Adulterants impose a new challenge in testing for abused drugs. Routine specimen integrity testing involving pH, creatinine, specific gravity, and temperature is not adequate to detect the presence of recently introduced adulterants such as Urine Luck, Klear, and Stealth. These agents can cause false negatives in immunoassay screening tests and may also affect the GC-MS confirmation tests. To counteract these effects, spot tests have been introduced, and several strip tests (AdultaCheck 4, AdultaCheck 6, Intect 7, and so on) are available for validation of specimen integrity. Studies are also needed to investigate effectiveness of hair shampoo in causing false negatives in a hair drug test and mouthwash products to invalidate saliva testing for abused drugs.

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