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The Value of Innovation
© by DOA_Consulting 2000
Chain of Custody
and Adulteration
The Value of Innovation
© by DOA_Consulting 2000
DefinitionDefinitionDefinitionDefinition
Reproduceability and Traceability of all Actions related to the Urine Specimen or the analytical Result
Security of Test Results
The Value of Innovation
© by DOA_Consulting 2000
ProceduresProcedures
Sample CollectionStorage
TransportStorage
AnalysisInterpretationConfirmationReporting
Documentation: Who?, Where?, When?, What?, How?
The Value of Innovation
© by DOA_Consulting 2000
Sample CollectionSample Collection Collection under sight if possible No jackets, bags, etc. allowed at collection site Patient should wash hands before donation Use special toilette for urine collection No soap at collection site No hot water at collection site Left hand in the neck Coloured rinse water Look for possible adulterants at the toilette Split B-specimen Immediate pH and temperature measurement Seal collection vessel; patient should sign vessel Store sample in locked fridge or freezer
The Value of Innovation
© by DOA_Consulting 2000
Collection Form 1Collection Form 1
The Value of Innovation
© by DOA_Consulting 2000
Collection Form 2Collection Form 2
The Value of Innovation
© by DOA_Consulting 2000
Transportation & Storage
Transportation & Storage
Storage:Restricted AreaCooled or frozenPhotosensitivity
of some drugs
TransportationSealed shipping boxLogbook
ID of all SpecimenSignature of Collection siteSignature of TransportTransport (Batch) ID
The Value of Innovation
© by DOA_Consulting 2000
Transportation Form
Transportation Form
The Value of Innovation
© by DOA_Consulting 2000
CoC FormCoC FormPatient Name and/or IDCollection Information:
Name of responsible supervisor at collectionName of requesting personNames of all persons having access to the specimenComments regarding specimen
Laboratory InformationDate and time on arrival to the LabName of person who receives the specimen within the labRequested ParameterName of Person who does the analysis/validates the resultsResults: immunological or confirmation, ev. with Cut-off values
The Value of Innovation
© by DOA_Consulting 2000
Results Form
Results Form
The Value of Innovation
© by DOA_Consulting 2000
CoC Laboratory Procedures
CoC Laboratory Procedures
CoC Form: control for signatures and sealsSpecimens to be stored in secured areaFull documentation of specimen entryLog of calibration dataLog of control dataPatient ID should be coded not identified by Pat. NameEv. Confirmation analysis (as requested)In case of pos. result: store specimen over agreed timeframe
The Value of Innovation
© by DOA_Consulting 2000
CoC Reporting Procedures
CoC Reporting Procedures
Declare reporting options with customerAvoid any transmission of results via phoneUpon transmission via fax, email or network printers:
check privacyDeliver hardcopies in anywaySend completed CoC form
The Value of Innovation
© by DOA_Consulting 2000
Collection DevicesCollection Devices
Specimen Collection Kits with implemented temp or pH control
pH stripsElectron. Thermo probes / one way thermo-sticksSealsLabelsTransport boxes
The Value of Innovation
© by DOA_Consulting 2000
Drug Testing Programm in your Company ? Yes ?Mary Jane Superclean 13 wipes off all dirty results from the Analyser !Dial: 1-800-TEST-CLEAN
Radio commercial, Feb.1994, Cal., USA
The Value of Innovation
© by DOA_Consulting 2000
Adulteration - Why?
Purpose of adulterantsA negative result from a sample that
contains drugTo generate an invalid result Force a retest, time to “get clean”
Specimen sources Urine Hair (cleansing shampoos & conditioners)
The Value of Innovation
© by DOA_Consulting 2000
Adulteration – Mode of Action
External adulterationCommercial products: Nitrites, GlutaraldehydeVinegar, soap, lemon juice, Visine, bleach
Internal adulterationCleansing drinks, teas, powders, herbal capsules,
diureticsVitamin B and Creatine
Substitution Drug-free urine (internal/external)
The Value of Innovation
© by DOA_Consulting 2000
External Adulteration - Products
WaterApple, Lemon JuiceVinegarSaltVitamin C
BleachAftershaveKaolin - PectinGlutaraldehyde (UrinAid)Nitrites (KLEAR)
The Value of Innovation
© by DOA_Consulting 2000
External AdulterationInterfere with screening test method
Produce false negativeRates lower than cutoff or negative
calibratorProduce invalid result
Increased Initial absorbance (A0)Absorbance flags / Invalid result flags
Interfere with GC/MS (Nitrites)
The Value of Innovation
© by DOA_Consulting 2000
External Adulteration - Markers
pHPresence of Nitrites or GlutaraldehydeSmellFoaming, when swirledColor / appearance
The Value of Innovation
© by DOA_Consulting 2000
Internal Adulteration Urine dilution Of greatest benefit in borderline positive samples Most of these products require drinking a lot of fluids
with the product Refrain from use of “toxins” for 24-72 hours prior to
testing Self over-hydration
Water loading Over-hydration
Carbohydrate-based “detoxification/purification” productsDiuretics - herbal productsAcidic beverages
The Value of Innovation
© by DOA_Consulting 2000
Internal Adulteration - Markers
Urine markers for dilutionCreatinineSpecific GravityOsmolality
Most commercial adulterant products contain Creatine and Vitamin B complex
JJ J
J JJ
J
J J J
J
J
J
J J J J J
J
J
J J J
-60 -30 0 30 60 90 120 150 180 2100
1
2
3
4
5
6
7
8
9
10
Urineproduction
rate(mL/min)
Drink 1 L. water
Time (min)
Urine Production Rate After Water Loading
Baldes and Smirk, 1934
The Value of Innovation
Drink 2 L. water
J
JJJ
JJJ
J
JJ
J
0
2
4
6
8
10
12
14
16
18
0 50 100 150 200 250 300
Urine Production Rate After Water Loading
Urineproduction
rate(mL/min)
Time (min)Macallum and Benson, 1909
The Value of Innovation
JJ
JJ
J
J
1
1.005
1.01
1.015
1.02
1.025
1.03
-150 -100 -50 0 50 100 150 200 250
Specificgravity
Time (min)
Drink 1 L. water
Urine Specific Gravity After Water Loading
Gounden and Newall, 1983
The Value of Innovation
The Value of Innovation
Drink 1.0 L water (
G
GG
G
G
G
J
JJ
J
J
J
0 1 2 3 4 50
20
40
60
80
100
120
140
160
180
200
Creatinine(mg/dL)
Time (hr)
Drink 0.5 L water ( G)
J )
Effect of Water Consumption on Urinary Creatinine
LaFolie et al., 1991
The Value of Innovation
© by DOA_Consulting 2000
Recommendations
Observed and controlled collections (EA) Minimize time limit for specimen collection - one hour or less (IA) Do not allow donor to drink more than one liter of liquid, and
preferably not all at once (IA) Check the temperature of the urine (Substitution) Include testing methods in screening procedure (IA / EA)
Creatinine Specific Gravity pH Nitrites Glutaraldehyde
The Value of Innovation
© by DOA_Consulting 2000
Adulteration Products Substitute drug free urine is available, in concentrate form
Most of the adulterants purchased offered money back guarantees,
in some cases double your money, upon receipt of official
unsatisfactory results
All claim to work for all drugs, unless otherwise stated such as
Whizzies, which only works for THC
Adulteration products tend to change frequently, while the name
remains the same
All of these products are quite expensive, US$30-50 average
The Value of Innovation
© by DOA_Consulting 2000
Clear Choice Instant Clean ADD-IT-ive
EXTRA STRENGTH
Appears to contain sodium nitrite Manufactured by HEALTH TECH
Instructions: “Add entire contents of vial into
sample then urinate.”
Not for human consumption.
“Not intended to be used for
lawfully administered urine tests.” is
printed on outer bottle.
The Value of Innovation
© by DOA_Consulting 2000
Terminador Pure
Contains nitrites or glutaraldehyde Manufactured by ONE-STOP, Inc. Customer service 1-800-539-1926
Instructions: Just add contents of bottle into 4 oz. Of
liquid for Pure to work.
“Compare to URINE LUCK & WHIZZIES”
The Value of Innovation
© by DOA_Consulting 2000
A SCIENTIFIC BREAKTHROUGH
KLEARTHE ULTIMATE PURIFIER IN 2 MICRO-TUBES
Clear crystals packaged in two small “micro-tubes”
Used to contain sodium nitrite, may be glutaraldehyde now Distributed by ITG, Inc.
For large samples of more than 4 oz, use two tubes
If kept away from moisture, remains potent for up to 2 yrs. Not sensitive to heat or cold
Instructions: Add contents of one tube of KLEAR
to each urine sample. KLEAR dissolves almost instantly. Swirl your urine for a complete mix.
For best results on urine tests, drink at least a quart of any liquid the day of the test. (Herbal teas are no better than water or coffee). If possible, take a 50mg B vitamin to turn your urine a nice golden color and impress the tester.
The Value of Innovation
© by DOA_Consulting 2000
WHIZZIES
Indications for use: Keep on hand for surprise attacks by piss testers at work
Do not eat WHIZZIES or expose to open flame
“There is a drug war going on, and Smoke Screen Laboratories guarantees nothing.” is printed on insert
Contains sodium nitriteDistributed by ITG, Inc.Manufactured by Smoke
Screen Laboratories
Instructions:Add one vial to 45-60mLs of
urine. In case of split samples, add before specimen is divided
The Value of Innovation
© by DOA_Consulting 2000
Tommy Chong’s URINE LUCK Vial of yellow liquid, looks like
Terminador Pure or Clear Choice
Manufactured/distributed by Spectrum Laboratories
Photo of Tommy Chong (of Cheech and Chong fame) with a dialogue bubble “It works for me, it will work for you!”
Contains sodium nitrite Do not store in sunlight
Instructions: Urinate 1-2 times before test. Add one vial to 3-5 oz (90-150mLs)
of urine. Use half vial for less than 3 oz (90mL) of urine.
Do not use with other detoxifying products, an do not drink more than 16oz of water on day of test. Mix slightly.
Special Note: Please call yearly to obtain the latest product formulation. Older formulations can be exchanged free of charge
The Value of Innovation
© by DOA_Consulting 2000
ResourcesWebsitesNORML (National Organization for the Reform
of Marijuana Laws)Informational pamphlets/publications
UR-INE TroubleConquering the Urine TestsSteal This Urine TestHigh Times MagazineDrug Test Digest
Many of these distributors have their own newsletters
The Value of Innovation
© by DOA_Consulting 2000
Websiteswww.peretto.comwww.urineluck.comwww.hightimes.comwww.testclean.comwww.testingfree.comwww.youreclean.comwww.testpure.comwww.cleartest.com