Effect of urine adulterants on commercial drug abuse screening test strip results

Ivana Rajšić 1 , Dragana Javorac 2 , Simona Tatović 2 , Aleksandra Repić 2 , 3 , Danijela Đukić-Ćosić 2 , Snežana Đorđević 4 , 5 , Vera Lukić 6 ,  and Zorica Bulat 2
  • 1 University of Novi Sad, Faculty of Medicine, Department of Pharmacology, Toxicology and Clinical Pharmacology, Novi Sad, Serbia
  • 2 University of Belgrade, Faculty of Pharmacy, Department of Toxicology “Akademik Danilo Soldatović”, Belgrade, Serbia
  • 3 Serbian Institute for Occupational Health “Dr Dragomir Karajović”, , Belgrade, Serbia
  • 4 Poison Control Centre, Military Medical Academy, , Belgrade, Serbia
  • 5 Medical Faculty, Military Medical Academy, University of Defence, Belgrade, Serbia
  • 6 Institute of Forensic Medicine, Faculty of Medicine, University of Belgrade, Serbia

Abstract

Immunochromatographic strips for urine drug screening tests (UDSTs) are common and very suitable for drug abuse monitoring, but are also highly susceptible to adulterants kept in the household, which can significantly alter test results. The aim of this study was to see how some of these common adulterants affect UDST results in practice and whether they can be detected by sample validity tests with pH and URIT 11G test strips. To this end we added household chemicals (acids, alkalis, oxidizing agents, surfactants, and miscellaneous substances) to urine samples positive for amphetamine, 3,4-methylenedioxymethamphetamine (MDMA), tetrahydrocannabinol, heroin, cocaine, or benzodiazepines (diazepam or alprazolam) and tested them with one-component immunochromatographic UDST strips. The UDST for cocaine resisted adulteration the most, while the cannabis test produced the most false negative results. The most potent adulterant that barely changed the physiological properties of urine specimens and therefore escaped adulteration detection was vinegar. Besides lemon juice, it produced the most false negative test results. In conclusion, some urine adulterants, such as vinegar, could pass urine specimen validity test and remain undetected by laboratory testing. Our findings raise concern about this issue of preventing urine tampering and call for better control at sampling, privacy concerns notwithstanding, and better sample validity tests.

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