Fraudulent Methods Causing False Negatives In Urine Drug Testing

Abstract

The urine drug test has a significant role in monitoring the use of legal and illicit substance [1]. Drug testing programs implement for all security-sensitive professions such as military forces, transport industry, the mining industry. Additionally, health care (facilitate treatment of clinical intoxication and rehabilitation programs), detect doping in sports, legal and criminal situations such as post-accident testing, rehabilitation testing of ex-convicts, are common areas for drug testing [2]. Drug testing screening programs are increasing day by day. Urine, blood, hair, saliva, sweat and nail samples are using for substance abuse screening tests. Depending on the method of measuring drug levels, screening tests have different specificity, sensitivity, and accuracy of each sample. The most frequently preferred sample for substance abuse screening test is urine because of its easy collection. Furthermore, urine has longer detection times and higher drug concentrations than blood [3]. At the stage of giving the urine sample can be easily cheated. Illegal drug users try to hide their substance use with adulterants (in vivo or in vitro). In vivo adulteration involves the dilution of urine with water or taking a diüretic substance for increasing the metabolism. In vitro adulteration is the act of adding foreign chemicals (such as vinegar, table salt, hypochlorite bleach, laundry detergent) to urine samples. Therefore, in order to prevent false negative results, the urine validity tests are used [4]. Studies have been carried out for many years to prevent false negative results by detecting adulteration action to the urine. For this purpose, urine specimen intake and admission procedures were developed. Surveillance of urine collection is the most important step. If we make this step meaningfully , we prevent urinary substitution and in vitro adulteration. The other steps of urine integrity tests are temperature, specific gravity, pH, nitrite and creatinine. measurements. Urinary sequencing DNA is the highest accuracy method of urine validation tests [5]. The cross-reaction of a urine adulterant with immunoassay tests include forming insoluble drug analyte-adulterant complexes. In this paper, I describe the oxidizing and non-oxidizing chemical adulter-ants which cross-react with the immunoassay method. ARTICLE INFO Substance analyzes are carried out to determine drug use. There is a workflow plan that should apply for drug use tests carried out for medico-legal purposes. The most important thing about this is the preservation of urinary integrity. These tests mostly perform for security-sensitive professions or forensic situations. Therefore, drug users try fraudulent ways to hide their dependencies. Easily obtained chemicals are used for his purpose. Examples include nitrite, some commercial products such as peroxide, or household chemicals such as table salt or bleach. Always be aware of adulterants use. Proper monitoring during urine collection will greatly prevent fraudulent conditions. Another important point is to conduct urine integrity tests (pH, nitrite, density, and creatinine). Samples which urine integrity test (pH, nitrite, density, and creatinine) results in an acceptable range should be analyzed. We use immunoassay screening and GC MS validation methods for analysis. Immunoassay screening tests are affected by these adulterants than false negative results obtain due to the deteriorate antigen-antibody relationship. GC-MS verification tests should perform in case of clinical suspicion. abstract