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.

1. Table salt.

2. Household vinegar.

3. Liquid laundry bleach.

4. Concentrated lemon juice.

5. Golden Seal tea (produces dark urine).

6. Visine eye drops.

AlthoughFPIA is less subjected to interference from adulterants compared to the EMIT, some interference has also been reported with FPIA. Sodium chloride caused negative interference with all drugs tested by EMIT and caused a slight decrease in measured concentrations of benzodiazepines by FPIA. Sodium bicarbonate caused false positive with an EMIT opiate assay and with a PCP assay by FPIA. Hydrogen peroxide caused false-positive benzodiazepine results by FPIA (16). Uebel and Wium studied the effect of

Table 2

Common Household Adulterants and Specimen Integrity Tests

Specimen integrity testsa

Household chemicals pH Creatinine Temperature Specific Gravity

Table 2

Common Household Adulterants and Specimen Integrity Tests

Specimen integrity testsa

Household chemicals pH Creatinine Temperature Specific Gravity

Sodium chloride

X

Vinegar

X

Laundry bleach

X

Liquid soap

X

Cloudy

Drano

X

Golden Seal

Dark Urine

Visine eye drops

X-denotes measurable change. aAbnormal test indicative of the adulterant.

X-denotes measurable change. aAbnormal test indicative of the adulterant.

household chemicals sodium hypochlorite, Dettol (chloroxylenol), glutaraldehyde, Pearl hand soap, ethanol, isoproponal and peroxide on cannabis and methaqualone tests using EMIT assays. Most of the agents tested interfered with the tests, and the greatest effect was observed with glutaraldehyde and Pearl hand soap for methaqualone (false negative). Dettol and Pearl hand soap also caused false-negative results in cannabis tests. Addition of isoproponal, ethanol and peroxide invalidated methaqualone tests (17).

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 urine. Out of six drugs tested (cocaine metabolites, amphetamines, opiates, phencyclidine, cannabinoid and barbiturates), the cannabinoid test was most susceptible to adulteration. Approximately half of the agents (ascorbic acid, vinegar, bleach, lime solvent, Visine eye drops and Golden Seal) tested caused false negatives. Both cannabinoid and opiate assays were susceptible to bleach, and actual degradation of THC was confirmed by GC/MS analysis. The PCP and BE (the metabolite of cocaine) analysis were affected by alkaline agents (18). Baiker et al. reported that hypochlorite (a common ingredient of household bleach) adulteration of urine caused a decreased concentration of THC as measured by GC/MS. A false-negative result was also observed with the FPIA screen as well as the Roche Abuscreen (19). Another report described adulteration of urine specimens with denture cleaning tablets (20).

The ability of Visine eye drops to cause false-negative drug testing in the screening phase of the analysis is troublesome because the presence of components of Visine eye drops in adulterated urine cannot be detected by routine specimen integrity testing or any routine urine analysis. Pearson et al. studied in detail the effect of Visine eye drops on drugs of abuse testing as well as the mechanism by which components of Visine eye drops produce false-negative drug testing results. Visine eye drops are effective in causing false-negative result in the analysis of the THC metabolite 11-nor-9-carboxy-delta 9-tetrahydrocannabinol. The GC/MS analysis showed that there was no modification in the structure of THC metabolite by the components of Visine eye drops. At low concentrations of Visine eye drops, the false-negative cannabinoid result was due to the benzalkonium chloride ingredient of Visine. Visine decreased the THC assay results in both EMIT-d.a.u. assays and Abuscreen (Abbott Laboratories, Abbott Park, IL) although Visine had no effect on glucose 6-phosphate dehydrogenase-drug conjugate used in the EMIT assay. Results of ultrafiltration studies with Visine eye drops suggest that the THC metabolite partitions between the aqueous solvent and the hydrophobic interior of benzalkonium chloride micelles, thus reducing the availability of THC metabolite in antibody-based assay (21). Visine eye drops and Ben Gay ointment can also cause false-negative drug testing with sweat testing (22). Components of Visine eye drops in urine may be detected by using high performance liquid chromatography combined with UV detection at 262 nm, a method originally developed for analysis of ophthalmic formulations (23).

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