Adulterants

SAMHSA guidelines require additional tests for urine specimens with abnormal physical characteristics or ones that show characteristics of an adulterated specimen during initial screening or confirmatory tests (non-recovery of internal standard, unusual response and so on). A pH less than 3 or more than 11 and nitrite concentrations greater than 500 ^g/mL indicate the presence of adulterants. A nitrite colorimetric test or a general oxidant colorimetric test can be performed to identify nitrite. These criteria are summarized in Table 3. Similarly, the presence of chromium can be confirmed by a chromium colorimetric test or a general test for the presence of oxidant. A confirmatory test can be performed using multi-wavelength spectrophotometry, ion chromatography, atomic absorption spectro-photometry, capillary electrophoresis or inductively couples plasma mass spectrometry. The presence of halogen (chloride, fluoride or bleach) should be confirmed by a halogen colorimetric test or a general test for the presence of oxidants. Confirmatory tests may employ multi-wavelength spectrophotometry, ion chromatography, atomic absorption spectrophotometer, capillary electrophoresis or inductively couples plasma mass spectrometry. The presence of glutaraldehyde should be detected by a general aldehyde test or the characteristic immunoassay response in one or more drug immunoassay tests for initial screening. The presence of PCC should be confirmed by using a general test for the presence of oxidant and a GC/MS confirmatory test. The presence of a surfactant should be verified by using a surfactant

Table 3

Identification of Adulterated and Substituted Specimens Following SAMHSA Guidelines

Parameter

Diluted specimen Adulterated specimen

Substituted urine

Creatinine pH

Specific gravity Nitrite Chromium PCC

Glutaraldehyde Halogen (Chloride, fluoride, bleach)

Surfactant

>50 pg/mL chromium (VI) equivalent or 200 pg/mL nitrite equivalent Present

Halogen colorimetric test/ >200 pg/mL nitrite equivalent/

>50 pg/mL chromium equivalent

Colorimetric test with >100 pg/mL

dodecylbenzene sulfonate equivalent

PCC, Pyridinium chlorochromate; SAMHSA, Substance Abuse and Mental Health Services Administration.

colorimetric test with >100 pg/mL dodecylbenzene sulfonate equivalent cut-off. Jones et al. described a modified methylene blue procedure for detection and quantitation of surfactants in urine. Based on the analysis of negative samples, an anionic surfactant level of 100 pg/mL or greater could be considered adulterated but most likely such specimens will have levels greater than 800 pg/mL (46).

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