OnSite Adulteration Test Strips

As a primary on-site screen for adulteration, test strips are available from several suppliers.

5.2.1. Urine Adulteration ID Test Strip

A lateral-flow device that detects substituted non-human urine called Urine ID™ is available from Applied Biotech, Inc. It uses a sandwich colloidal gold immunochromatographic dipstick to detect the presence of human immunoglobulin G in urine at a cut-off concentration of 0.5 ^g/mL (16).

5.2.2. Multi-Panel Adulteration Test Sticks

Urinalysis test strips such as Multistix® from Bayer Diagnostics and Combur-Test® from Roche Diagnostics were sometimes used as an on-site rapid test for sample adulteration. However, among the various panels of these urinalysis dipsticks, only three are related to specimen validity testing. These include specific gravity, pH, and nitrite. The pH and the nitrite panels, however, cover clinically significant ranges that are outside established specimen validity criteria. Moreover, the specific-gravity panel does not differentiate the levels between 1.000 and 1.005, rendering it useless as a detection tool for substitution and dilution.

Multi-panel dipsticks specifically developed to detect adulteration are available from several manufacturers. These include Adultacheck® from Sciteck Diagnostics, Inc., MASK™ Ultra Screen from Kacey, Inc., and Intect 7. Peace and Tarnai (17) evaluated the performance of several dipsticks for their ability to detect adulteration in urine contaminated with commercial and household adulterants; they found that Intect 7 can correctly detect all contaminated samples.

5.2.3. The Intect 7 Adulteration Detection Strip

Because of the continuous formulation changes of some commercial adulterants, the Intect adulteration dipstick product has been improved over time (Intect 6 I, Intect 6 II, Intect 6 III, Intect 7 ver. 1, and Intect 7 ver. 2) to meet the challenge. The following description is of the second generation of Intect 7 (Intect 7 ver. 2).

The Intect 7 ver. 2 test dipstick is a plastic strip covered with seven chemical-treated pads (Fig. 1). To run the test, the strip is dipped into the urine specimen, removed immediately, and blotted sidewise to remove excess

Fig. 1. Intect® 7 with chemical pads for adulteration tests.

urine. After 1 min, the color on each pad is read and compared with a color chart to determine whether the specimen shows abnormality on any of its pads. To aid correct interpretation, each pad is numbered and the orientation of the strip during the reading process is shown on the color chart. The pads provide qualitative results for the following criteria at the indicated levels: creatinine (Cr), 10 to100 mg/dL; nitrite (Ni), 10 to >50 mg/dL; glutaraldehyde (Gl), trace; pH, 2 to >11; specific gravity (SG), 1.000 to >1.020; bleach (Bl), trace; and pyridinium chlorochromate (PC), trace.

Test results of the Intect 7 strips on urine samples treated with various adulterants are shown in Table 2. All the adulterants were added to positive urine drug controls obtained from Biochemical Diagnostics, Inc., containing 150 ng/mL of THC-acid (THC), 900 ng/mL of benzoylecgonine (BE), 75 ng/mL of phen-cylidine (PCP), 900 ng/mL of morphine (MOR), and 3000 ng/mL of amphet-

Table 2

Effects of Adulterants on Abused Drugs and Intect® 7 Test Strips

Abnormal Intect 7 panels

Table 2

Effects of Adulterants on Abused Drugs and Intect® 7 Test Strips

Abnormal Intect 7 panels

Adulterant name (chemical composition)

On-site drug tests affected

Cr Ni G1

pH

SG

B1

PC

Commercial products:

ADD-IT-ive™

MOR, THC

X

Clear Choice™"

None

X

X

Instant Clean™"

THC, BE, PCP

X

X

X

Lucky Labs LL418™" (PCC)

All 5 drugs

X

X

X

Klear™" (nitrite)

None

X

Rrystal Kleen™"

None

Purafyzit™"

None

X

X

Stealth™ Catalytic Purifier"

None

X

X

Stealth"(peroxidase and peroxide)

THC, BE, PCP

X

X

Urine Luck™ 5.3"(pyridine)

None

X

X

X

Urine Luck 6.3" (hydrofluoric acid)

THC, BE

X

Urine Luck 6.4"

THC

X

Urine Luck 6.5" (iodine)

THC, MOR

X

X

Urine Luck 6.7"

THC, MOR

X

UR'n Kleen™"

THC, BE, MOR, PCP

X

Household products

Chlorine bleach''

All 5 drugs

X

X

3% hydrogen peroxide solution''

None

X

Iodine tincture''

None

X

X

Liquid drain cleaner (Drano®)c

MOR, AMP

X

X

Vinegar (5% white distilled)''

AMP

X

Chemicals

Glutaraldehyde (50% liquid)*

None

X

Pyridinium chlorochromate''

All 5 drugs

X

X

X

X

Sodium Nitritec

None

X

X

X

X

"Use per product instruction. ''10% volume/volume. c10% weight/volume.

MOR, morphine; THC, tetrahydrocannabinol; BE, benzoylecgonine; PCP, phencyclidine; PCC, pyridinium chlorochromate.

amine (AMP). Commercial adulterants were added according to product instructions, and chemical and household adulterants were added according to the concentrations shown on the table. The effects of these adulterants on drugs were monitored by testing the adulterated urine samples on an on-site lateral-flow immunoassay drug-screen cassette, Monitect® PC11, from Branan Medical Corporation. Test results obtained after the urine controls were treated with adulterants for 5 min (18,19) showed that some adulterants were effective in masking the presence of some drugs, especially THC. The majority of these adulterants were oxidants. The results also confirmed that some adulterant manufacturers continue to modify their formulations to foil detection. There are also commercial adulterants that are not very effective in modifying the drug-test results. Chemicals used in some of the adulteration formulas have been reported. Available information on these formulas is also included in Table 2.

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