Home Drug Detox Program

Total Detox Friend

Total Detox Friend is an ebook which will provide you with many solutions on how to cleanse the wastes and toxins from the entire body to help or aid you in passing drug and urine tests effortlessly. Detoxifying and masking the urine and learning how to pass a urine drug test is not a complicated thing. Most people do need help since everything you need to pass a the test isn't lying around your house. People also need realistic and honest help assessing their situation since everyone's situation is different and one size does not fit all in the world of urine detox. Total Detox Friend differs from everyone else out there in that we keep things very simple. Total Detox has years of experience counseling people through tough times. Whether it is a pre employment test, probation or even a random test at work that you have to pass or else Drug Test Friend can help. Download information of passing drug tests now and you will be ready to pass your test within 2 hours!

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Growth of Drug Testing

By the mid-1970s, the field of drug testing had begun to take root, as many young Americans, both military and civilian, experimented with illegal drugs such as marijuana (tetrahydrocannabinol, or THC), lysergic acid diethyl-amide (LSD), and cocaine. Most urine testing for illicit drugs was being done either by forensic laboratories or in methadone treatment programs. In these programs, patients undergoing methadone substitution therapy for heroin addiction were monitored for illicit drug use and compliance with the methadone therapy (4). A modest amount of drug testing was being conducted in the workplace by innovative companies that recognized the productivity value of promoting a drug-free work environment. Then on May 26, 1981, an event occurred that had tremendous repercussions on the drug-testing industry (5). There was a serious and deadly crash involving fighter aircraft on the carrier USS Nimitz, in the Atlantic Fleet. Fourteen servicemen died, 48 were injured, and 150...

Specimens for Drugsof Abuse Testing

A wide variety of body fluid specimens have been utilized for analysis for the presence of drugs of abuse. Urine has been and remains the most widely used body fluid specimen for routine testing for drugs of abuse, but several alternative specimens are establishing their place as suitable for drug testing. Hair, sweat, and oral fluid have reached a sufficient level of scientific credibility to be considered for use in the federally regulated workplace drug-testing programs. Each specimen provides different information about time and extent of use and likelihood of impairment. Some of these specimens (e.g., urine and oral fluid) can even be analyzed with simple on-site, nonin-strumented testing devices, as well as through standard laboratory methods. These drug-testing tools, as objective pieces of information identifying drug use, have proven highly useful in addressing our society's ongoing substance abuse challenges. This chapter reviews the use of these various body fluid specimens...

Scenario 2 Drug screening 1 oclock position in Figure

The second approach is to screen through a large database of known molecules and check their binding affinity to the target protein. The advantage of this approach is that, mostly, the compounds that have been accumulated in a database have been investigated before - though mostly in a different context. Their bioaccessibility and toxicity may have been studied and they probably have been synthesized. Screening compounds from a library can been done in the laboratory or in the computer. In the latter case, the process is called virtual screening. Compound databases become large, so a mixture of the two processes may be advisable. Here, a set of compounds is preselected from a large library with virtual screening. These compounds are then tested in the laboratory. Chapter 6 of volume 2 by Matthias Rarey, Martin Stahl, and Gerhard Klebe gives more detail on virtual drug screening.

Complications Introduced by Pointof Collection Drug Tests

The introduction of these products, however, created special concerns in workplace DOA testing applications. Pregnancy tests, designed for home use by patients, were ideal in their design for self-collection, interpretation, and receipt of the test results in the privacy of the home (8). For workplace DOA testing,

The myeScreencom Portal

In the eScreen model, the digital information record begins when the employer orders a drug test online, schedules the event at the collection site via the portal at myeScreen.com, and the collection site has the complete donor information pre-accessioned. The donor's failure to appear within the prescribed time frame, usually 24 h, results in an e-mail to the employer, and a flag on the collection site record to cancel the collection. If the collection proceeds as scheduled, the laboratory, MRO, administrator, and employer have pre-accessioned data of the eScreen drug test, and know whether they should expect a specimen or result in the coming days. Exception reports can be generated to alert the service providers that the specimen or result has not been received when expected, before the customer calls looking for a missing result. myeScreen.com is a robust application service provider (ASP) software model, allowing employers to manage their drug-testing programs from beginning to...

Federal Guidelines for Drugsof Abuse Testing

Drug-testing programs in the United States can be classified as mandatory or nonmandatory. In the first group (e.g., Department of Transportation), a regulated employer is required by federal regulation to test their employees for drugs of abuse. In the second category, employers choose to test their employee for reasons other than the federal requirements. Private employers who are not mandated to test under federal authority have instituted employee drug-testing programs in order to create a drug-free workplace. In fact, in 1986, President Reagan issued Executive Order No. 12564, directing all federal agencies to achieve a drug-free work environment. Guidelines for DOA testing were then developed by the Substance Abuse and Mental Health Services Administration (SAMHSA, formerly The National Institute on Drug Abuse NIDA ) and became the gold standard for all drug-testing programs to follow. The overall testing process under mandatory testing consists of proper collection of specimen,...

Adulteration of Hair and Saliva Specimens for Drug Testing

Hair and saliva specimens are alternatives to urine specimens for drug testing (see Chapter 11). Several products available through the Internet claim that washing hair with their shampoos can help pass a drug test. Clear Choice Hair Follicle Shampoo claims to remove all residues and toxins within 10 min of use. One application is sufficient for shoulder-length hair, and the effect can last for 8 h. Root Clean hair-cleansing system shampoo has also been commercially available. However, no systematic study has been reported to investigate the effect of using these products in a drug test. Saliva samples are also used for drug testing. The chances of adulteration of saliva specimen are very low to non-existent. However, the manufacturer of a commercially available mouthwash claims that by rinsing the mouth twice with this product, a person can beat saliva-based drug testing, which is a popular method of testing by insurance companies. The same company claims that its specially...

Introduction to Drugs of Abuse Testing

Urine Drug Testing Processes Testing for drugs of abuse for clinical or forensic purposes has become a significant service of a toxicology laboratory. This chapter will summarize the basic practice of the various technical processes of drug testing, from specimen collection to analysis and reporting. Although urine remains the primary test specimen, the advantages and disadvantages of performing testing on alternate specimen matrices (hair, oral fluid, and sweat) will be discussed. The importance of initial test immunospecificity on test accuracy will be examined for the common drug groups. The need for confirmation will be discussed and the basic principles of mass spectrometry including gas chromatography-mass spectrometry, liquid chromatography-mass spectrometry, and tandem mass spectrometry will be presented.

Adulteration Product Urine Luck

Wu et al. reported that the active ingredient of Urine Luck is 200 mmol L of PCC. The authors reported a decrease in the response rate for all EMIT II drug screens and for the Abuscreen (Abbott Laboratories) morphine and THC assays. In contrast, Abuscreen amphetamine assay produced a higher response and no effect was observed on the results of BE and PCP. This adulteration of urine did not alter GC MS confirmation of methamphetamine, BE and PCP. However, apparent concentrations of opiates and THC as determined by GC MS were reduced (24). Paul et al. also studied the effect of Urine Luck on testing for drugs of abuse. When THC-COOH-containing urine specimens were treated with 2 mmol L of PCC, 58-100 of the THC-COOH was lost. The loss increased with decreasing pH and increasing time of incubation (0-3 days). There was no effect on the concentration of free codeine or free morphine if the pH of the urine was in the range of 5-7, but at lower pH, significant loss of free morphine was...

Key Stakeholders of Drug Courts 21 The Judge

Most drug courts utilize the services of the public defenders office to represent the participant in court and to ensure that their rights are protected. In a typical drug court, however, the participant is required to speak directly to the judge. The attorney, present as a part of the team, does not speak on behalf of the participant during the court proceeding. Defense attorneys in drug court adopt the principle that their clients are best served through a chance to face life drug-free and with the skills and opportunities necessary to be productive members of the community. tional model, treatment providers are active members of the team, participate in staffing of cases prior to the review hearings, recommend and enforce incentives and sanctions, share information concerning treatment compliance and drug-testing results with the court, and strive to educate the other members of the team on the basic aspects of addiction and how they affect the behavior of each participant.

Functional Significance of Drug Courts

Drug courts, through the cooperative efforts of all stakeholders, provide a comprehensive and efficient utilization of community resources and have proven very effective in reducing recidivism among program participants. According to a September 2003 report by the American University Drug Court Clearinghouse, the 1078 operational drug courts have collectively served more than 300,000 adults and 12,500 juveniles and graduated more than 73,000 adults and 4000 juveniles (2). The report further states that 75,000 of these offenders had been sentenced to periods of incarceration prior to their entering drug court and that despite this fact, drug courts consistently retain over 70 of those who enroll. A 2001 Columbia University National Center on Addiction and Substance Abuse (CASA) study concluded that, even though drug-court participants receive significantly more comprehensive and closer supervision than offenders participating in other forms of community supervision, drug use and...

Key Components of Drug Courts

In 1996, twelve drug-court practitioners and ancillary experts began the process of establishing a set of guidelines upon which drug courts around the country could base their own unique programs. Recognizing the need for cultural and jurisdictional diversity, this group set out to identify the fundamental similarities and standards of the few operational drug courts at that time. What resulted was the publication of Defining Drug Courts The Key Components (4). The following is simply a listing of these 10 key components of a drug court 1. Drug courts integrate alcohol and other drug treatment services with justice system case processing. Drug courts serve as a true partnership between drug and alcohol treatment professionals and the court system. The treatment team, which is comprised of all major stakeholders, meets regularly to discuss each participant's progress and to determine incentives, sanctions, and the future direction of the case plan. 3. Eligible participants are...

The Future of Drug Courts

To expand into other specialty courts dealing with issues other than primary substance abuse. Domestic violence, mental health, driving under the influence (DUI), tribal, university campus, child support, and re-entry courts were added to the growing number of adult, juvenile, and family drug courts. With an ever-increasing volume of evaluation data supporting the efficacy of these intensive intervention strategies, the model promises to expand into other special-population areas. Early prison release, prostitution, property offenses, impulse-related violent offenses, and parole or probation violations are all viable arenas for specialty courts. Even though most of these specialty courts do not deal with substance abuse as the primary issue, drug testing is still a very important component. Statistics shows that more than 80 of the crimes committed in the United States each year are drug-related (6). That means either the defendant was under the influence of drugs or alcohol at the...

How Can I Combat Drug Testing 1471 As a job seeker

Only consider employment from ethical companies. Support the companies that care about you enough to respect your privacy. If you decide to work for someone who drug tests, you are actively supporting their disrespectful privacy policy you are actively supporting lifestyle discrimination, and you are actively supporting the drug testing industry - even if you use techniques in this paper to beat the test. If you seek employment from a company you are not sure about, and discover that they drug test, then decline the test and explain that you will not tolerate having your privacy violated and dignity stripped. Tell them you are drug free, and make it clear to them that they lost a good worker because of their intrusive policy.

Adulteration Remains a Challenge to Urine Drug Testing

Addicts to abused drugs have great incentives to try to defeat drug tests, and they often use adulteration products. Because of the high profit margin, great customer demand, low cost of entry, and wide accessibility via the Internet, there are many manufacturers in this market. Not only do some of them employ innovative chemists, they also provide informative educational materials on their Web sites, which help the abusers understand how the drug-testing system works and how to defeat the tests. Although legislators in many states have banned adulterant-product sales, and guidelines for detecting their presence have been established, adulteration will remain a challenge to urine drug testing (see Chapters 13 and 14).

Ultra Rapid Opiate Detoxification

UROD is however associated with considerable risks, serious adverse events such as inadvertent anaesthetic overdose, aspiration, or death may occur as the inherent anaesthetic risk. To avoid severe and possible life threatening withdrawal symptoms, the patient must be intubated and treated with several substances mainly influencing the functions of the vegetative nervous, cardiovascular and gastrointestinal systems, this must me done in a professional intensive care setting. Normal opiate detoxification is per se not fraught with a high risk of mortality and it has been argued that UROD has an unacceptable risk benefit-ratio. On the other hand the drop out ratio in traditional detoxification is very high and the risks of continued heroin use are well-known. Ultra caine Colloquial term for look-alike cocaine (procaine, benzocaine, lidocaine). Ultra set Colloquial term for lidocaine. Ultracaine Colloquial term for ephedrine used to adulterate cocaine...

Issues of Special Interest in Oral Fluid Testing

Although oral fluid can be collected under direct supervision and opportunity for sample adulteration is low, measurement of human IgG is recommended for sample validity. 4. There are a number of products available on the Internet that guarantee to beat oral fluid drug of abuse tests. There is no scientific evidence that these products work. Using an on-site oral fluid drug screen, Oratect, Wong et al. (79) investigated the effects of various adulterants and foodstuffs. Common foods, beverages, food ingredients, cosmetics and hygienic products were demonstrated not to cause false-positive results when tested 30 min after their consumption. In addition, two commercial adulterant products Clear Choice Fizzy Flush and Kleen Mouthwash were tested and had no effect in destroying the drug compounds or changing the pH of the oral fluid. Their effect was through washing oral cavity and not different from a common mouthwash. In another study, a series of potential adulterants of oral fluid...

Hemp Seed Oil Products Synthetic THC Medication and Drug Testing

The question of whether the consumption of cannabinoid-containing foodstuffs or cannabinoid-based therapeutics could be used to justify the presence of urinary THC-COOH has been extensively investigated and reported in the literature (70,110,136-144). A number of studies in 1997 clearly showed that ingestion of what were commercially available hemp seed oils could produce positive cannabinoid immunoassay results for several days (137-140). These screen-positive specimens were shown to contain THC-COOH by GC MS in most of the studies (137-139). Later studies indicated that there has been a significant reduction in the THC concentration of hemp food products. These studies observed only occasional screen-positive samples and showed decreased levels of urinary THC-COOH with shortened detection time (141,142). In addition, the Drug Enforcement Agency (DEA) and Justice Department added an interpretive rule to 21 CFR Part 1308. DEA interprets the Controlled Substances Act and DEA...

Products Claiming to Beat Hair Drug Test

There are numerous sites on the Internet that sell products and claim to beat or pass the hair drug test. Searching on Google using the phrase pass hair drug test showed 6,620,000 hits in 0.22 s. Although most of these sites claim that their product works 100 , and some with money back guarantee, there is very little scientific evidence whether these products actually work.

Sample Adulteration in Urine DOA Testing

The instant DOA testing procedures are instituted, opposing forces are at work to develop methods to avoid detection of drug use. Initially, common household chemicals such as laundry bleach, table salt, toilet-bowl cleaner, hand soap, and vinegar were used. More recently, a variety of products became commercially available, which can be ordered through Internet sites and tollfree telephone numbers. Commercially available adulteration products can be classified into two broad categories. The first category consists of specific fluids or tablets, which when taken along with plenty of water, serve to flush out drugs and metabolites, resulting in diluted urine and reduced concentrations of drugs or metabolites. Examples of products in this category include Absolute Detox XXL drink, Absolute Carbo Drinks, Ready Clean Drug Detox Drink, Fast Flush Capsules, and Ready Clean Gel Capsules. All products are available from Internet sites. Root Clean is a hair-cleansing system targeting drug...

Diluted Urine A Simple Way to Beat Drug Tests

A negative result for the presence of abused drugs in a urine specimen does not necessarily mean that no drug is present. It is also possible that the amount of drug was below the cut-off values used in the drug-testing protocol. Diluting urine is a simple way to beat an otherwise positive drug test if the original concentrations of drugs in the urine are just slightly above the cut-off values. To counteract this strategy, creatinine analysis in urine is an effective method to detect diluted urine. Neeedleman and Porvaznik considered a creatinine value of less than 10 mg dL as suggestive of replacement of urine specimen largely by water (4). Beck et al. (5) reported that 11 of all urine specimens submitted to their laboratory for DOA testing were diluted. The SAMHSA program currently does not allow analysis of dilute urine specimens at lower screening and confirmation cut-offs. However, in Canada, the Correction Services of Canada (CSA) program incorporates the following lower drugs...

Changeable Bar Code Prelude to Digital Drug Testing

Confirmation laboratory can positively identify the drug. Removing the drug names from the cassette means that if all the color lines are present, as is the case with most strips, no drugs are detected in the specimen (i.e., the result is negative). If one or more color lines are absent from the series, the result is presumptively positive. It does not matter which drug is detected, because in every case, the outcome is the same. The specimen must be sent to a confirmation laboratory for further testing. From the bar code prospective, this argument presents a unique opportunity to translate the lines and spaces on the LFDOA test strips into a digital code, or a series of 0s and 1s. Consider the presence of a target line as indicated by a 1 and a space by a 0, then a five-drug test with one control line would be translated by a barcode reader into 10101010101 (six lines and five spaces) when the sample is negative and all six lines appear. If, for example, the THC test in the second...

Drug Testing at the Workplace

Opponents of employee drug testing view it as a degrading experience that qualifies as an illegal search and seizure. They also argue from a more utilitarian perspective that the costs of testing outweigh the benefits. Given these limited benefits of identifying marijuana smokers, the costs of drug testing may only appear worthwhile to those with a strong moral opposition to cannabis. A study of the federal government's 11.7 million drug testing program examined the efficiency of the procedure. Given the large number of abstainers and the price of the tests, identifying In addition to their direct cost, drug tests decrease productivity because employees are not working while providing hair or urine samples. Data suggest that computer firms with drug testing programs actually score lower on productivity measures than comparable firms that do not test for drugs. The impact on employee morale can also be particularly negative. Some companies have dropped preemployment drug testing...

Cannabinoid Test System

Cannabis is by far the most widely cultivated, trafficked, and abused illicit drug in the world (1-3). According to the recent Drug Abuse Warning Network update (51), the rate of drug abuse-related emergency department visits involving marijuana rose 139 nationally from 1995 to 2002. As reported in the Drug Testing Index series published by Quest Diagnostics (52), cannabinoid analysis has always had the highest drug positivity rate by drug category among all of the abused drugs tested in workplace drug-testing programs. Likewise, cannabinoid assays are among the most frequently performed tests in society drug testing, behavior toxicology, and criminal justice testing. In The Federal Register (21 CFR 862.3870), the cannabinoid test system is identified as a device intended to measure any of the cannabinoids, hallucinogenic compounds endogenous to marihuana, in serum, plasma, saliva, and urine. Cannabinoid compounds include A9-THC, CBD, CBN, and CBC. Measurements obtained by this device...

The eScreen123 Software Runs the eScreen System

The eScreen system consists of a suite of hardware installed at the point of collection. The hardware suite consists of a Windows PC, monitor, eReader (Fig. 2), signature capture device, barcode reader, and laser printer. The PC is connected to the Internet, preferably via a broadband connection, and runs the eScreen123 (eScreen) software platform. The eScreen123 (Fig. 3) software is a Web-based application allowing each of the service providers e.g., the collection site, laboratory, MRO, and administrator to access their respective portion of the drug-testing record in real time throughout the drug-testing process. The collection site portal allows the collector to check in the donor, if not previously scheduled by the employer, based on a set of rules previously established by the system and embedded in the software. Collector screens guide the collector through the specimen-collection process, and require the completion of the custody and control form (CCF) elements. The date and...

The Results of the Roadside Drug Testing Assessment Project

The 21-mo Roadside Testing Assessment (ROSITA) project started in January 1999 and included a literature survey of drugs and medicines that have detrimental impacts on road users' performance, an inventory of the available roadside drug-testing equipment for urine, oral fluid, and sweat, an evaluation of the operational, user, and legal requirements for roadside testing equipment in the different European Union countries, and an extensive evaluation of several devices in eight countries. On-site immunoassays were used for the detection of drugs in urine, oral fluid, and or sweat in 2968 subjects. Police officers liked having the tools to detect drivers under the influence of drugs, and they were very creative in finding solutions to the practical and operational problems they encountered. On-site drug testing gave the police confidence, and saved time and money. Police officers had no major obj ections to collecting specimens of body fluids. In the majority of the participating...

Witnesses for Workplace Drug Testing

In workplace drug testing cases, the arbitration or hearing is usually a result of punitive employment action taken as a result of a positive finding. It is the employers' responsibility to provide evidence that the action taken was consistent with their routine policies and procedures. The expert witness provides testimony in support of the drug testing results, that the testing was performed accurately and in accordance with laboratory standard operating procedure as well as in accordance with any applicable regulatory requirements.

Hair testing

When THC metabolites are in the blood, they go through the blood vessels in the head, and get filtered through the hair. THC metabolites remain in the hair as a permanent record. The hair test costs several hundred dollars ( 150-300) and is rarely given because urinalysis is cheaper (approximately 65) and more accurate. (The hair test equipment and setup goes for over a million). According to Jeff Nightbyrd, hair tests are widely used in the casino industry. They cut 50 strands of hair from the scalp, and send it in to the testing lab where they liquefy it. A hair sample is disolved in a series of solvents which extract the drug metabolites and then are analyzed via GC MS. It can take from several hours to days just to extract metabolites. Average hair grows 1 4 inch per month. Typically they just use hair one and a half inches from the scalp though some labs will take enough to test for up to 3 years. The liquid is run through the most sensitive GC MS machines available, and can...

The eScreen System

In view of the deficiencies associated with the conventional POCT and the perception that a digital drug test could be created, a system known as eScreen was developed. eScreen combines the benefits of point-of-collection specimen collection with recent advances in information technologies to create an instrumented POCT system. eScreen monitored the progress of LFDOA development closely. LFDOA clearly led the market as the analytical method of choice. Easy-to-use, low-cost, highly sensitive lateral-flow test strips could do everything that the lab-based immunoassay could do. eScreen did not compete in the manufacturing of LFDOA devices, but realized that commoditization would likely develop as tests got better and cheaper. eScreen uses the current Federal drug testing standards as a starting point, extracts the immunoassay screening procedure from the centralized laboratory, and shifts it to the point of collection. It keeps in place many of the safeguards already built into the...


During a job interview, have you ever been asked to piss for your new employer New applicants for many of the Fortune 500 corporations are now being forced to take a drug test. Drug byproducts can be detected in urine, blood, hair, external residue, and even perspiration Drugs aren't the only things they test for employers are using urinalysis to test women for pregnancy. Pregnant women are getting laid off or denied employment after taking such a test. Parents are spying on their children. The DOD Directive requires the military to screen all active duty members annually. If you don't want to be a victim of the drug war, this text will help you. If you are well known, this text may protect your reputation. I strongly recommended that drug users (pot smokers in particular) read this. Other drugs are covered as well, but marijuana is the main focus of this paper.

If You Fail

Failing the drug test has been known to make a quiet person go ballistic. You will be interviewed by a medical review official (MRO), who would try to find out why you tested positive. MRO's are NOT impartial. An MRO is an employee of the lab, and is there for quality control. They are also there to protect the lab by coercing the court into thinking that the person who failed is a drug abuser. Anything you say to an MRO can and will be used against you (RDW). If you fight it, your lawyer can subpoena the proficiency testing records of the laboratory for review Anonl . These questions should be asked about the lab you are challenging If you're an adult, contact ACLU. If you're a child, don't bother ACLU won't do anything for children who fail the drug test. Then mail me at hbcsc096 csun.edu and tell me what you tried so I can use that to help others. Many people ask for advice before the test, then do not report back.

Specifically Which Companies Test and Which Do

There are too many companies to list in this document. An online searchable database called The Non-testers List1 maintains a current list of companies that drug test and companies that do not. The data contained in this list comes from reports by Internet users. So if you have first hand experience with a company, you should report it to the list operator. If you are drug tested by a company that is not listed, you can submit a report to the list operator, who will add it. If you have a good experience with a company that does not violate your privacy, please also report it to the list operator, who will provide good publicity for the company. The usenet Just-Say-No-To-Piss-Tests Project2 used to maintain a similar list of the drug testing policies of varies companies, but it has not been updated since 1994.

Passive smoke and positives

Second hand marijuana smoke in a car can cause you to fail the next day (Nightbyrd). It is possible that second hand marijuana smoke will raise someone to the 50 ng mL level however, extreme exposure is required. For instance, a closed car full of pot smokers and a non-smoker may render the non-smoker positive for both urinalysis and the hair test, provided that they are sealed in the car for a while. The Army did a case study where volunteers were put in a room pumped full of smoke for an hour, five times daily. Subjects started testing positive after the second day. The non-smoker would have to take in virtually as much second hand smoke as a smoker inhales. Non-smokers are safe in a ventilated area, as long as they don't get a hair test. According to Clinton, simply blowing crack smoke on ones hair may cause a positive hair test. Second hand pot smoke doesn't affect the hair test results as much as crack smoke does mainly because exhaled smoke contains no THC. The only pot smoke...

A2 For Additional Information

Carson, Ed Book Just Say No to Drug Tests How to Beat the Whiz Quiz. ISBN 0-87364-624-X Drug Testing Hotline in California (900) 844-test Drug Watch This page represents the position of drug testing advocates. It Hyperreal Drug Testing Archives Links and articles related to drug testing. Just-Say-No-To-Piss-Tests Project This is a list of drug testing policies Non-Testers List The Hemperor maintains a searchable database that lists employers who do not drug test in one table, and a list of Orwellian employers who do drug test in another table. NORML NORML operates a Drug Testing & Information Hotline. I don't recommend this hotline. People have called this line needing important drug testing information in a hurry, only to get a recording. For the price, I would expect a live person. The charge is 2.95 per minute. 900 97-NORML. 1636 'R' St. N.W., 3rd Floor, Washington D.C. 20009

Naturally Klean Herbal Tea c

Naturally Klean claims to clear any drug metabolites for a few hours after taking. Drink this shortly before the test. Naturally Klean was also listed as a drug screen in previous versions, but according to Nightbyrd, it will do NOTHING to help you pass a urine test with the exception that it will dilute your urine. You can get Naturally Klean from Martha Butterfield-Jay


Creatinine is a substance produced by vertebrates, and it shows up in urine. If someone substitutes their urine with something other than urine, like Mountain Dew, they will test negative for drugs. However the testee will most likely not get away with it because Mountain Dew contains zero creatinine, and labs test creatinine levels to ensure that the sample is valid. Creatinine levels drop below normal when people dilute their urine. This tests to ensure that the subject did not drink unusual amounts of water. An *accurate* creatinine clearance test would require a urine and blood test 24 hours before the drug test to determine the normal creatinine level for that individual. This is almost never done. You should still be cautious because they do often use the inaccurate method of comparing your creatinine level during the drug test to an average. People who are drug-free sometimes lose their jobs for having too low of a creatinine level.


Bernard Williams of the Philadelphia Eagles failed the drug test for marijuana. He was suspended from the NFL for six games for using a drug that does not enhance performance. If anything, marijuana would detract from an athletes performance. Let the coach judge Williams performance. The U.S. Supreme court just ruled June 1995 that public high schools can require drug test for all student athletes. Many high schools already do random searches on students not for weapons, but for drugs. After all, the Constitution has failed to protect children in the classroom, why not expand Students have lost 1st, 4th, and 5th amendment rights, and I think it is absurd. We have patriotic history teachers telling children of their Constitutional rights, yet children's rights are not protected on campus. Kids get kicked out of school for questioning rules that violate the Constitution.

As an employer

Whatever you do, do not drug test Respect the privacy of your employees lifestyle, and do it with pride. Some companies that do not drug test post bulletins around the workplace which proudly state the companies privacy policy. Also, be sure to reward yourself by adding your company to The Non-Testers List 2 for free advertizing and positive publicity. As an employer who has to manage safety critical applications, do not use drug tests to test for impairment. It does not work. This strategy leads to the elimination of drug-free workers (in cases of false positives), and it also fails to catch workers who are impaired (false negatives). False negatives can lead to disasters. Use impairment tests such as that developed by Performance Factors 3. Impairment tests are not intrusive, they are more cost effective and take less time to administer, and they test impairment rather than lifestyle.

Poppy Seeds

Poppy seeds, usually on breads, contain traces of morphine, and lead to positives for opiates. According to Dr. Grow, eating a pastry filled with poppy seeds will bring results showing that you are a *high level* opiate user. Harold Crossley, a nationally known chemical dependency expert, said you would have to eat 100 poppy seed bagels to score a positive on a drug test. When taken into account that very few poppy seeds are sprinkled on bagels, you can see that poppy seeds from a hundred poppy seed bagels will easily fill a single large pastry. Purim cookies, a Jewish food known as Hamantashen, may have five to six tablespoons of poppy seeds. A couple Purim cookies may cause a positive test. Poppy seeds can be distinguished from illicit drugs on the GC MS test. Although poppy seeds have the same metabolites as opium, these metabolites are shown to have different patterns when viewed with the GC MS.

The Alternatives

There is an alarming number false negatives and false positives in the drug testing industry. That's a fact. And what it means is that competent, law abiding workers are unfairly being denied employment and losing jobs. The employers evaluation of the employees competency is dependent on the competency of the lab. Even when the lab is competent, there are still false positives due to other factors, all of which are outside the control of the employee. So we have a situation where people assume that because someone passes a drug test, then they must be safe. The fact is, an airline pilot can snort a line of cocaine five minutes before a drug test and pass no problem then step into the cockpit for a couple hour flight and be severely impaired. It is impairment we want to test for - not lifestyle preference. This is where performance impairment tests comes in. Impairment tests use a computer to assess the employees hand-eye coordination, and a variety of other variables that are related...

Beta2 Agonists

Studies have shown that Clenbuterol reduces fat, which would help rid lipid tissue of THC metabolities. Clenbuterol also increases metabolism. No studies have directly shown that Clenbuterol will help pass a drug test. However, provided that it reduces fat, I would assume that the fat breakdown would result in less fat soluble substances in the system. Caution Clenbuteral is labeled as a performance enhancer, and it's on the banned list for athlete testing. If are being tested as an athlete, avoid Clenbuterol

The Workplace

Drug used by adults, and the one detected in up to 90 percent of all positive drug tests (half of which are false), this fact has radical implications for current public and employer policies. I see greater negative effects in drug testing than in drug use. In my opinion, drug testing is un-American because guilt is assumed until the test proves innocence. The peoples' civil liberties are suffering. This particular privacy intrusion costs businesses 1.2 billion a year for urinanalysis of their workers. Nightbyrd has counseled several, very straight, elderly workers - close to retirement - who were fired and lost their pension benefits because they 'failed their drug test' (Jeff Nightbyrd).

Analysis of drugs and poisons

Blood and urine are the common specimens for drug analysis in both antemortem and postmortem cases. Usually, urine is used for drug screening using immunoassays at the first step secondly, the drug detected is chromatographically quantitated with blood. The data obtained are carefully assessed with taking the values reported in references into consideration together with clinical and postmortem findings the judgement of poisoning and its degree is made comprehensively.

The Antibody Component

By virtue of their high levels of specificity and binding affinities, antibodies are the ideal choice of agent for drug detection. Antibodies are produced by the immune system as weapons to eliminate invading pathogens (1). Antibodies to a specific DOA can be produced by immunizing animals with the selected DOA conjugated to a carrier protein. A carrier protein is necessary because small chemicals (DOAs) by themselves are usually not immunogenic enough (as a hapten) to elicit an antibody response (2-6). Common protein carriers for this purpose include bovine serum albumin (BSA) and keyhole limpet hemocyanin (KLH). However, this technique is not as simple as it sounds and is not for the amateur protein chemist. The type of linker used, the length of the linker used, the molar ratio of the drug to the carrier protein, and the type of carrier protein to be used are only some of the factors that must be carefully considered to achieve effective conjugation.

Chemical Abstracts Service Registry Number 125735 Type Depressant opioid class See page 24 Federal Schedule Listing

This substance is closely related to levorphanol and can produce a false positive for levorphanol in drug screen tests. The human body will transform part of a dextromethorphan dose into dextrorphan. The same transformation occurs in rats when comparing results in males and females, researchers found that a given amount of dextrorphan lasts twice as long in female rats.

Pharmacological Properties

Anti-inflammatory and analgesic effects have been revealed in several pharmacological studies of extracts of Hp and of compounds isolated from Hp 1, 14 . These studies were carried out over the years using in vivo and in vitro models for antiinflammatory or analgesic drug screening. More recently, studies of Hp extracts and constituent compounds have been performed with the aim of establishing the molecular targets within the network of cytokines, intracellular signal pathways and effector molecules that promote or mediate inflammation. The various pharmacological investigations of Hp are reviewed here. They generally support the notion that Hp extracts exert anti-inflammatory effects and provide some plausible insight into the possible mode of action of Devil's Claw as an anti-inflammatory drug.

Preliminary Screening Assays for Drugs of Abuse in Hair

Analysis for the presence of the drug opiates in hair was performed using RIA as early as 1979 (22). This was followed soon after with tests for phen-cyclidine (PCP) (23) and cocaine (24). In fact, it was the availability of RIA as an ultrasensitive analytical tool that initially prompted the pioneering testing of drugs in hair. As enzyme immunoassays develop greater sensitivity, nonradio-active immunoassays are increasingly being used for hair testing. A review of the immunological methods for testing drugs in hair from the early period to the year 2000 has been presented by Spiehler (25). MS confirmation methods took a few additional years to achieve the necessary sensitivities.

The Analytical Goal of a Drug Screening Assay

The goal of a drugs-of-abuse screening immunoassay is simpler than that of a clinical assay, which must accurately quantify normal serum components or abnormal markers over a range of concentrations. In forensic drug testing, there is usually just one standard reference, which contains the cut-off concentration of drug. Samples containing less than the cut-off drug concentration are considered negative, with no further testing required. Certain issues, such as cross-reactivity with related drugs or metabolites, which would produce unacceptable error in diagnostic clinical assays, are tolerable for workplace or other forensic screening because a second and more specific confirmatory test will be performed on the sample. precision of the signal measurement, and (3) the level of nonspecific binding. Because hair-testing laboratories often purchase well-characterized immuno-assay kits from vendors, the selection of the antibody is usually not a factor. The job of the laboratory is to...

Applications of Hair Analysis in Criminal Justice and Rehabilitation Settings

Mieczkowski et al. (57) have reported on use of hair testing as an objective measure of drug treatment outcome in a criminal justice diversionary treatment program for first-time, nonviolent offenders. Violations of the program conditions, including drug use, result in dismissal from the program. Hair samples were taken at intake to the program and at approx 2-mo intervals during the program, with random urine testing also being employed. Hair analysis at intake showed 50 of the 91 subjects positive for cocaine, 35 for marijuana, 3 for opiates, 1 for PCP, and none for amphetamines. Urinalysis done at the same time showed 12 positive for cocaine, 24 for marijuana, 1 for opiates, and none for PCP or amphetamines. These results highlight the diagnostic value of hair analysis in assessing the status of subjects as they enter a rehabilitation setting. The effectiveness of hair as a diagnostic tool in drug treatment has been discussed by Brewer (60), who noted a good correlation between...

Medical Applications of Hair Analysis

A number of investigators have applied hair testing to detect prenatal drug exposure (61-70). The retrospective power of hair analysis allows, at the time of birth of an infant, an assessment of drug intake for as long a portion of the gestation period as the length of the mother's hair specimen permits. The first example of determining prenatal drug exposure by hair analysis, reported in 1987, was that of a mother who had ingested PCP during her pregnancy (61). This study and that of Grant et al. (66) demonstrated that determining the pattern of drug usage over the term of the pregnancy by segmental hair analysis may be especially useful in evaluating effects on neurodevelopmental outcomes of varying levels of drug use during specific trimesters. Callahan et al. (67), in comparing hair, meconium, and urine analyses for identifying cocaine use in mothers, found hair and meconium (when performed by GC-MS) to be about equivalent, whereas urine was about half as effective. The Hospital...

Pending Toxicology Conference

In cases where the cause of death is not obvious, and determinations have been put on hold pending the results of toxicological testing, the toxicologist and pathologist together review the investigation, autopsy, and toxicology results. When both are satisfied that the toxicology results answer the questions pertinent to the case, a final toxicology report is issued. The need for communication and teamwork for an effective system cannot be overemphasized.1-5,223,224 Refer to Figure 4.3 summarizing the analytic strategies for drug screening in pending tox cases.

Homogeneous Competitive Immunoassays

In recent years, routine laboratory screening of drugs of abuse in urine has mainly been carried out by homogeneous competitive immunoassays. The most widely used homogeneous drug-testing immunoassay technologies include enzyme-multiplied immunoassay technique (EMIT), fluorescence polarization immunoassay (FPIA), kinetic interaction of microparticles in solution (KIMS), and cloned enzyme donor immunoassay (CEDIA). The major assay labels and the technologies are implied in the respective immunoassay nomenclature. The principle of microparticle agglutination-inhibition tests has been applied to various drug screening assay formats (11-15). One KIMS DAT format is based on the competition of microparticle-labeled drug derivatives and the free drugs in the specimen for binding to a limited amount of free antibodies in solution (14,15). The drug conjugates are labeled with microparticles through covalent coupling. These drug conjugates react with free antibodies and form particle aggregates...

Regulations and Guidelines

Globally, various guidelines for substance abuse management have been developed by government agencies, forensic societies, and clinical organizations. Some of the guidelines include more detailed technical and procedural recommendations for specimen collection and processing, initial drug screening, confirmation analysis, quality control and assurance, and documentation and result-reporting requirements. In the United States, the federally regulated drug-testing programs are implemented and administered by the Substance Abuse and Mental Health Services Administration (SAMHSA, formerly National Institute of Drug Abuse) and Department of Health and Human Services. The 1994 SAMHSA Mandatory Guidelines for Federal Workplace Drug Testing Programs (90) define initial test or screening test as an The proposed revisions for the next version of the Mandatory Guidelines (91,92) will include regulations on specimen validity testing, POCT, and alternative specimen testing. Additionally, the new...

Decentralizing Laboratory Services

In the laboratory-centric model of DOA testing, the testing process of negative and positive results is essentially indiscernible by all except those deeply engaged within the confirmation laboratory. Although the screening and confirmation laboratory are under one roof in a centralized laboratory facility, they are actually distinct in their objectives. The object of the screening laboratory is to identify which samples are negative (i.e., contain no drugs). The object of the confirmation laboratory is to identify which samples are positive (i.e., contain drugs). Nearly all laboratories utilize immunoassay testing, an inexpensive yet highly sensitive screening method capable of detecting nanogram quantities of drug analytes in a milliliter of urine. This highly sensitive method of screening, combined with automation and robotics in the laboratory, cost-effectively eliminates more than 93 of all specimens from further testing in normal workplace demographics. Criminal justice testing,...

Cannabinoidto Creatinine Ratio Studies

Regardless of the cutoff levels chosen for cannabinoids testing, substantial variabilities have been observed between subjects and between doses in the excretion profiles of THC-COOH. Huestis et al. (67) demonstrated that mean detection times in urine following smoking varied considerably between individuals even in highly controlled smoking studies. It has been documented that consecutive urine specimens may fluctuate below and above the cutoff during the terminal elimination phase when THC-COOH concentrations approach the cutoff (67,71). The normalization of drug excretion to urine creatinine concentration has been well documented not only to predict new drug use but also to reduce the variability of drug measurements attributable to urine dilution (146-150). Gustafson et al. (70) observed an up to fourfold intrasubject variation across doses and a sixfold intersubject variation for a single dose in terminal elimination half-lives. However, the authors found no significant effect of...

Benefits of a Closed Information System

Historically, in the laboratory-centric model, drug testing has been an open information system. The MRO receives laboratory data when then lab completes the specimen testing. The MRO doesn't know what they will be receiving until they receive it. The same is true for the laboratory. The laboratory receives samples each day sent from the collection site, not knowing what they will be receiving. There is no feedback loop in an open system, and the result is a lack of anticipated information and an arduous task of tracking missing specimens or results, starting at the end of process and moving forward until the problem has been identified. In the eScreen closed-loop information model, each of the parties to the transaction communicates via the Web to a common server. The donor, employer, collector, eReader, laboratory, and MRO each have access to the drug-test record in real time. Any party can access their respective portion of the record, sharing common file elements. Pre-accession...

Peroxidase Activities in Urine Adulteration

Stealth is an adulterant advertised as an effective way to beat a urine drug test. Stealth consists of two vials, one containing a powder (peroxidase) and a second one containing a liquid (peroxide). Combining the contents of both vials results in a strong oxidizing potential capable of oxidizing several drugs and metabolites. Stealth can mask detection of marijuana metabolite, LSD, and opiate (morphine) at 125-150 of cut-off values assayed by Roche OnLine and Microgenic's CEDIA immunoassay (16). Low concentration of morphine (2500 ng mL) could be effectively masked by Stealth, but not higher concentrations (6000 ng mL). Stealth also affects the GC-MS confirmation step. Cody et al. (17) reported that results of GC-MS analysis of Stealth-adulterated urine using standard procedures proved unsuccessful in several cases, and in 4 out of 12 cases, neither the drug nor the internal standard was recovered. Addition of sodium disulfite prior to extraction allowed recovery of both drugs and...

Accreditation Programs

Accreditation is playing an increasing role in the quality of work performed in forensic laboratories. It ensures that the laboratory has acceptable analytical methods, general procedures, and most important, that the standard operating procedures are followed. There are currently four organizations that offer accreditation in the field of forensic toxicology. The National Laboratory Certification Program (NLCP) is operated under private contract through the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).33 That NLCP program applies only to U.S. federally regulated testing in the specific area of forensic urine drug testing for amphetamine and methamphetamine, cannabinoids, codeine and morphine, cocaine, and phencyclidine. The College of American Pathologists also operates a voluntary program for forensic urine drugs testing, but which covers a slightly greater range of drugs of abuse in urine.34 However, the two major, broad-based accreditation programs that...

BWelfare and other Public

In 1996, Congress ended the federal welfare system as a cash assistance entitlement program. Under the new Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), cash assistance for individuals is now limited and can be conditioned on meeting job-seeking requirements and adhering to personal responsibility codes.100 One provision of the new act authorizes states to impose mandatory drug testing as a prerequisite to receiving state assistance.101 As a result, Louisiana passed a law in 1997 requiring drug testing for welfare recipients and certain public employees. (A task force subsequently decided to limit testing to only those applicants who indicated on a questionnaire that they use illegal drugs). In 1998, Florida implemented a similar system. New Jersey, Minnesota, South Carolina and Wisconsin also randomly drug test welfare recipients with felony drug convictions.102 In 1999 Michigan legislators passed a law conditioning public assistance on passing a...

Long Term Effects Drug abuse

Six cases of complications loosely related to the use of naltrexone pellet implantation during the highly controversial rapid and ultra-rapid opioid detoxification procedures have been reported (22). These included pulmonary edema, prolonged opioid withdrawal states, drug toxicity, withdrawal from cross-dependence to alcohol and benzo-diazepines, aspiration pneumonia, and death. The risk of these controversial procedures and of naltrexone in this novel delivery system are high a robust scientifically validated program of research is needed to justify such treatment packages.

Promoting Self Change Taking the Treatment to the Community

Interestingly, effective January 2007, the U.S. Centers for Medicare and Medicaid Services added two new reimbursement codes for use by Medicaid, Medicare, and other third-party payers. These codes allow providers to be reimbursed for alcohol and drug screenings and brief interventions (SBIs) in clinical settings. Bertha Madras (2006), Deputy Director of Demand Reduction from the White House Office of National Drug Control Policy, reported that the impetus behind the Medicaid decision to reimburse for alcohol and drug screening services was the recognition of the number of people who go unidentified who are in need of an intervention or treatment (Medscape Medical News, 2006). In addition to the fact that so few substance abusers seek treatment, the other compelling reason behind these two new codes appears to be financial. It is estimated that conducting alcohol and drug SBIs in clinical settings will save the federal Medicaid budget 520 million annually. Given scarce medical...

Liquid Chromatography Mass Spectrometry

A technical challenge for the design of a LC-MS instrument is the large volume of liquid (mobile phase) that must be removed before the analytes can enter the mass spectrometer, which is under vacuum, for ionization and detection. In recent years, techniques have been developed for the ionization of analyte molecules to take place outside of the mass analyzer at atmospheric pressure (i.e., atmospheric pressure ionization). The ability to have the ionization process occurring at atmospheric pressure outside of the mass analyzer is a major advantage of LC-MS over GC-MS. Two atmospheric ionization techniques in common use for drugs of abuse testing are electrospray ionization (ESI) and atmospheric pressure chemical ionization (APCI).

Chemical Adulteration

Chemical adulteration is the process of adding exogenous chemicals to the urine sample to prevent proper identification of the drug. A wide range of commercial products is available. These adulterants, often comprised of corrosive and toxic chemicals, are advertised as being able to prevent laboratories from detecting drugs or their metabolites in urine. Usually, the product consists of one or two small vials, which can be easily hidden. During collection, the user would mix the vial content with the urine sample. Many of these products offer 200 money back guarantee if they fail to beat the drug tests. Although product formulations are frequently changed to foil detection, recently developed adulterants are mostly oxidants (examples include nitrite, pyridinium chloro-chromate PCC , hydrogen peroxide, and iodine). Brands like Urine Luck , Stealth , and ADD-It-ive are most popular.

Adulteration of Urine with Nitrite Containing Agents

Klear may cause a false-negative GC MS confirmation for marijuana. ElSohly et al. first reported this product as potassium nitrite and provided evidence that nitrite leads to decomposition of ions of 9-THC and its internal standard. The authors reported that using a bisulfite step at the beginning of sample preparation could eliminate such interference (30). Tsai et al. further investigated the effect of nitrite on immunoassay screening of other drugs. These drugs include cocaine metabolites, morphine, THC metabolites (THC-COOH), amphetamine and phencyclidine. Nitrite at a concentration of 1.0 M had no effect on the Abuscreen assay. At a higher nitrite concentration, the amphetamine assay becomes more sensitive and the THC metabolite assay becomes less sensitive. The GC MS analyses of BE, morphine, amphetamine and phencyclidine were not affected while recovery of the THC metabolite was significantly reduced. Again, this interference could be eliminated by bisulfite treatment (31)....

Marriage Made in Court John N Marr

The establishment of drug courts, coupled with their judicial leadership, constitutes one of the most monumental changes in social justice in this country since World War II. Since the development of specialized drug courts in 1989, the drug court movement in the United States has swept through the criminal justice system, revolutionizing the way many court systems process drug, domestic violence, driving under the influence (DUI) driving while intoxicated (DWI), juvenile, re-entry, and mental health cases. The movement has grown from one experimental court in Miami, Florida, to more than 1000 specialty courts in operation and another 500 in some stage of planning. The federal government, through the Bureau of Justice Assistance, provided more than 45 million in direct funding for drug courts in the United States during 2003. The Office of Justice Programs initial funding proposal for drug courts during fiscal year 2004 was 68 million. Why did they do this Because drug courts work....

Drug Court Testing Protocol

Owing to the impact of drug-test results in a drug-court system, it is imperative that the testing results be accurate and timely. Because cost is the major factor in the design of most drug court testing protocols, programs utilize the most comprehensive testing protocol possible based on available resources. Protocols are designed and followed to minimize these attempts to invalidate the drug-testing portion of the drug-court program. A basic tenet of drug courts is the necessity of providing immediate responses to both negative and positive drug tests. Participants appear before the drug-court judge on a regular basis so that their progress in treatment can be reviewed, their compliance with other programs and community supervision conditions can be monitored, and their behavior can be rewarded or sanctioned. Drug-test results are vital to this process. Research has shown consistently that rapid response is more effective than delayed response where any meaningful behavior change...

Drug Testing Methodologies and Technology

As a result of the above-mentioned issues of cost and immediacy, drug courts have experimented with most of the testing methodologies in an effort to discover the most efficient means to achieve their testing agenda. Based upon the high concentration of drug metabolites present in urine, the basic ease of urine sample collection, the accuracy of urine testing, and the relatively low cost of testing a urine sample, urinalysis has become the primary choice of most drug courts. Drug courts have experimented with other matrices, such as hair, saliva, sweat, breath, and ocular scans. All of these methodologies have specific, limited value within a typical drug court. Because courts test multiple times per week and are concerned about new use, long-term methods such as sweat patches and hair testing have only minimal relevance in specific situations. Untimeliness of results, lack of long-term validity studies, and high cost have minimized the acceptance of saliva tests. Ocular scans have...

Drug Testing Volume and Cost A Mathematical Perspective

How important is drug testing to the overall drug-court experience As stated earlier, drug testing provides the objective standard by which to measure a participant's progress and level of compliance. A December 2003 report by the Bureau of Justice Assistance Drug Court Clearinghouse at American University (5) stated that 1098 drug courts were operational at that time. A 2001 Drug Court Clearinghouse study (6) reported a moving total of nearly 80,000 active participants at any given time. Using the standard model of three drug tests per week during the first 3 mo in the program, two tests per week during the next 3 mo, and once per week during the final 6 mo, the average drug-court participant is drug tested 84 times during the first 12 mo in drug court. This does not take into account that many participants do not complete Pphase I in the minimum 3-mo period and that subsequent relapses result in a return to Phase I and its more frequent testing schedule. Length of stay in drug court...

Market Volume Across Europe

In terms of market development and test utilities, the overall European market for DOA testing is still considered to be approx 10 yr behind the US market. It is believed that whereas certain European markets have been slow to accept DAT, others have shown much more enthusiasm (3,4). Data indicate that there is a noticeable discrepancy in the level of test adoption in Europe in the form of a North-South divide, as illustrated in Fig. 1. Thus, cultural differences may be one of the factors responsible for holding back the development of the European DAT market (4). Spain and France are the countries currently exhibiting the highest level of resistance to drug testing. In Spain, drug testing is viewed with caution, in both health care and non-health care environments (4). Owing to the lack of legislation and national guidelines, doctors in Spain are reluctant to carry out a DAT, unless obligatory, for fear of being implicated in legal proceedings. In France, people involved in road...

Assessment of Relative Crash Risk Following Marijuana

The data from studies that made odds ratio assessments based on the presence of the inactive THC-COOH metabolite uniformly failed to show significant differences at the p 0.05 level in rates of accident involvement for the drug-positive drivers. This can be rationalized in terms of the fact that the metabolite is inactive and that in most cases urine was being tested. Bearing this in mind, together with the fact that urine can test positive for the metabolite for many hours or even days after the effect has passed, its detection in urine is not a good surrogate for impairment, and the negative findings are not surprising. Several studies have evaluated crash risk in drivers positive for both alcohol and marijuana (THC or THC-COOH). Table 4 shows that irrespective of whether the parent drug or metabolite was measured, when combined with alcohol the odds ratio for crash involvement was between 3.5 and 11.5 (significant in all cases, p 0.05) and compared to alcohol positive cases was...

Oral Fluid and Saliva Tests

In the 2003 European Workplace Drug Testing Society (EWDTS) Symposium, held in Barcelona, the merits of oral fluid, oral mucosal transudate, and saliva as DAT matrices were debated. Although the use of oral fluid-based assays remains low, their demand is definitely on the increase in Europe (4). For example, the original British Rail Alcohol and Drug Policy recommended use of urine tests for standard DOA screening. However, at least one rail operator has already switched to using oral fluids instead, because it is more acceptable among its staff. Less invasive and intrusive than either blood or urine, testing of oral fluid may be performed under direct visual supervision. Furthermore, by eliminating the need to send the sample for laboratory analysis, less time is taken to obtain the results (12). Presence of DOA in oral-fluid samples is also more indicative of recent consumption. At present, however, the levels of sensitivity and specificity of the current generation of oral-fluid...

Immunoassay Screening

Quite often antibody specificity is influenced by the intended use of the testing. The term amphetamines is typically used to denote immunoassay testing specific for the two stimulants amphetamine and methamphetamine. Government-mandated and workplace drug testing typically specifies testing for amphetamine and metham-phetamine only. Laboratories performing workplace drug testing desire immunoassays specific for only those compounds specified in appropriate legislation or contracts. On the other hand, laboratories affiliated with an emergency department (ED) desire immunoassays directed toward the broad spectrum of sympathomimetic amines. This desire is articulated as a recommendation in the National Academy of Clinical Biochemistry's (NACB) Laboratory Medicine Practice Guidelines (LMPG) that the optimum immunoassays for amphetamines testing in ED patients are those directed toward phenylethyl amines as a class (3). These guidelines also recommend that the name of the test should be...

Syndromes Associated With Intoxication

An accurate diagnosis is of fundamental importance in the assessment of patients who may be intoxicated. A full history must be obtained in the awareness that progression to potentially fatal overdose or withdrawal syndromes may occur. The focus of physical examination should be the acute effects of intoxication (such as vital and neurologic signs) and chronic signs and symptoms associated with drug dependence (size of liver, evidence of venipuncture). Drug use within the previous 4-12 hours can be determined by analysis of blood and breath samples whereas urinalysis is useful for assessing substance use within the preceding 24-72 hours. Urinalysis is the preferred option (with the exception of determining alcohol use) though saliva testing is becoming more widely used. Immediate results can be obtained with urine testing kits suitable for use in an office or clinic.

Analytical True Positive Versus Clinical False Positive

The assumption underlying interpretation of a drug test result is the accuracy and reliability in the analysis and identification of the drug or drug metabolite present in the urine. The standard urine drug test protocol involves an initial test using a battery of immunoassays. The accuracy of an immunoassay is determined by the immunospeci-ficity of the assay antibody, and immunoassays in general do not have strict specificity for the target drug or drug metabolites. Many immunoassays have demonstrable reactivities with structurally similar compounds, some of which are not illicit drugs or are not abused. Moreover, some immunoassays may even detect substances that are structurally unrelated to the target analyte (e.g., PCP assay detects dextromethorphan) (1,2). This limitation of specificity of immunoassays is well recognized, and this awareness has led to two important tenets of urine drug testing programs (a) the positive result of an immunoassay is only a presumptive positive...

Andrea Terrell PhD William Clarke PhD Michael Evans PhD and Jennifer Collins PhD

Often in judicial trials, employment arbitration or administrative hearings positive drug tests are a factor in the proceedings. In these cases, it is important to consider the validity, or lack of validity, of the drug testing results. An expert witness in these instances is a laboratory professional who has the expertise to render an opinion regarding the validity of test results based on the information provided to them as well as information from the scientific literature. Depending on the situation, the expert's background will be in forensic or workplace drug testing. It is important for the expert witness to be familiar with testing procedures and potential interferences, the various settings where their testimony may occur, possible alternative explanations for positive results and how their testimony may be used. This chapter will discuss venues for expert testimony, provide a description of what an expert witness is, discuss preparation for proceedings where expert testimony...

How To Prepare As An Expert Witness

Because many states adhere to or model programs after the federal workplace drug testing guidelines, familiarity with those documents and applicability is necessary. The most current federal workplace drug testing guidelines can be accessed over the internet (5).

Adulteration Test Products Become a Necessity

With the spread of adulteration knowledge via the Internet, use of adulterants has increased . Hence, adulteration testing has become a necessity for guaranteeing the integrity of the drug-test process. However, laboratory-based adulterant test systems may not sufficiently detect all of the adulteration products in submitted specimens, because of the time delay involved in shipping and the quick dissemination of many newer-generation adulterants. Hence, the importance of on-site adulterant tests will increase (an example is discussed in Chapter 14). With the incorporation of adulterant test panels into lateral-flow drug test devices like the test cup, specimen integrity is established while the drug testing is being performed (an example is discussed in Chapter 12). This type of test product will become the device of choice.

Robert V House Peter T Thomas and Hemendra N Bhargava introduction

First, test materials were evaluated in vitro using murine splenic lymphocytes from B6C3F1 (C57BL 6 X C3H) hybrid mice. This hybrid strain was chosen because of the large database that exists of drug and chemical effects on immunity. The panel of immune function assays was carefully chosen to represent relevant host defense mechanisms and be adaptable to drug screening. Second, standard in vivo pharmacological models of tolerance abstinence were validated in this strain and then used for in vitro multidrug exposure studies as above.

Procedure For Body Fluid Antidepressant Test

Armbruster DA, Schwarzhoff RH, Pierce BL, and Hubster EC. Method comparison of EMIT II and ONLINE with RIA for drug screening. J Forensic Sci 1993 38 1326-1341. 5. Baselt RC. Urine drug screening by immunoassay interpretation of results, in Advances in Analytical Toxicology, Volume 1 (Baselt, RC, ed), Biomedical Publications, Foster City, CA 1984 pp. 81-123. 6. Cone EJ, Presley L, Lehrer M, et al. Oral fluid testing for drugs of abuse positive prevalence rates by Intercept immunoassay screening and GC-MS-MS confirmation and suggested cutoff concentrations. J Anal Toxicol 2002 26 541-546. 7. Ferrara SD, Tedeschi L, Frison G, et al. Drugs-of-abuse testing in urine statistical approach and experimental comparison of immunochemical and chromatographic techniques. J Anal Toxicol 1994 18 278-291. 8. Gronholm M and Lillsunde P. A comparison between on-site immunoassay drug-testing devices and laboratory results. Forensic Sci Int 2001 121 37-46. 9. Hammett-Stabler CA, Pesce AJ, and Cannon DJ....

Lorazepam methylsulfonate Lorazepam mesilate

Court of Appeals dissolved the trust. Lorillard's chief cigarettes have been Old Gold (introduced in 1926) and Kent (1952). The company, now called Lorillard, is a division of the conglomerate Loews Corporation and is headquartered in New York City. Lorimer method Ultra Rapid Opiate Detoxification. Lorinon Diazepam. Lorivan Lorazepam.

Cutoff Concentrations and Immunoassay Evaluations

Because a cutoff is the concentration of drug below which all specimens are considered to be negative, the cutoff decision has a direct impact on the detection time window and the positive rate. The most commonly used method for immunoassay performance comparisons is to evaluate the so-called true-positive (TP), true-negative (TN), false-positive (FP), and false-negative (FN) of the assay. These results can then be used to calculate the specificity TN (TN + FP) x 100 , sensitivity TP (TP + FN) x 100 , efficiency (TP + TN) (TN + FP + TP + FN) x 100 , or positive or negative predictive values of the assay. Because the criteria for either true or false are based on the comparison of immunoassay and GC MS interpretation at their respective screening and confirmation cutoff levels, the goals and strategies for balancing the relative performance around the selected cutoff concentrations are among the important considerations for designing an immunoassay for cannabinoid testing....

Normalization of Cannabinoid Urine Concentrations to Urine Creatinine Concentrations

Normalization of the cannabinoid drug concentration to the urine creatinine concentration aids in the differentiation of new vs prior cannabis use and reduces the variability of drug measurement due to urine dilution. Due to the long half-life of drug in the body, especially in chronic cannabis users, toxicologists and practitioners are frequently asked to determine if a positive urine test represents a new episode of drug use or represents continued excretion of residual drug. Random urine specimens contain varying amounts of creatinine depending on the degree of concentration of the urine. Hawks first suggested creatinine normalization of urine test results to account for variations in urine volume in the bladder (Hawks 1983). Whereas urine volume is highly variable due to changes in liquid, salt, and protein intake, exercise, and age, creatinine excretion is much more stable. Manno et al. recommended that an increase of 150 in the creatinine normalized cannabinoid concentration...

Withdrawal from Opiates

With opiate detoxification, it is particularly important to consider the indications for it, and to establish an adequate treatment plan after detoxification is completed. Chronic opioid use induces tolerance, and detoxification reduces or eliminates tolerance. Because of the loss of tolerance, detoxified opiate addicts are at increased risk of death from opiate overdose doses that they routinely self-administered previously when tolerant could now be lethal, a problem exacerbated by the variable and sometimes high potency of illicit heroin. In general, the risk of relapse following opioid detoxification is high. Therefore, patients should be assessed for overdose risk, and those with a history of past overdoses, or with multiple past relapses, should be encouraged to take agonist maintenance treatment, with methadone or buprenorphine, rather than undergoing detoxification. For those not entering agonist maintenance, a strong plan for psychosocial treatment is important, for example...

Detection of Specific Drugs in Meconium

Although meconium is more easily collectable from a newborn as compared to urine, its analysis is considerably more difficult. Before analysis, it is important that the sample be homogenized, as meconium is a non-homogenous and is a gelatinous material. The methods of analysis include immunoassays for screening and GC-MS for confirmation. Although there is no FDA-approved immunoassay for drugs of abuse testing for meconium, the laboratories generally modify commercially available urine assays for drugs of abuse. The commonly used immunoassays are RIA, enzyme multiplied immunoassay technique (EMIT), kinetic interactions of microparticles in solution, cloned enzyme donor immunoassay and fluorescence polarization immunoassay. Moore et al. (107) compared several methods of drug detection from meconium. The authors compared extraction efficiency, false-positive and false-negative rates using hydrochloric acid, phosphate buffer methanol and glacial acetic acid dipheny-lamine acetone as...

The Toxicology Examination

Occasionally, mere detection of a drug is sufficient. But, in the case of some prescription medications, the actual amount present must be quantified. A request for therapeutic drug analysis may be made even if the autopsy has already determined the cause of death. If a history of seizure is obtained, the pathologist may request an antiepileptic drug screen to determine whether or not the person was taking any such medication. The same holds true for, e.g., theophylline in individuals with asthma. An individual who has committed suicide may have been prescribed therapeutic drugs for depression or other mental illness. A test for these drugs may indicate the degree of patient compliance. In forensic toxicology, a negative laboratory result carries the same weight as a positive result. Often the nature of a suspected toxin is unknown. This type of case is termed a general unknown. 41,42 In cases of this nature, a full analysis of all available specimens by as many techniques as possible...

Gas Chromatography Mass Spectrometry

GC-MS is still the mainstay confirmation technique in drugs of abuse testing, although in recent years there has been a greater use of LC and tandem MS. The successful interface of a GC to the mass spectrometer offers the advantage of combining chromatographic separation and spectral analysis for identification of analytes. For confirmation of drugs of abuse, electron ionization is the most common form of ionization. The molecules in the ion source, which is under vacuum, are exposed to a beam of electrons, resulting in the loss of an electron from a molecule to form a positively charged molecular ion (M+). The molecular ion is usually fragmented due to the high energy of the electrons (70 eV). The fragmentation pattern (the mass spectrum) is characteristic of a molecule and can be used for identification of the compound. This can be accomplished by comparing the unknown spectrum to a library of mass spectra of known reference standards. A search algorithm helps to identify the...

Drug Testing Technologies and Applications

Over the past few decades, a remarkable gamut of increasingly sophisticated technologies has been employed for the development of drug-testing applications. Recent advancements in analytical instrumentation and computer technologies have further expanded the capabilities and dimensions for drug testing and toxicological analysis. Technologies of different chemical principles can be used sequentially or in combination to accomplish the specific goals and requirements of the drug analysis programs. Ligand-binding assays such as immunoassays are commonly used for screening. Separation techniques such as chromatography or electrophoresis, as well as their coupling with powerful detectors such as mass spectrometry, can be effectively used for confirmatory testing of preliminary positive results or systematic analysis of generally unknown toxic compounds. Each of these technology categories can be further broken down into multiple selections for instrumentations and methodologies. This...

Concerns About Accuracy of Analysis

Further complicating POCT is the shift in analysis from the laboratory to the point of collection. Decentralizing the analytical process of DOA testing places the burden of responsibility for analytical interpretation on the collector and potentially unskilled personnel. Visually read endpoints of test results, although quite simple in most pregnancy tests, is dramatically more complicated in DOA testing. Most DOA tests contain multiple analyses, testing for cannabinoid (tetrahydrocannabinol THC), cocaine, amphetamine, morphine, and phencyclidine (PCP) on one or more lateral-flow strips. Included on each lateral-flow strip is a control, ensuring that the sample has migrated across the test area. A five-drug test will have one target zone for each drug analyte and one target control zone for each strip. Hence, a two-strip, five-drug panel will have a total of seven target zones. Most competitive binding assays produce a color indicator in the absence of the analyte. However, some tests...

Concerns About Necessity of Specimen Aliquoting

Manually performed DOA tests introduce several complications to the standard model of laboratory-centric testing. The first complication in the process of testing for drugs at the point of collection is aliquoting the specimen. Although aliquoting the specimen is standard procedure in the laboratory, there are standard operating procedures (SOP) and supervisory controls to reduce the potential for contamination of the forensic specimens. In the decentralized, point-of-collection model of DOA testing, there is little standardization in the method and procedures for aliquoting or handling of the original specimen. The sealed specimen must have its tamper-evident seal broken, and the specimen exposed to allow for the introduction of the aliquoting device. The introduction of a foreign object, such as a pipet, to obtain the aliquot in an uncontrolled environment, creates a potential legal challenge to the integrity of the specimen. This concern led to the invention of the testing cup,...

Selection Of Postmortem Specimens

Drugs and their metabolites in urine results in relatively high drug concentrations, facilitating detection of an exposure to a potential poison. Immunoassays and non-instrumental spot tests can be performed directly on the urine specimen for the analysis of certain drug classes. Detection times for drugs in urine can vary from 24 h to as long as a month, depending on the drug. Thus, except for acute drug deaths where survival time is less than an hour and drugs may not yet have been excreted into the urine, urine provides an ideal matrix for the detection for the widest variety of compounds. More recently, hair has been successfully used as a specimen from which chronic drug use may be determined.59 Numerous drugs have been identified in hair including drugs of abuse60,61 and, more recently, various therapeutic agents.62,63 The usefulness of hair analysis in determining compliance remains controversial.64 However, in postmortem toxicology, segmental analysis can offer a temporal...

Cannabinoids Pharmacokinetics and Drug Analysis

Metabolic Transformations

Chemical structure of naturally occurring cannabinoids. 21 CFR 862.3870 defines a cannabinoid test system as a device intended to measure any of the cannabinoids, hallucinogenic compounds endogenous to marihuana, in serum, plasma, saliva, and urine. Cannabinoid compounds include A9-tetrahydrocannabinol, cannabidiol, cannabinol, and cannabichromene. Measurements obtained by this device are used in the diagnosis and treatment of cannabinoid use or abuse and in monitoring levels of cannabinoids during clinical investigational use. Fig. 1. Chemical structure of naturally occurring cannabinoids. 21 CFR 862.3870 defines a cannabinoid test system as a device intended to measure any of the cannabinoids, hallucinogenic compounds endogenous to marihuana, in serum, plasma, saliva, and urine. Cannabinoid compounds include A9-tetrahydrocannabinol, cannabidiol, cannabinol, and cannabichromene. Measurements obtained by this device are used in the diagnosis and treatment of cannabinoid use or...

Methods for determination of nontcas

There is no reliable spot test for commonly used non-TCAs. Also, currently there are no widely used immunoassays for non-TCAs. Chromatography techniques are most common, and well-established techniques are available for measurements as either a single drug or a group. Most of these antidepressants are well detected during comprehensive drug screening performed by using GC or HPLC.

Analytical Chemistry In Postmortem Toxicology

Immunoassay technology, now a mainstay of drug screening protocols, first became commercially available only about 25 years ago.10-14 At that time, classical thin-layer chromatography (TLC),15-23 packed column gas chromatography,24,25 strip chart recorders, and ultraviolet-visible spectrophotometry were the state of the art in toxicology laboratories.26-29 Over the intervening years, capillary column gas chromatography,30-44 solid-phase extraction technology,46-53 nitrogen-phosphorus gas chromatography detectors,42,43,54,55 high-performance liquid chromatography (HPLC),56-74 ion trap mass spectrometry,75-79 and computerized mass spectrometry have become essential to the practice of postmortem toxicology.80,99

Household Chemicals as Urine Adulterants

Simple household chemicals are found to be effective adulterants of urine drug tests. These include table salt, vinegar, liquid laundry bleach, concentrated lemon juice, and Visine eye drops (8,9). The effectiveness of these chemicals on specific drug tests is summarized below. Amphetamines sodium chloride at a concentration of 75 gm L of urine caused a false-negative drug test in a urine specimen containing 1420 ng mL of amphetamine. Similarly, Drano (bleach SC Johnson & Son) at a concentration of 18 mL L masked a urine specimen containing 1800 ng mL of amphetamines by EMIT assay. Benzodiazepines Visine, hand soap, and Drano caused false-negative tests with benzodiazepines at concentrations less than 6500 ng mL. authors tested these adulterating agents at 10 by volume concentration of urine. Out of six drugs tested (cocaine metabolite, amphetamines, opiates, phencyclidine, cannabinoid, and barbiturates), it was found that the cannabinoid test was the most susceptible to adulteration...

Common Household Chemicals as Urinary Adulterants

People try to beat drug testing by adding adulterants into urine specimens. Several adulterants can cause false-negative results in drug testing by immunoassays. Common adulterants for masking drug testing are as follows and detection of these adulterants by specimen integrity tests is given in Table 2. 6. Visine eye drops. Visine eye drops Schwarzhoff and Cody studied the effect of 16 different adulterating agents ammonia-based cleaner, L-ascorbic acid, Visine eye drops, Drano, Golden Seal root, lemon juice, lime solvent, Clorox, liquid hand soap, methanol, sodium chloride, tribasic potassium phosphate, toilet bowl cleaner (Vanish, Drackett Products), white vinegar, ionic detergent (Multi-Terge) and whole blood anticoagulated with EDTA on FPIA analysis of urine for abused drugs. The authors tested these adulterating agents at 10 by volume concentration of urine with the exception of Golden Seal because of the insolubility. For Golden Seal tea, one capsule was suspended in 60 mL...

Correlation of Results From Cannabinoid Immunoassay and GCMS Analysis

Thc Cooh Half Life

A number of studies have been conducted to investigate how well results from cannabinoid immunoassays can correlate to GC MS analysis and or to select an appropriate cutoff value for each of the initial test methods (99-105). In all cases the general correlations exist, yet the data points could be rather scattered. Generally speaking, the correlation coefficients are more sensitive to the change of sample groups, in which the distributions in the relative concentrations of THC-COOH and other cross-reacting compounds varies. The relative concentrations of THC metabolites in plasma and urine have been studied to determine if a temporal relationship could be estimated between marijuana use and metabolite excretion (65,69). With the addition of the P-glucuronidase hydrolysis step in the extraction protocol, the presence of significant quantities of THC and 11-OH-THC in urine could be demonstrated (69). The relative concentrations of THC-COOH and 11-OH-THC can be shown in a scatter plot...

Behavior of Tac1 and NK1R Knockout Mice in Models of Depression

The two most widely employed animal models for antidepressant drug screening are the behavioral despair models of depression, such as the forced-swim (Porsolt 1997 Porsolt et al. 1977b) and tail-suspension tests (Steru et al. 1985). These models are based on the observation that rodents, when forced into an aversive situation from which they cannot escape, will rapidly cease attempts to escape and become immobile. Although the relationship between immobility and depression remains controversial (Gardier and Bourin 2001), drugs with antidepressant activity generally reduce the time in which the animals remain immobile (Borsini and Meli 1988 Porsolt et al. 1977a). Both the forced-swimming test and the tail-suspension test are conceptually similar, but they seem to be controlled by different sets of genes. A recent quantitative trait loci (QTL) study has identified several genetic links to the propensity of behavioral despair using the same assays (Yoshikawa et al. 2002)....

Pyridinium Chlorochromate As a Urine Adulterant

Besides simple household chemicals, more sophisticated substances are advertised commercially as adulterants for urine drug tests. Wu et al. (13) reported that the active ingredient of Urine Luck is 200 mmol L of pyridinium chlorochromate (PCC). The authors reported that Urine Luck caused a decrease in response rate for all EMIT II drug screens and for the Abuscreen morphine and THC assays. In contrast, Abuscreen amphetamine assay produced a higher response rate, and no effect was observed on the results of BE and PCP. This adulteration of urine did not alter GC-MS confirmation of methamphetamine, BE, and PCP. However, apparent concentrations of opiates and THC were reduced.

Amitava Dasgupta PhD

Adulteration of Hair and Saliva Specimen for Drug Testing Persons abusing drugs attempt to adulterate urine specimens in order to escape detection. Household chemicals such as bleach, table salt, laundry detergent, toilet bowl cleaner, vinegar, lemon juice and Visine eye drops are used for adulterating urine specimens. Most of these adulterants except Visine eye drops can be detected by routine specimen integrity tests (creatinine, pH, temperature and specific gravity). However, certain adulterants such as Klear, Whizzies, Urine Luck and Stealth cannot be detected by using routine specimen integrity testing. These adulterants can successfully mask drug testing if the concentrations of certain abused drugs are moderate. Several spot tests have been described in the literature to detect the presence of such adulterants in urine, and recently, urine dipsticks are commercially available (AdultaCheck 4, AdultaCheck 6, Intect 7 and MASK Ultrascreen) for detecting...

Punishment For Making And Distributing Mdma

Until the last few years, drug trafficking of MDMA was not punished as severly as many other drugs of abuse. However, the Ecstasy Anti-Proliferation Act of 2000 increased the guideline sentence for the trafficking of 800 MDMA pills by 300 percent, from 15 months to 5 years. The penalty for trafficking 8,000 pills was increased by nearly 200 percent, from 41 months to 10 years.30 Penalties for sale or possession of MDMA may vary by state, but can be punishable by 3-5 years in prison for a single offense. However, in many jurisdictions drug courts have been set up in an attempt to direct drug abusers into treatment and counseling, rather than simply sending addicts to prison. Frequent court dates and court-mandated treatment programs have been extremely successful in aiding addicts in the process of rebuilding their lives.