testing, helping to assess the concentration of solutes in urine and identify potential sample dilution or adulteration. Monitoring specific gravity is an integral part of the overall efforts to maintain the accuracy and reliability of drug testing results.

Creatinine (CR)

Creatinine is a waste product of creatine; an amino-acid contained in muscle tissue and found in urine. A person may attempt to foil a test by drinking excessive amounts of water or diuretics such as herbal teas to “flush” the system. Creatinine and specific gravity are two ways to check for dilution and flushing, which are the most common mechanisms used in an attempt to circumvent drug testing. Low Creatinine and specific gravity levels may indicate dilute urine.

Creatinine is excreted in the urine at a constant rate. Normal range: 20 mg/dl to 200 mg/dl. pH Normal urine range from 6.0 to 7.0, but can vary from 4.5 to 8.0. High pH urines can be seen in UTIs or from diets high in vegetables and diary products. Low pH urines result from uremia, severe diarrhea, starvation and diets high in ascorbic acid or citric fruits.

Creatinine is a key component used to assess the integrity and validity of urine samples. Creatinine is a waste product produced by the muscles during the breakdown of creatine phosphate, which is an energy source for muscles. Monitoring creatinine levels in urine is an essential part of specimen validity testing during drug testing procedures. Here are key points related to creatinine in the drug testing context:

  1. Normal Creatinine Levels:
    • Creatinine levels in urine can vary based on factors such as age, sex, muscle mass, and hydration status. Typically, normal levels fall within a certain range, and significant deviations may indicate potential issues with the sample.
  2. Adulteration Detection:
    • Creatinine is often measured as part of specimen validity testing to detect sample adulteration or dilution. Low creatinine levels may suggest intentional dilution of the urine sample, which can be an attempt to mask the presence of drugs.
  3. Impact on Drug Test Results:
    • Creatinine levels are used to assess the concentration of urine and ensure that the sample is not excessively diluted. Excessive dilution may lead to inaccurate drug test results, including false negatives.
  4. Creatinine Normalization:
    • In drug testing, creatinine levels are often used to normalize the concentration of drugs or their metabolites in urine. This helps account for variations in urine dilution and provides a more accurate representation of drug concentrations.
  5. Validity Testing:
    • Drug testing kits typically include creatinine measurement as one of the parameters for sample validity. Laboratories may reject samples with extremely low creatinine levels due to concerns about intentional dilution or adulteration.
  6. Regulatory Guidelines:
    • Regulatory bodies, such as the Substance Abuse and Mental Health Services Administration (SAMHSA) in the United States, provide guidelines and standards for drug testing procedures, including considerations for specimen validity testing and creatinine levels.
  7. Creatinine Cutoffs:
    • Specific cutoff levels for creatinine may be established, and samples falling below these levels may be flagged for further investigation.
  8. Quality Control:
    • Maintaining quality control measures is crucial in drug testing laboratories. Regular calibration of equipment and monitoring of testing conditions help ensure accurate creatinine measurements.

In summary, creatinine is a vital component in drug testing procedures, used to assess the concentration of urine and detect potential sample adulteration or dilution. Monitoring creatinine levels contributes to the overall efforts to maintain the accuracy and reliability of drug testing results.

Nitrite (NI)

Present in the urine from urinary bacterial infections with levels at 0.1 mg/dL to 5 mg/dL. The cutoff for adulterated samples is >15 mg/dL. The presence of bleach will give an abnormal result.

Nitrates generally refer to chemical compounds containing the nitrate ion (NO₃⁻). Nitrates are not typically substances of interest in drug testing for the detection of illicit drugs. However, nitrates can be relevant in the context of urine sample validity testing, particularly when assessing for specimen adulteration or manipulation.

Here are key points related to nitrates in the drug testing realm:

  1. Adulteration Testing:
    • Nitrates are sometimes used as an adulterant in attempts to manipulate urine drug test results. Adulteration involves adding substances to a urine sample with the goal of interfering with or masking the detection of drugs.
  2. Common Source of Nitrates:
    • Commercially available products, such as certain medications or dietary supplements, may contain nitrates. Individuals may use these products with the intention of affecting the validity of a urine sample.
  3. Impact on Drug Test Results:
    • Nitrates, when added to a urine sample, can potentially interfere with the detection of specific drugs or their metabolites. Laboratories and drug testing protocols include measures to identify and mitigate the impact of adulterants.
  4. Testing for Adulteration:
    • Drug testing kits often include parameters for detecting common adulterants, including nitrates. If nitrates are detected in a urine sample, it may raise suspicions of sample tampering, and further testing or scrutiny may be warranted.
  5. Validity Testing:
    • Validity testing in drug screening involves assessing various parameters, including pH, specific gravity, and the presence of common adulterants like nitrates. Abnormal results in these tests may lead to the rejection of the sample or the need for additional testing.
  6. Regulatory Guidelines:
    • Regulatory bodies, such as the Substance Abuse and Mental Health Services Administration (SAMHSA) in the United States, provide guidelines and standards for drug testing procedures, including considerations for specimen validity testing.

It's important to note that the detection of nitrates in a urine sample does not directly indicate the presence of drugs of abuse. Instead, the presence of nitrates may suggest potential sample adulteration, and further investigation is necessary to maintain the accuracy and reliability of drug testing results. Regular updates to testing methodologies and the use of advanced technologies contribute to improving the robustness of drug testing procedures.

Oxidants (OX)

Oxidants/PCC (Pyridinium Chlorochromate) tests for the presence of oxidizing agents such as bleach and hydrogen peroxide. Pyridinium Chlorochromate (sold under the brand name UrineLuck) is a commonly used adulterant. Normal human urine should not contain oxidants or PCC. Oxidants, when present in urine, will produce a blue or green color.

Oxidants often refer to substances or conditions that have the potential to interfere with the accuracy of drug test results. Drug testing typically involves detecting the presence of specific drug metabolites or substances in biological samples such as urine. Oxidants can affect the stability and reliability of these samples, leading to potential false-positive or false-negative results.

Here are some key points regarding oxidants in relation to drug testing:

  1. Adulteration Testing:
    • Oxidants may be used as adulterants by individuals attempting to manipulate drug test results. They might add substances with oxidizing properties to the urine sample to break down or mask the presence of drugs.
  2. Common Oxidants Used for Adulteration:
    • Bleach: Sodium hypochlorite, found in household bleach, is a common oxidizing agent used to adulterate urine samples.
    • Nitrites: Compounds containing nitrites, such as those found in certain commercial products, can also act as oxidants.
  3. Impact on Drug Test Results:
    • Oxidants can potentially cause the breakdown of drug metabolites in the urine, leading to false-negative results where the drugs may not be detected even if they were initially present.
  4. Adulteration Detection in Drug Tests:
    • Many drug testing kits include parameters to detect common oxidants and other adulterants. These tests help ensure the integrity of the urine sample and the accuracy of the drug test.
  5. Laboratory Procedures:
    • In a laboratory setting, rigorous procedures are in place to detect and control for potential adulteration. This includes assessing the pH and other chemical properties of the urine sample to identify signs of interference.
  6. Validity Testing:
    • Drug testing protocols often include validity testing to check for signs of sample tampering or adulteration. Any indication of adulteration may lead to further investigation or retesting.

It's crucial for drug testing protocols to consider the potential impact of oxidants and other adulterants to maintain the accuracy and reliability of results. Laboratories and testing kits employ various measures to detect and mitigate the influence of substances that could compromise the validity of drug test outcomes. Regular updates to testing methodologies and the use of advanced technologies contribute to improving the robustness of drug testing procedures.

GLUTARALDEHYDE (GL)

Glutaraldehyde tests for the presence of an aldehyde. Adulterants such as UrinAid and Clear Choice contain glutaraldehyde which may cause false negative results by disrupting the enzyme used in some immunoassay tests. Glutaraldehyde is not normally found in urine; therefore, detection of glutaraldehyde in a urine specimen is generally an indicator of adulteration.

Glutaraldehyde is not typically a substance directly associated with drug testing. Instead, it is commonly used as a fixative or preservative in laboratory settings, including those related to pathology, histology, and microbiology. In the context of drug testing, the focus is more on the detection of drugs or drug metabolites in biological samples rather than the use of specific fixatives or preservatives.

Here are some general points about glutaraldehyde:

  1. Preservative and Fixative:
    • Glutaraldehyde is known for its antimicrobial properties, making it effective as a fixative for preserving tissues and biological specimens. It helps prevent decomposition and maintains the structural integrity of samples.
  2. Use in Laboratory Settings:
    • Laboratories may use glutaraldehyde to fix and preserve tissues for later examination under a microscope. It is also employed in the preparation of samples for electron microscopy.
  3. Disinfectant Properties:
    • Glutaraldehyde has disinfectant properties and is sometimes used for sterilization purposes in medical equipment and laboratory instruments.
  4. Not a Substance of Interest in Drug Testing:
    • Glutaraldehyde is not typically a substance of interest in drug testing for the detection of illicit drugs or substances of abuse. The focus in drug testing is more on detecting specific drugs, their metabolites, or indicators of sample integrity.

It's important to note that drug testing involves the identification and quantification of drugs or their metabolites in biological samples such as urine, blood, or saliva. Common methods include immunoassays and chromatography techniques, depending on the specific requirements of the testing protocol.

*If you have concerns or questions about the specific chemicals or substances used in a drug testing process, it's recommended to refer to the guidelines and protocols established by the relevant regulatory authorities or testing facilities. These guidelines provide information on the methods, substances, and procedures used to ensure the accuracy and reliability of drug test results.

Some common substances used by donors to adulterate a urine specimen
SUBSTANCE DRUG TEST AFFECTED ADULTERATION STRIP AFFECTED
Chlorine Bleach THC, OPI, AMP PH, SG, OX
Liquid Drain Cleaner OPI, AMP PH, SG
Vinegar AMP SG
Pyridinium CI Cr (PCC) THC, COC, OPI, PCP, AMP SG, OX
Stealth THC, COC, PCP OX
Instant Clean THC, COC, PCP OX
UR’n Kleen THC, COC, OPI, PCP SG