Urine Adulteration Research Articles

Analysis of Nitrite in Adulterated Urine Samples by Capillary Electrophoresis

A simple method for analyzing nitrite in urine has been developed to confirm and quantify the amount of nitrite in potentially adulterated urine samples. The method involved separation of nitrite by capillary electrophoresis and direct UV detection at 214 nm. Separation was performed using a bare fused silica capillary and a 25 mM phosphate run buffer at a pH of 7.5. Sample preparation consisted of diluting the urine samples 1:20 with run buffer and internal standard, and centrifuging for 5 min at 2500 rpm. The sample was hydrodynamically injected, then separated using -25 kV with the column maintained at 35 degrees C. The method had upper and lower limits of linearity of 1500 and 80 microg/mL nitrite, respectively, and a limit of detection of 20 microg/mL. The method was evaluated using the National Committee for Clinical Laboratory Standards (NCCLS) protocol (Document EP10-A2), and validated using controls, standards, and authentic urine samples. Ten anions, ClO-, CrO4(-2), NO3-, HCO3-, I-, CH3COO-, F-, SO4-, S2O8(-2), and Cl-, were tested for potential interference with the assay. Interferences with quantitation were noted for only CrO4(-2) and S2O8(-2). High concentrations of Cl- interfered with the chromatography. The method had acceptable accuracy, precision, and specificity.

Effects of oxidizing adulterants on detection of 11-nor-delta9-THC-9-carboxylic acid in urine.

Bleach, nitrite, chromate, and hydrogen peroxide-peroxidase are effective urine adulterants used by the illicit drug users to conceal marijuana-positive results. Methods for detecting nitrite and chromate are available. Effects of other oxidizing agents that could possibly be used as adulterants and are difficult to detect or measure are presented in this report. Urine samples containing 40 ng/mL of 11-nor-delta9-THC-9-carboxylic acid (THC-acid) were treated with 10 mmol/L of commonly available oxidizing agents. Effects of horseradish peroxidase of activity 10 unit/mL and extracts from 2.5 g of red radish (Raphanus sativus, Radicula group), horseradish (Armoracia rusticana), Japanese radish (Raphanus sativus, Daikon group), and black mustard seeds (Brassica nigra), all with 10 mmol/L of hydrogen peroxide, were also examined. After 5 min, 16 h and 48 h of exposure at room temperature (23 degrees C) the specimens were tested by a gas chromatographic-mass spectrometric method for THC-acid. A control group treated with sodium hydrosulfite to reduce the oxidants, was also tested to investigate the effect of oxidizing agents on THC-acid in the extraction method. THC-acid was lost completely in the extraction method when treated with chromate, nitrite, oxone, and hydrogen peroxide/ferrous ammonium sulfate (Fenton's reagent). Some losses were also observed with persulfate and periodate (up to 25%). These oxidants, and other oxidizing agents like permanganate, periodate, peroxidase, and extracts from red radish, horseradish, Japanese radish and black mustard seeds destroyed most of the THC-acid (> 94%) within 48 h of exposure. Chlorate, perchlorate, iodate, and oxychloride under these conditions showed little or no effect. Complete loss was observed when THC-acid was exposed to 50 mmol/L of oxychloride for 48 h. Several oxidizing adulterants that are difficult to test by the present urine adulterant testing methods showed considerable effects on the destruction of THC-acid. The time and temperature for these effects were similar to those used by most laboratories to collect and test specimens. In several cases, the loss of THC-acid was > 94%.

Rapid spot tests for detecting the presence of adulterants in urine specimens submitted for drug testing.

Several adulterants are used to mask tests for abused drugs in urine. Adulterants such as "Klear" and "Whizzies" contain potassium nitrite, and "Urine Luck" contains pyridinium chlorochromate (PCC). The presence of these adulterants cannot be detected by routine specimen integrity checks (pH, specific gravity, and temperature). We developed rapid spot tests for detecting these adulterants in urine. Addition of 3% hydrogen peroxide in urine adulterated with PCC caused rapid formation of a dark brown color. In contrast, unadulterated urine turned colorless when hydrogen peroxide was added. When urine contaminated with nitrite and 2 to 3 drops of 2N hydrochloric acid were added to 2% aqueous potassium permanganate solution, the dark pink permanganate solution turned colorless immediately with effervescence. Urine contaminated with nitrite liberated iodine from potassium iodide solution in the presence of 2N hydrochloric acid. Urine adulterated with PCC also liberated iodine from potassium iodide in acid medium but did not turn potassium permanganate solution colorless. Urine specimens from volunteers and random urine samples that tested negative for drugs did not cause false-positive results. These rapid spot tests are useful for detecting adulterated urine to avoid false-negative drug tests.

Capillary Ion Electrophoresis of Endogenous Anions and Anionic Adulterants in Human Urine

Normal human urine contains many anions and cations. Ionic concentrations in urine have classically been determined by spectrophotometry of color reactions, flame emission spectrophotometry, atomic absorption spectrophotometry, high performance liquid chromatography, or potentiometry with ion-specific electrodes. Capillary ion electrophoresis (CIE) is a form of capillary electrophoresis which uses the differential electrophoretic mobility of ions to perform a separation of an ionic mixture. Various salts can be added to urine specimens to abnormally elevate ionic concentrations and interfere with either immunoassay urine drug screening procedures or gas chromatographic/mass spectrometric confirmation techniques. Application of CIE for the direct detection of endogenous anions and anionic adulterants in human urine specimens was the purpose of this investigation. CIE was performed using a Waters Quanta 4000 Capillary Electrophoresis System with either direct or indirect ultraviolet absorption detection at 254 nm. CIE of 30 random normal urine specimens and 21 urine specimens suspected of adulteration was performed. Duplicate aliquots were assayed by CIE and by colorimetric technique for nitrite. Sixteen specimens had elevated concentrations of nitrite and/or nitrate. The correlation coefficient between nitrite CIE and colorimetric results was 0.9895. Three specimens had detectable concentrations of chromate and were suspected of being adulterated with "Urine Luck," an adulterant found to contain chromate. Two specimens suspected of being adulterated with bleach were found to only contain chloride, sulfate, and phosphate. CIE is applicable to forensic analysis of urine anion concentrations. CIE can easily quantitate numerous endogenous anions and offers a method to detect and/or confirm anion adulteration of urine specimens.

Investigation of nitrite adulteration on the immunoassay and GC-MS analysis of cannabinoids in urine specimens.

Nitrite ion has been identified as the active ingredient of two commercial adulterants that could cause discrepant results between the immunoassay screening and gas chromatographic-mass spectrometric (GC-MS) confirmation of 11-nor-delta9-tetrahydrocannabinol-9-carboxylic acid (THCCOOH) in urine. Procedures to chemically convert the nitrite ion at the beginning of sample preparation for GC-MS analysis may not overcome all nitrite adulteration cases because portions of the THCCOOH might have been lost between the time of sample collection and the time of analysis. This study was conducted to further investigate the influence of both urine sample matrix and the duration of nitrite exposure on nitrite interference of THCCOOH detection. Forty clinical "THC-positive samples" that had been screened and confirmed positive for the presence of THCCOOH were spiked with 0.15M or 0.3M of nitrite. The levels of THCCOOH at various time intervals after nitrite spiking were monitored by instrument-based cannabinoids immunoassays (Syva EMIT d.a.u. and/or Roche Abuscreen ONLINE assays) and by an onsite THC immunoassay (Roche ONTRAK TESTSTIK). Results from this report demonstrate that the two outstanding "urine specimen factors" that dictated the effectiveness of the nitrite adulteration were urinary pH and the original drug concentration before nitrite spiking. Significant decreases in the immunoassay results could be observed within 4 h of nitrite treatment in the majority of samples with acidic urinary pH values. Regardless of their original concentration of THCCOOH (GC-MS ranging from 33 to 488 ng/mL), all of the 20 samples that had acidic pH values gave negative immunoassay results 1 day after nitrite adulteration. In contrast, the immunoassay results of samples with neutral or basic pH values were less affected by nitrite exposure in the same studies. Approximately two-thirds of the samples with pH values greater than 7.0 remained immunoassay-positive 3 days after nitrite spiking. Nevertheless, some of the adulterated urine that showed no change in immunoassay results might exhibit significant decrease in GC-MS recoveries even with bisulfite treatment, collaborating with the observations that a portion of samples screened positive with THC immunoassay in the laboratory could fail to confirm with GC-MS analysis. The decrease or loss of immunoassay detectable cannabinoid cross-reactives in acidic "THC-positive samples" can be attenuated by chemically increasing the pH value of the samples to the basic pH range.

The measurement of nitrite in adulterated urine samples by high-performance ion chromatography.

With the increased availability of nitrite-containing commercial products that are used for the adulteration of urine samples in the workplace, it is necessary for laboratories to be able to detect and confirm the presence of nitrite in these samples. We have developed a method to confirm the presence of nitrite in urine samples. The method uses the IonPac AS 14 analytical column with the Dionex series 45001 Bio LC system equipped with an anion self-generating suppressor and conductivity detector. Using a single-point calibration, the method is linear and accurately quantitates nitrite to 12,000 microg/mL. The limit of detection is 30 microg/mL, and the day-to-day precision of the assay has a coefficient of variation (CV) of 4.3% at 1200 microg/mL and 3.8% at 2700 microg/mL of nitrite.

The Effect of Pathologic Substances and Adulterants on the DNA Typing of Urine

Human urine has not been adequately investigated as a potential source of DNA for forensic identity testing. The advent of polymerase chain reaction technology has made possible the analysis of previously undetectable levels of nucleic acids from human urine and other body fluids lacking nucleated cells. In this study, we evaluated the ability to genotype DNA extracted from adulterated urine specimens using the AmpliType PM + DQA1 PCR amplification and typing system. Fresh, first-void male urine specimens were contaminated with household bleach, E. coli, human serum albumin, glucose and saponin (a strong detergent). All of the adulterated samples were typed without difficulty. Frozen male urine specimens were split into equal volumes; one aliquot was adulterated with either E. coli or saponin, and the other was left free of contaminants. Seventy-one percent of all frozen urine specimens tested (adulterated and unadulterated) were successfully typed using this amplification and typing system. Our data, therefore, suggest that the AmpliType PM + DQA1 PCR amplification and typing system described is suitable for genotype analysis of adulterated fresh and frozen urine specimens.

Adolescents and Drug Abuse: Clinical Use of Urine Drug Screening

ABSTRACT Urine screening for clinical diagnostic purposes is used to answer the question of whether adolescents are continuing drug abuse. The purpose of this study is to examine the use of urine screening as a procedure to assess and monitor adolescents in an outpatient program who are suspected of continued drag abuse. To systematically evaluate the procedure, 296 adolescent urine screens were analyzed. A total of 36% of the adolescents tested positive for one or more drags of abuse, and 30% tested positive for caneabinoids (THC), with eight testing positive for other drag use. Among the total sample, five (2%) tested positive for opiates, and ten (3%) tested positive for multiple drug use. Of the total sample, twenty-seven (9%) had adulterated urine. In this study, urine screening, which was done for clinical purposes, appeared to be helpful in assessing continued drug use but provides little information regarding the diagnostic level and pattern of drag use.

Antibody-mediated interference of a homogeneous immunoassay.

We hypothesized that an antibody-mediated interference could arise in a homogeneous immunoassay used to determine the presence of cocaine metabolites in urine. Urine specimens containing benzoylecgonine (BE) at concentrations near the National Institute on Drug Abuse (NIDA) threshold were assayed in replicate determinations by EMIT. Excess reagent protein (containing antibody specific for cocaine metabolites) was added to specimens to test for an antibody-mediated interference. Replicates of the BE-fortified specimens tested by EMIT that did not contain excess reagent antibody were all positive by the assay, while those that contained the excess reagent antibody were all negative. Because it may be difficult to detect excess interfering antibody by using some traditional tests for urine adulteration, we present these findings to illustrate a potential problem for some homogeneous immunoassays in forensic urine drug testing programs.

Detectability of Phencyclidine and 11-nor-Δ9-Tetrahydrocannabinol-9-Carboxylic Acid in Adulterated Urine by Radioimmunoassay and Fluorescence Polarization Immunoassay*

The ability to alter immunoassay test results by the addition of some commonly available chemicals to drug-positive and drug-negative urine specimens was investigated. Urine specimens containing either phencyclidine (PCP) or 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid (9-THC-COOH) were adulterated with sodium chloride, bleach, vinegar, potassium hydroxide, liquid soap, 2-propanol, and ammonia. Subsequent analyses by radioimmunoassay (RIA) and fluorescence polarization immunoassay (FPIA) demonstrated false positive and false negative results with some adulterants. Radioimmunoassay false positives occurred with potassium hydroxide (PCP and THC-COOH assays) and bleach (THC-COOH assay) adulterants. Bleach (PCP assay) and soap (THC-COOH assay) additives resulted in false negative analyses by RIA. No adulterant caused FPIA false positives. FPIA false negatives occurred with bleach (PCP and THC-COOH assays) and potassium hydroxide (PCP assay) adulterants.

The Medical Review Officer

The role and responsibilities of the medical review officer are considered in relation to drug testing in the workplace. Knowledge of substance abuse disorders, pharmacology and toxicology, laboratory techniques for screening and confirmation, forensic collection techniques, and the relevant rules and regulations that govern drug testing is essential. The means for detecting adulterated urine samples are offered, and a procedure for the management of urine-testing results is provided.

The detection of group-specific component from urine samples

The detection of group-specific component (Gc) from serum and bloodstains has been widely used in the forensic laboratory. A recent increase in substituted or adulterated urine samples in various drug screening programs has necessitated methods to determine the donor. This paper discusses the detection of Gc from urine samples. The samples were concentrated and applied to ultrathin polyacrylamide gel and focused for 150 min. This method separates the samples into the three common phenotypes found in all human populations. A nitrocellulose membrane blotting technique was used to detect the Gc bands. Serum and urine samples were collected from each individual and were typed for Gc. Urine samples tested after 6 months of storage (4°C) were still readable. This method provides the forensic laboratory with an additional test from a body fluid which, until recently, provided little information.

Adulterants causing false negatives in illicit drug testing.

Illicit-drug users may attempt to falsify results by in vitro adulteration of specimens. We investigated eight additives (NaCl, Visine, handsoap, Drano, bleach, vinegar, golden-seal tea, and lemon juice) claimed by drug users to invalidate enzyme immunoassay (EIA) drug assays. We also analyzed adulterated urine specimens to determine if they could be identified, adding adulterants at several concentrations to 222 EIA-positive specimens confirmed by gas chromatography and mass spectrometry (GC/MS) to contain illicit drugs. To identify adulterated urines, we monitored pH, relative density, and urine color and turbidity at adulterant concentrations that falsified EIA results. Specimens contaminated with NaCl had relative densities greater than 1.035. Liquid Drano, bleach, and vinegar shifted urine pH outside the physiological range. Golden-seal tea caused a dark appearance, and specimens containing liquid soap were unusually cloudy. Lemon juice had no effect on the assays. Visine was the only adulterant not detected. The adulterants interfered somewhat differently with each of the drug assays. EIA assays for illicit drugs can be invalidated by specimen adulteration producing false-negative results. Therefore, if urine drug testing is to be conducted, pH, relative density, and appearance should be assessed and suspect specimens should be rejected. Not all adulterants can be detected, so observed collection is strongly recommended.