Stepped-up efforts aim to thwart cheating on drug tests

Washington -- What do salt, bleach, soap, drain cleaner, detergent, lemon juice and white vinegar have in common? All are promoted on Web sites as substances that can be added to urine to mask the presence of illegal drugs.

Thousands of sites provide information on how to cheat on drug tests, and many of the techniques have been publicized for decades. No sooner had regulations been developed to institute President Ronald Reagan's 1986 call for a drug-free federal workplace than people began searching for ways to evade detection, said Amitava Dasgupta, PhD, professor of pathology and laboratory medicine at the University of Texas Medical School at Houston.

Labs have been successful, so far, at keeping up with the methods employed, but "it's a cat and mouse game," Dasgupta said. Just when labs catch up with one subterfuge, another comes along.

Dasgupta spoke July 29 at the Annual Meeting and Clinical Laboratory Expo 2008 of the American Assn. for Clinical Chemistry in Washington, D.C.

With drug abuse a critical problem in the U.S. and many other nations, the screening of potential employees has become common, Dasgupta said. More than 47 million adults reported working in settings where testing for illicit drug or alcohol use occurred during the hiring process, according to the Substance Abuse and Mental Health Services Administration.

Drug testing is also a public safety issue, and American Medical Association policy outlines the need to safeguard the validity and integrity of the testing system.

Deceptions are carried out in numerous ways, Dasgupta said. Adulterating urine with common household chemicals is one method. Labs have been able to detect the additions by looking at color and pH. For example, urine's normal pH of 4 to 8 can shoot up to 14 when drain cleaner, which is used to mask cocaine, is added.

Dilution is another technique, Dasgupta said. As one way to eliminate the temptation to dilute urine by using the water in the toilet bowl of a testing site, federal guidelines recommend placing a bluing agent in the tank. Blue urine would be an obvious giveaway.

Consuming large amounts of caffeine and other fluids before a test is another method, Dasgupta said. But labs can detect this scam by testing for creatinine. A concentration less than 20 mg/dL, or a specific gravity below 1.003, is considered an indication of diluted urine, he said.

Laboratories routinely check pH, temperature, specific gravity and creatinine of urine to assure the validity of a specimen, he noted.

Corrections are in the works

Meanwhile, Congress and the federal government are taking steps to eliminate the stream of information flowing from the Internet on how to beat drug tests.

The Drug Testing Integrity Act, introduced July 14 by Reps. Eliot Engel (D, N.Y.), Jean Schmidt (R, Ohio) and Lee Terry (R, Neb.), would outlaw the manufacture, sale, shipment or provision of any product designed to assist in defeating a drug test. The bill also would institute fines and other penalties for violations.

It's received a positive response.

"Drug testing defrauding products are a dilemma not only for criminal justice and employment screening purposes, but they also compound a larger public health issue, such as drugged driving, which is a primary concern for anti-drug coalitions throughout the country," said Arthur T. Dean, chair of the nonprofit Community Anti-Drug Coalitions of America.

In another effort to make it more difficult to cheat on drug tests, the U.S. Dept. of Transportation is instituting a rule this month that requires labs to analyze every drug test on the nation's approximately 12.1 million transportation employers and employees in safety sensitive areas for tampering.

Labs had been given the option of testing urine samples for signs of cheating under the earlier regulation, but now they would be required to do so. Testers also will be required to observe all tests for transportation workers who return to their jobs after a previous test failure.

In addition, information no longer will be available publicly on the level of the drug detected by a test.

Before, cheaters had ready access to such information and could make sure the product they used covered drug traces above that limit. Now such information will go directly to labs.

"We want to make sure there are no doubts about the ability of anyone working in transportation to do their job as safely as possible," said Transportation Secretary Mary E. Peters.

Plus, there is another move under way to thwart the Web sites. Labs are encouraging private-sector employers to steer clear of the collection of urine samples and switch to hair and oral fluids, said Laura Shelton, executive director of the Drug & Alcohol Testing Industry Assn. in Washington, D.C. So far, there aren't any effective adulterants for hair and oral fluids, she said.