Urine Collection

The quality of testing, be it for clinical or forensic purposes, can only be as good as the quality of the specimen. Hence, individuals who want to escape detection of their drug use would attempt to tamper with the testing process to produce negative test results. Various attempts to accomplish this include substitution with negative urine, dilution of the urine so that drug concentrations fall below the cutoffs, and addition of various chemicals to either inactivate the assays or chemically modify the analytes so that they become "invisible" to the initial and confirmation tests. Urine specimens can be easily tampered with and the collection protocol must be designed to deter and detect attempts at tampering. An observed collection is the most effective way to guard against attempts at tampering, but it is invasive and is objectionable to both the donor and the collector. Simple procedures, such as visual inspection for unusual appearance and taking specimen temperature, are used in all collection protocols to assess the validity of a urine specimen, and these can be supplemented with urine creatinine and specific gravity measurements. SAMHSA and DOT have published urine specimen collection guidance documents (53,54), and SAMHSA has promulgated a set of definitions for specimen validity and also laboratory tests to assess validity (55). Although these are specific requirements for the Federal Drug Testing Programs, many of the procedures can be adapted for use in nonregulated workplace or clinical testing programs (also see Chapter 17).

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