Frequently Asked Questions: General
Specific gravity is a ratio of the density of the urine sample to the density of water.
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Adulterants are foreign substances either ingested or added directly to urine specimen to prevent the detection of drug in the sample. Commonly uses adulterants are promoted as “cleansing agents”, these substances can be found in house hold items or chemical additives obtained through the internet.
Examples of adulterants include:
- Baking soda
- Bleach
- Detergent
- Eye drops
- Liquid chlorine bleach
- Liquid drain cleaner
- Glutaraldehyde
- Iodine tincture
- Pyridinium chlorochromate
- Vinegar
- Water
Some commercially available products that are ingested prior to providing the urine specimen that include:
- Amber 13
- Clean-X
- Clear Choice
- Instant Clean ADD-It-ive
- Lucky Lab LL418
- Klear
- Krystal Kleen
- Mary Jane Superclean 13
- Purafyzit
- Stealth
- Test Clean
- THC-Free
- Urine Luck 6.3
- UR’n Kleen
- Whizzies
Drugs of abuse (DoA) are drugs that the user consumes in amounts or with methods which are harmful to themselves or others. It is a form of substance-related disorder.
Adulteration test is included in the multi-drug test cups or it can be performed separately. This test determines the authenticity of the sample by measuring sample specific gravity (1.003-1.025) and creatinine levels (20mg/dl).
- Nitrite tests for commonly used commercial adulterants such as Klear or Whizzies. They work by oxidizing the major cannabinoid metabolite THC-COOH. Normal urine should contain no trace of nitrite. Positive results generally indicate the presence of an adulterant
- Creatinine is a waste product of creatine (an amino-acid contained in muscle tissue), is a normal constituent of human urine. In specimen validity testing, creatinine is used as a marker for dilution. Specimen dilution can be either in vivo (the donor drank excessive volumes of liquids) or in vitro (liquid was added to the urine after collection) and represent the most common form of specimen tampering. In vivo dilution using diuretics is often referred to as “flushing.” Creatinine and specific gravity are often interpreted simultaneously as indicators for dilution. Low creatinine and low specific gravity levels indicate dilute urine.
- Glutaraldehyde is a chemical compound that, when used as an adulterant, is believed to inactivate the enzyme used in the EMIT automated drug screening reagent. Although it is not believed to produce false negative results on a lateral flow test, commercial adulteration agents UrinAid and Clear Choice still contain glutaraldehyde. Glutaraldehyde is not normally in urine so detection of the compound is generally an indication of adulteration.
- pH tests for the presence of acidic or alkaline adulterants in urine. Normal urine pH levels should be in the range of 4.0 to 9.0. Values outside of this range may indicate the sample has been adulterated.
- Specific Gravity tests for the “viscosity” of the urine sample. The SG range for normal human urine is from 1.003 to 1.030. Values outside this range should be considered abnormal and may indicate specimen tampering.
- Oxidant/PCC tests for the presence of oxidizing reagents such as bleach, hydrogen peroxide, and pyridinium chlorochromate (PCC). Like nitrites, oxidants work to modify the structure of the target drugs in urine (like THCCOOH). Many commercial adulterants contain oxidants or PCC. Examples include UrineLuck (PCC) and Stealth (peroxidase). Normal urine should contain no trace of oxidants/PCC. Nitrites are a class of chemicals not usually found in normal human urine. Commercial adulterants Klear and Whizzies use nitrites as their primary active ingredient. Nitrites work by oxidizing the major cannabinoid metabolite (THCCOOH). The intent of oxidizing THC-COOH is to render it undetectable by the immunoassay or confirmation methods. Recent research suggests that performing the immunoassay drug screen shortly after the urine collection limits the effectiveness of the nitrite since the chemical needs time to modify the THC-COOH compound. By the time a positive sample arrives to the lab for confirmation, however, the THC-COOH has often been destroyed. Normal human urine should contain no trace of nitrites and, as such, presence of nitrites in urine generally indicates the use of an adulterant.
| Name | Abbr. | Street Name |
|---|---|---|
| Barbiturates pentobarbital (Nembutal®), phenobarbital (Luminal®) | BAR | Barbs, Phennies, Red, Birds, Reds, Tooies, Yellow Jackets, Yellows |
| Benzodiazepines | ||
| alprazolam (Xanax®), chlorodiazepoxide (Limbitrol®), diazepam (Valium®), lorazepam (Ativan®), triazolam (Halicon®), | BZO | Candy, Downers, Sleeping Pills, Tranks |
| Flunitrazepam, Rohypnol® | Circles, Date Rape Drug, Forget Pill, Forget-Me Pill, La Rocha, Lunch Money, Mexican Valium, Mind Eraser, Pingus, R2, Reynolds, Rib, Roach, Roach 2, Roaches, Roachies, Roapies, Rochas Dos, Roofies, Rope, Rophies, Row-Shay, Ruffies, Trip-and-Fall, Wolfies | |
| Buprenorphine | BUP | |
| Sleep Medications: eszopiclone (Lunesta®), zaleplon (Sonata®), zolpidem (Ambien®) | Forget-me Pill, Mexican Valium, R2, Roche, Roofies, Roofinol, Rope, Rophies | |
| Cocaine | COC | Blow, Bump, C, Candy, Charlie, Coke, Crack, Rock, Flake, Rock, Snow, Toot |
| Marijuana | THC | Blunt, Bud, Dopa, Ganja, Grass, Green, Herb, Joint, Mary Jane, Pot, Reefer, Sinsemilla, Skunk, smoke, Trees, Weed, Hashish, Boom, Gangster, Hash, Hemp |
| Synthetic Cannabinoids | K2 | K2, Spice, Black Mamba, Bliss, Bombay Blue, Fake Weed, Fire, Genie, Moon Rocks, Skunk, Smacked, Yucatan, Zohai |
| Methadone (Dolophine®, Methadose®) | MTD | Amidone, Fizzies |
| Methamphetamine (Desoxyn®) | mAMP | Crank, Chalk, Crystal, Fire, Glass, Go Fast, Ice, Meth, Speed |
| Ecstasy | MDMA | Adam, Clarity, Eve, Lovers, Speed, Peace, Uppers |
| Morphine (Duramorph®, Roxanol®) | MOP | |
| Ketamine (Ketalar®) | KET | Cat, Valium, K, Special K, Vitamin K |
| Lysergic acid Diethylamide | LSD | Acid, Blotter, Heaven, Cubes, Microdot, Yellow |
| Pyote | Buttons, Cactus, Mesc | |
| Fentanyl (Actiq®, Duragesic®, Sublimaze®) | FEN | Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, Tango and Cash, TNT |
| Hydrocodone or dihydrocodeinone (Vicodin®, Lortab®, Lorcet®, and others) | Vike, Watson-387 | |
| Opiates 2000 (Morphine) | OPI | M, Miss Emma, Monkey, White, Stuff |
| Oxycodone (OxyContin®, Percodan®, Percocet®, and others) | OXY | O.C., Oxycet, Oxycotton, Oxy, Hillbilly, Heroin, Percs |
| Phencyclidine | PCP | Angel, Dust, Boat, Hog, Love, Boat, Peace, Pill |
| SteroidNandrolone (Oxandrin®), oxandrolone (Anadrol®), oxymetholone (Winstrol®), stanozolol (Durabolin®), testosterone cypionate (Depo-testosterone®) | Juice, Gym Candy, Pumpers, Roids | |
| Propoxyphene | PPX | |
| Tricyclic Antidepressants | TCA | |
| Ethyliden dimethyl diphenyl pyrrolidine | EDDP | |
| Amphetamine (Adderall®, Benzedrine®) | AMP | Bennies, Black Beauties, Crosses, Hearts, LA Turnaround, Speed, Truck Drivers, Uppers |
| Codeine | COD | Captain, Cody, Lean, Schoolboy, Sizzurp, Purple |
| Methylphenidate (Concerta®, Ritalin®) | JIF, MPH, R-ball, Skippy, The Smart Drug, Vitamin R | |
| Cathinone | CAT | Abyssinian Tea, African Salad, Catha, Chat, Chat, Kat, Oat |
| Synthetic Cathinones (Bath Salts) | Bloom, Cloud Nine, Cosmic Blast, Flakka, Ivory Wave, Lunar Wave, Scarface, Vanilla Sky, White Lightning |
The screen test is accurate and sensitive to the specified cut-off levels, but is qualitative and not as accurate as laboratory tests. If drugs are present in the system, you will usually see a presumptive positive result. When the result is preliminary positive, you should send the samples to the laboratory for a second, quantitative and more accurate test.
When a screening test show a negative result, but lab (EIMS) test shows positive, the result is called a false negative. While the illicit drug or drug metabolites are present in the donor’s system their concentration is less than the cutoff level results in a no-show on the test device. Lab (EIMS) tests are, however, much more sensitive and can detect lower drug concentrations. For example, if a patient is taking Oxycodone but the test shows negative—it is a false negative.
No, several factors may cause a negative test result, even if the person is using drugs. The most common factor is the adulteration of the sample (e.g, addition of water to dilution the sample) in an effort to lower the drug concentration below the cut-off value. If there is suspicion that person is taking drugs, you should test again, test for other types of drugs, and talk to your doctor for advice.
A test result is considered negative when there is no illicit drug is present in the system or its concentration is below the cut-off level.
If no lines show after 5 to 10 minutes the test is called invalid. A probable cause for an invalid test could be a defect in device—the strips may not be inserted all the way to the bottom of the panel. Or it could be caused by improper handling of the testing device and insufficient sample amount that could not saturate the stripes, resulting in no contact between the test strip and the specimen. If this happens, the lot number should be provided to the quality control department to review batch production records.
Codeine—a commonly prescribed pain medication and the active ingredient in some prescription cough medicines—and Meperidine are structurally related to morphine so they can cause positive opiates test. In addition, poppy seed bagels or other food containing poppy seeds also cause false positive opiates test if cutoff level of the test is less than 2000 ng/ml.
Drug of abuse detection is a two-step process. The first step involves the initial screening of an illicit drug, suggesting that an illicit drug may be present in the system. The second step is a confirmatory test— done in laboratory to quantitatively determine and confirm the presence of an illegal drug. Screening tests are not as accurate as laboratory tests and have a greater propensity to provide inaccurate results. Some food items and medications may cause the screen test to inaccurately read positive, such as poppy seeds, diet pills, inhalers, and cough syrup. One should consult with their physician to better understand how a particular medication can interfere with the test results.
No, a presumptive positive screen test does not mean the illegal drug has been identified in the donors system. Many home-run rests can result in false positives, therefore it is important to send samples to the laboratory for further evaluation.
Since positives can occur when the donor is taking certain prescription medications or consuming particular food items it is advised to discuss with their doctor which items are responsible. After the food or drug is identified as the cause, stop consuming the item (in accordance to your doctors recommendations) and retake the drug test.