In the classroom, kids get caught cheating on a test by looking over someone's shoulder. When it comes to a drug test, cheaters get caught because someone is looking over their shoulder. In the United States alone, over 50 million drug tests are administered annually. And just like classmates who “forget” to study, some struggling with addiction are inclined to cheat on a drug test when they already know what the results will be. In fact, some manner of cheating may occur on 1 to 2 percent of drug tests, according to Bill Current, director of the Institute for a Drug-Free Workplace. That translates to over 1 million phony or adulterated samples every year. However, Current contends that properly administered drug tests remain a valuable tool to combat substance abuse. “It can be a powerful deterrent to future drug use and a very effective way to identify people who need help,” he says. “Once they are discovered, it opens up the opportunity to provide assistance that they might not otherwise be able to accept. But people who are in the throes of drug abuse will do almost anything [to pass].” For this reason, test administrators must remain vigilant by maintaining appropriate precautions, ensuring test validity, and establishing firm consequences. As they try to improve the process associated with traditional lab-based urine testing, some are incorporating new methodologies such as rapid-result and oral fluid testing. Tricks of the trade Today there are countless websites that promise successful cheats for desperate donors. A quick Google search for “how to cheat on a drug test” returns almost 600,000 matches. Despite the apparent variety of elaborate and often bizarre techniques, virtually all cheats are based on three basic approaches: dilution, substitution and adulteration. Dilution involves drinking large amounts of liquid (usually water) to dilute the drug concentration in a urine sample. While a diluted sample does not automatically mean the individual is a drug user, labs will usually report the specimen as unfit for testing. Some rapid-result urine testing devices even have built-in strips to verify the concentration level of the sample. Substitution methods are just that-switching the subject's urine with that of someone (or something) else. “There are lots of ways to go about getting a sample for substitution,” explains Current. “A person could borrow urine from another person-his wife, a friend or even one of his children. A sample of supposedly clean urine can be purchased online for around $50, while synthetic samples have price ranges that are all over the place.” Some people have resorted to injecting someone else's urine directly into their bladder, or even using animal urine. Of course, the actual substitution can be problematic. The substitute urine might be dirty, or the container with the substitute urine might break or leak before it can be poured into the collection vial. With the “adulteration” (or “additive”) method, a liquid is added to the specimen after it has been voided. Many household products are purported to mask the presence of drugs in a sample: bleach, vinegar, eye drops, various juices, dish soap, even drain cleaner. And, a variety of commercially available products promise similar results. However, adulteration is difficult, since it requires the donor to smuggle the substance into the bathroom, concealed in clothing or on the body. But desperate people find ways. Many drug users have heard of the “two pairs of underwear” method for smuggling vials of substitute urine or adulterating agents. By hiding a vial between two pairs of underwear, cheaters claim to get past body searches, even when they must leave their jackets or purses behind. Other would-be cheats suggest the use of prosthetics filled with clean urine or synthetic substitutes, which can then be used to mimic the process of voiding a sample. “There are a variety of different products out there [to help cheaters],” Current explains, noting a variety of pills, liquids, or devices for sale. “We laugh because some of these things are absolutely ridiculous, but there are people out there who are desperate enough to try them. And some of them work-and work very effectively.” Cheaters beware Despite the wide variety of possible methods, cheating on a drug test is still not easy. But it does happen. And, these cheats are most often successful when drug test administrators fail to take the threat seriously. With that in mind, there are several precautions that should be taken. “When collecting urine samples for testing, make sure that the collection site is secure-not just the stall where the collection is going to take place, but outside the area as well,” suggests Current. “In addition, the donor should be required to wash his or her hands prior to voiding the sample and leave outer clothing such as coats and jackets outside the stall.” Considering oral fluid testing? Often preferred by test administrators. Eliminates gender-related differences in test method. Far fewer precautions are required than with urine testing. Sample collection is easily observed and free of embarrassment. “Shy bladder” issues and the “yuck” factor of urine testing are eliminated. Lowers the risk of cheating by sample adulteration, dilution, or substitution. Scientifically accurate; more effective at detecting recent use. Method is legally defensible and considered reliable. It has been upheld in court. Source: Orasure Technologies Inc. Other common precautions include adding a colored dye to toilet water in the donor stalls, turning off running water (or hot water) during the collection process, and reading the temperature of all samples immediately after voiding. Of course, physically observing the donor voiding their sample is always an effective precaution. “When donors are not being observed, they will sometimes peel the temperature strip from the collection vial,” Current explains. “They apply it to their forehead or wrist until the temperature reads within a normal range. Then they reapply it to the vial, which probably contains a substituted sample. If no one is paying attention, they might get away with that.” To detect if a specimen was diluted, adulterated or substituted, a validity test can be conducted for each collected specimen. This can take place at the lab or onsite by utilizing one of several commercially available validity testing devices. For urine samples, labs primarily look at two factors to confirm the validity of a specimen: the creatinine level (which is present in all urine) and the specific gravity (which refers to the urine's density). Dilute specimens will have creatinine and specific gravity values that are lower than the norm for human urine. Values for substituted specimens are typically too diminished or divergent to be consistent with human samples. “There is a lot of science behind these tests and the labs go to great lengths to detect samples that are outside a normal reading,” says Current. “It is a legitimate way to determine if a sample has been tampered with in some way, but it's certainly not foolproof. Cheaters know how to dilute and tamper with their urine samples to get them below the drug detection cutoffs and still fall within an acceptable range.” Testing alternatives While most organizations continue to rely on lab-based urine tests, alternative methods are becoming more popular, most notably oral fluid drug testing. One important reason is that oral fluid testing significantly reduces concerns about adulteration, dilution, and substitution. Another is that oral fluid tests are somewhat simpler for the administrator and more dignified for the test subject. “There's no ‘yuck’ factor involved,” he jokes. “This certainly doesn't denigrate urine testing or contend that they aren't valid, but for those being tested it currently happens to be one of the easiest to cheat,” Current contends. “Oral fluid is a much more difficult sample to adulterate, and could represent a viable alternative.” Behavioral Healthcare 2011 January-February;31(1):28-29
Read the complete post at http://www.behavioral.net/ME2/dirmod.asp?type=Publishing&mod=Publications::Article&mid=64D490AC6A7D4FE1AEB453627F1A4A32&tier=4&id=643F4DC273BC4CA28AC34F67E7655F88
Posted
Fri, Dec 31 2010 7:00 PM
by
Behavioral Healthcare Current Articles