Drug screening is widespread in contexts such as the criminal justice system, employment, and substance abuse treatment centers. Traditionally, drug testing methods have targeted urine matrices and extensive research is available regarding urine drug screening. Due to the nature of sample collection, urine specimen may be tampered or adulterated in efforts to invalidate or pass a drug test. Examples of this include substituting a sample with synthetic urine, diluting a sample with water, or adding a substance to the sample. The addition of a substance is referred to as adulteration and is done in an effort to mask drugs in the sample or to invalidate the test results. For various reasons, including the effects of adulteration, time, and costs associated with urine drug tests, oral fluid (OF) has become an increasingly important alternative matrix for screening drugs of abuse. It offers distinct advantages since tests can be administered noninvasively, quickly, and under observation, thus reducing the risk of tampering. Studies have also shown that drugs of abuse detected in OF may correlate better to user impairment at the time of collection, as compared to other matrices.
In 2019, the Substance Abuse and Mental Health Service Administration (SAMHSA) published mandatory guidelines for oral fluid testing. Although these guidelines only directly impact federal spaces, they also serve as a blueprint for developing drug testing laws and policies in other organizations. Despite requirements and procedures controlling for specimen adulteration, it is recognized that manufacturers will continue to develop and market new products to avoid drug detection, just as with urine drug tests.
The design of this experiment was to investigate the effects of the commercially available drug testing subversion products High Voltage Saliva Cleanse Mouthwash (High Voltage Detox, Las Vegas, Nevada, USA) and Stinger Detox Mouthwash (Stinger Detox, Phoenix, Arizona, USA) on immunoassay testing for tetrahydrocannabinol (THC) and methamphetamine (MET) in OF. The High Voltage Saliva Cleanse was designated adulterant “A”, and the Stinger Detox was designated adulterant “B”. Two separate immunoassay kits, Discover™ (American Screening Corporation, Inc., Shreveport, Louisiana, USA) and Orawell® (Jiangsu Well Biotech Co., Ltd, Changzhou, Jiangsu, China), were assessed to investigate the differences in performance of the current available test devices in addition to the effects of the subversion products. Using Discover™, samples were spiked according to 0.5 times (x), 1x, and 2x the cutoff concentrations of 50 ng/mL THC and 50 ng/mL MET without adulterant, with Adulterant A, and with Adulterant B. Testing with Orawell® devices was initially conducted at 1x and 2x the cutoff concentrations of 40 ng/mL THC and 50 ng/mL of MET. Based on the lack of response, testing at 0.5x was not conducted. Additional testing was conducted at 1.5x and 3x the cutoff concentrations without adulterant, with Adulterant A, and with Adulterant B. It was concluded that the adulterants affected the test results in the Orawell® device, by producing false positives for drugs of abuse not present in the sample for 17 (56.7%) of the 30 tests containing adulterants. Additionally, it was concluded that both immunoassay tests assessed were lacking in analytical sensitivity and reproducibility.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/43848 |
| Date | 09 February 2022 |
| Creators | Huerta, Alicia Rita |
| Contributors | Botch-Jones, Sabra |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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