With the developments of reliable sweat collection devices and sensitive analytical methods, interest in sweat drug testing has increased over the years. The advantages of sweat analysis for drugs of abuse include continuous drug monitoring for a longer period of time (from a few days to a few weeks) and less invasive and easy process of sample collection. Passive diffusion is thought to be the major mechanism of drugs transport in sweat. Sweat may be collected as liquid perspiration on sweat wipes or with a sweat patch. Sweat patches are commercially available and may be worn for extended period of time. They are waterproof, tamper resistant, comfortable to wear and are generally acceptable by patients. In contrast to urine testing to monitor compliance that requires three sample collections per week, sweat patch worn for 7-14 days provides continuous monitoring for the whole time period.

Sweat testing has been shown to be useful in drug treatment and work place drug testing programs (81,82). SAMHSA-proposed screening and confirmation cutoff concentrations in sweat for various drugs of abuse are shown in Tables 6 and 7 (3). As cutoff values are significantly lower than urine, sensitive methods are needed for sweat testing. Similar methods that are used for urine, hair and oral fluid testing such as immunoassays, GC-MS and LC-MS are frequently used for sweat testing.

Before the application of the sweat patch, the skin should be thoroughly cleaned with an organic solvent such as isopropyl alcohol to remove any dirt, skin oils or skin care products such as lotions and creams. Once the patch is in place, it is difficult to contaminate, as the outer polyurethane layer is impermeable to molecules larger than water. Contaminants applied to the outer layer do not reach the collection pad (83).

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