Testing for drugs of abuse was once an issue confined to the laboratory. However, due to widespread drug screening in the workplace, schools, drug rehabilitation centers, parole, and the probation environment, this issue has become extremely controversial. One aspect of drug screening that has received much attention in the medical and lay press is the topic of the accuracy and reliability of the testing process. Since the stakes are so high with the reporting of a “dirty” specimen, attempts to fool the testing process are commonplace. Regardless of technology, the quality of laboratory testing is dependent upon the quality of the specimen to be tested. As a result, much attention should be given to the development of a collection process which ensures both the integrity of the specimen and the legal rights of the individual providing the sample.
Prior to urination, the individual should remove coats, jackets, purses, briefcases, or any other item which could conceal a sample-tampering apparatus. Ideally the individual should be asked to remove their clothing and provided a gown. To thwart attempts to conceal items on or around the hands and arms the individual should be instructed to wash. Observed or unobserved urination should take place in a stall or partitioned area with no access to water fountains, faucets, soaps or any other cleaning agents. Bluing agents in toilet tanks are suggested as this prevents individuals from diluting samples with toilet water. A minimum of 60 milliliters (2 oz.) should be collected as this provides adequate specimen for testing and prevents attempts by individuals to “short-sample” the laboratory. The best means to ensure that a specimen has not been altered or substituted is to measure the sample’s temperature. Within 4 minutes the collector measures the temperature with a temperature strip or temperature gun, which should between 90 and 100 F.
Once the specimen is collected, the collector must immediately label the specimen with the name or identification number, date, time collected, and name of the collector. Tamper-proof security tape should be affixed on the container’s cap and the individual providing the specimen should initial the label, thereby attesting to the specimen’s identity and that the collection process was satisfactory. The collector begins a chain-of-custody form that whenever the sample changes hands, is dated and signed by the person releasing the specimen and the person accepting it. The specimen can now be sent to the laboratory along with a copy of the chain-of-custody form.
Methods to adulterate urine samples for drugs of abuse testing generally fall into three categories: 1) urine substitution; 2) ingestion of liquids or compounds in hopes of flushing out the system, diluting the sample, or interfering with the testing process; or 3) direct adulteration of the urine specimen itself. The substitution of one’s urine sample with one which is clean is a common practice. The best means to combat this practice is to measure urine temperature, as urine specimens even held close to the body for extended periods of time will not produce a physiologically temperature correct specimen. However, practices of reverse catheterization with clean urine and placement of urine-filled balloons in the vaginal cavity can produce urines of correct temperature.
Drinking large volumes of liquid, especially, according to street lore, cranberry juice or vinegar, is of common practice. Studies demonstrate these practices have no effect on any of the testing methodologies and can at times have an unexpected result. Many drugs are pH dependent, which is when the urine pH is lowered, as occurs after consuming cranberry juice or vinegar, the excretion rate of these drugs increases. If timed correctly, larger amounts of the drug will appear in the sample than would have normally occurred. Also, drinking large volumes of vinegar can be toxic. One potentially effective method is to consume large volumes of water as short-term water loading can increase urine volume up to 8-fold. Therefore, if the individual’s drug concentration is near the cutoff of an assay, the urine may be diluted enough so that the sample will test below the cutoff level. However, this effect is short-lived and urine collection must be timed correctly, a practice which can be eliminated with random collections. Other methods of adulteration include ingesting large amounts of vitamin C, vitamin B, niacin, Golden Seal, et cetera, all practices which have been shown to be completely ineffective by various studies.
Adulteration of a urine sample with various chemicals has been shown in the literature to inactivate some of the laboratory testing methodologies. Addition of compounds such as sodium chloride, sodium bicarbonate, hydrogen peroxide, bleach, alcohols, blood, various soaps, etc., have been shown to produce both false negatives and false positives. However, there are means at the laboratories disposal to detect these compounds which are discussed below.
Urine adulteration is a double edged sword as both false-negative and false-positive results can occur. However, most adulteration attempts can be detected by either trained collection-site personnel or by laboratory procedures as outlined above. Coordination and cooperation between the collection site and the testing laboratory can provide effective and reliable drugs of abuse testing.
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Step 1: Place temperature strip on specimen container. Fill specimen container and secure the lid to avoid leaking during transport. |
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Step 2: Put security seal across the top and down the sides of the specimen container. Please note not to cover up the client information. |
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Step 3: Fill out the chain of custody with the proper information |
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Step 4: Peel the stickers from the top right corner of paperwork and place on specimen container(s) as shown on images. |
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Step 5: Place specimen container in the security bag. Note: Place paperwork in the front pouch of security bag. |
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Step 6: Peel adhesive from the security bag and seal the security bag. |
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Step 7: Place one of the stickers from the chain of custody on the outside of the security bag. |
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Step 8: Place sealed security bag with the specimen container into the shipping bag. Fill out the shipping label and affix to the bag in the designated area. Please place a minimum of ten samples in the bag. If you are using pre-paid postage box mailers, place a minimum of three specimens in the box mailer and give to your postmaster. Thank you. |
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Fluid Specimen Collection and Shipping Instructions1. Remove the kit contents from the packaging. Save the outer packaging because the specimen must be placed in the re-closable outer packaging for shipment to Forensic Laboratories. IMPORTANT! The sample cannot be processed without the information supplied on the test request form. If the test request form does not accompany the specimen, testing will be delayed. Please follow these guidelines when shipping your specimen(s) to the laboratory: |
1) Using a large hair clip, select a clump of hair in the crown area of the head. Using thinning shears (scissors) cut the donor's hair as close to the scalp as possible. A comb may be used to help harvest the cuttings. A sample of approximately 100 milligrams is needed, (a pencil erasers amount). If necessary, collect from several different areas.
2) Place hair in foil with the root end at the notched area of the foil. Fold and cinch foil and place foil inside the envelope.
3) Seal the envelope with red security seal and initial seal. Place chain of custody number sticker from the Requisition Form on the envelope. The donor (guardian/witness/etc.) reads and initials the appropriate area on the envelope, then dates, prints and signs his/her name on the Requisition Form. The collector does the same. This initiates chain of custody.
4) In the presence of donor, place the white copy of the Requisition Form in outer pocket of security bag. Place envelope in other pocket of security bag; then seal and initial bag. The other two copies of the Requisition Form are to be distributed at the discretion of the collecting institution.
Forensic Laboratories will provide preprinted UPS and FedEx for your convenience. Place as many sealed hair bags as possible into the overnight courier's mailing containers. Call your local overnight courier office or Forensic Laboratories for pick-up of package. Other couriers may be utilized; however, Forensic Laboratories recommends shipment by overnight courier.
For collection questions or additional supplies call Forensic Laboratories at (800) 282-6574, or send written inquirys to:
Forensic Laboratories
4895 Joliet Street, Suite 7G
Denver, CO 80239
www.forensiclaboratories.com
800-282-6574 • Email Forensic Laboratories • 4895 Joliet Street • Denver, Colorado 80239
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