Ascertain whether an individual has administered drugs of abuse or not. Drug testing is commonly employed to check for the presence of any drug(s) of abuse. Their metabolites in the donor’s biological specimen such as blood, urine, oral fluid, sweat or hair. You’ll need urine drug tests kits to administer such tests.
Urine has been and remains the widest used body fluid specimen for routine testing for drugs of abuse. But oral fluid, sweat, and hair are gaining scientific credibility. As alternative specimens following the advancement of testing technology. Let’s review the uses and limitations of different specimens for testing below:
Purposes of drug testing
Over the past several decades, drug testing has been used worldwide in a variety of disciplines. Including criminal justice, emergency medicine, and clinical toxicology, and workplace.
Criminal justice
Drug testing plays an important role in facilitating the judicial sentence of drug abusers in courts, drug surveillance programs of inmates. Who is detained under the custody of drug treatment centers, as well as the enforcement of the legislation of driving under the influence by the police?
Emergency medicine and clinical toxicology
Timely and reliable drug test results are of prime importance in the field of emergency medicine and clinical toxicology. The objective of testing focused on determining the class of drugs that has exposed to the patients. Mortalities and morbidities would greatly reduce by effective, appropriate and prompt antidotal treatment or supportive care.
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Workplace
Pre-employment and workplace drug testing has increased. Rapidly over the last decade in western countries such as the United States of America and the United Kingdom. Federal organizations, government agencies, military, and private corporations exercise drug testing either under mandatory legislation. Also, corporate commitment as a measure to improve safety within the workplace.
Types of specimens for testing
Blood
Blood widely use for drug testing in clinical and emergency toxicology. Because it offers the best correlation each other drug level and pharmacological impairments to the body. The time window for drug detection in the blood is shorter, mostly within several hours than in urine. For example, at a given dosage of cocaine, blood testing can detect use within 12 hours. While urine testing can detect use within 48 to 72 hours. Even though blood is a good specimen for determining the presence of drugs, the concerns about invasiveness of the collection, ease of transportation and storage, and specimen stability greatly hamper. Its popularity in other fields of application even though substitution and dilution of the specimen to tamper with drug testing are considered impossible.
Urine
By far, urine is the most used specimen for drugs of abuse testing. Because of the advantages of large specimen volume and relatively high drug concentrations. That render drug detection comparatively easier than in other specimens. In addition, the technology used in urine testing well develop and has withstood legal challenges. Furthermore, urine collection considered non-invasive, and specimens can collected by non-medical personnel. Urine is a matrix that remains stable over time and can freeze to maintain the integrity of the sample. Drugs in urine are normally detectable up to 1-3 days. However, unless the urine sample obtained under direct observation, adulteration, substitution or dilution to circumvent drug testing is possible.
Hair
Following the advancement of technology in detecting trace quantity of drug(s) in hair. Hair testing has gained attention because of its ability in providing a longer window of detection from months to years. When compared to other specimens. In contrast to providing short-term drug abuse profile through blood and urine testing. Hair testing provides complementary information about the long-term drug abuse history of a donor.
Furthermore, sampling head hair specimen considered non-invasive. The drugs incorporated in the hair remain stable and bound for a long time leading to no concern about specimen adulteration. Head hair sampled from the scalp preferred in order to obtain the retrospective chronological drug abuse history of a donor. Head hair tends to grow at a rate of about 1 cm per month. So a 3 cm section of hair would represent a 3-month history. However, testing for a drug in hair is comparatively time-consuming and costly. It must perform in the laboratory because of the unavailability of on-site screening kits.
Oral fluid
Oral fluid is increasingly used for drug testing. Because the concentrations of many drugs in oral fluid correlate well with blood concentrations. Advancement of instrumental sensitivity makes oral fluid a suitable alternative to blood. Oral fluid is a non-invasive specimen that can sample under direct observation to prevent adulteration or substitution. The main disadvantage of oral fluid testing is its short window of detection, with most drugs being detectable within several hours only. This characteristic renders it suitable for determining very recent drug abuse but weakens its ability in detecting use over time. For example, someone administered heroin a day ago is likely to tested negative by oral fluid test. But positive by a urine test.
Sweat
Collection of sweat undertaken by attaching a tamper-evident patch, with an underlying absorbent pad inside, to the skin over a relatively long time (10-14 days). Analysis of sweat must be performed in a laboratory and on-site test kits are not available. Sweat testing has not used because of challenges of the potential contamination from the environment and from residual levels of a drug in the skin from prior use.
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Characteristics of different specimens for drug testing
The advantages, disadvantages and time window of detection of different specimens summarized below.
Screening test versus confirmatory test
In order to undertake drug testing, there must be a cutoff level for each type of drugs to test. Such a cutoff point serves as an administrative breakpoint in distinguishing a positive or negative result. Any sample that contains the drug/drug metabolite of interest at the concentration levels equal to or greater than the designated cutoff level is reported as positive. Whilst a negative reported for the concentration level than the cutoff. Generally, a drug test can categorize as either a screening test or a confirmatory test, with respect to the detection method and testing principle employed.
Screening test
Screening test refers to the initial test undertaken to test for a broad class of drugs and their metabolites in the specimen with the presumptive result, i.e. positive or negative. Generally, the screening test is rapid, sensitive, inexpensive with acceptable levels of precision and reliability. However, it lacks precise specificity and may be subject to a false-positive result due to cross-reactivity with other non-targeted drugs of similar chemical structure.
On-site screening test
Use of on-site immunoassay screening kits is highly popular in the fields of workplace testing and emergency toxicology. Because results are available within several minutes, with reliability similar to laboratory screening, at the site of specimen collection. These kits involve no calibration or maintenance, and no special skills needed to perform the screening test. Most kits have built-in quality control zones in each panel, which ensures reagent integrity and testing validity. Nowadays, commercially-available on-site screening test kits designed for urine and saliva specimens only. But not for sweat or hair as yet.
Laboratory screening test
Instead of on-site testing, drug screening may performed by instrumental immunoassay method in the laboratory by automated, sophisticated and high throughput analyzers. Generally, laboratory drug screening has to take at least 1-2 days before, the results are ready for collection. Because of time take in delivering the specimens to the laboratory, running the tests and preparation of test reports.
Confirmatory testing
Any specimen, which has been presumptively screened positive, should subject to confirmatory testing eliminate false-positive results that arise from cross-reactivity. Confirmatory testing should employ the highly specific and alternate chemical technique in order to obtain unequivocal and accurate analytical results.
Kits for on-site testing
Over the past 10 years, testing kits of different designs have market order to meet the growing demand for drug screening at point of collection. These on-site test kits are commonly used by healthcare professionals, and drug treatment and rehabilitation program supervisors to help deter drug use by the patients and supervisees. Discards and cassette kits that employ lateral flow immunoassay technology have proven to reliable and easy to use. Recently, newly designed testing cups, also employing the same technology, with integrated test strips in the interior surface have grown in popularity because of their ease of testing and sanitary protection to the test operator, with the elimination of specimen transfer or direct contact with the specimen.