detox drug kit
A drug test is commonly a technical examination of urine, hair, blood, sweat, or oral fluid samples to determine the presence or absence of specified drugs or their metabolized traces. It can also be used to test for a multitude of substances at the same time, rather termed drug screening.
General information about drug testing in the USA
Drug tests in the USA can be divided into two general groups, federally and non-federally regulated testing. Federally regulated testing started when Ronald Reagan enacted executive order 12564, requiring all federal employees refrain from using illegal substances in specified DOT regulated occupations. Drug testing guidelines and processes, in these areas exclusively, are established and regulated (by the Substance Abuse and Mental Health Services Administration or SAMHSA, formerly under the direction of the National Institute on Drug Abuse or NIDA) require that companies who use professional drivers, specified safety sensitive transportation and/or oil and gas related occupations, and certain federal employers, test them for the presence of certain drugs. These test classes were established decades ago, and include five specific drug groups. They do not account for current drug usage patterns. For example, SAMHSA / DOT tests exclude semi-synthetic opioids, such as oxycodone, oxymorphone, hydrocodone, hydromorphone, etc., and other prescription medications that are widely abused in the United States.
- Cannabinoids (marijuana, hashish - tests for metabolite THCCOOH)
- Cocaine (cocaine, benzoylecgonine, cocaethylene)- tests for cocaine metabolite)
- Amphetamines (amphetamine, methamphetamine)
- Opiates (heroin, opium, codeine, morphine, 6-MAM)
- Phencyclidine (PCP)
- Methadone (MTD)
- Barbiturates (BAR)
- Benzodiazepines (BZO)
- Tricyclic antidepressants (TCA)
- Methylenedioxymethamphetamine (MDMA or ecstasy)
While SAMHSA/NIDA guidelines only allow laboratories to report quantitative results for the "NIDA-5" on their official NIDA tests, many drug testing laboratories and on-site tests also offer a wider or "more appropriate" set of drug screens which may be more reflective of current drug use patterns. As noted above, these tests include synthetic pain killers such as Oxycodone (Oxycontin, Percocet), Oxymorphone, Hydrocodone (Vicodin), Hydromorphone, benzodiazepines (Valium, Xanax, Klonopin, Restoril) and barbiturates in other drug panels (a "panel" is a predetermined list of tests to run). The confirmation test (usually GC/MS, or LC/MS/MS) can tell the difference between chemically similar drugs such as methamphetamine and methylenedioxymethamphetamine (MDMA or ecstasy), and in the absence of detectable amounts of methamphetamine in the sample, the lab will either report the sample as negative or report it as positive for MDMA. What the lab reports to the client depends upon whether MDMA was included in the panel as something to be tested for.
Gamma-hydroxy-butyrate (GHB) was not routinely tested for in the early 1990s, but due to increasing use, some laboratories have added it as an optional test. GHB is rare in pre-employment screening, but is commonly checked for in suspected cases of drug overdose, date rape, and post-mortem toxicology tests. Ketamine (Special K) may or may not be tested for, depending upon the preferences of the entity paying for the test, though testing for it is uncommon. In general, the greater the number of drugs targeted, the higher the cost of the test, which means that many employers only target the NIDA 5 for financial reasons.
Other drugs, such as meperidine (Demerol), fentanyl, propoxyphene, and methadone are not commonly tested for in most pre-employment situations. These drugs are more likely to be included in tests for certain demographic groups (such as healthcare workers, drug rehab patients, etc.)
Hallucinogens other than cannabis and PCP, such as mushrooms (psilocybin), LSD, Ketamine (Ketamine) and peyote (mescaline) are rarely tested for.
Detection periods
The following chart from LabCorp gives approximate detection periods for each substance by test type. The ranges depend on amount and frequency of use, metabolic rate, body mass, age, overall health, and urine pH. For ease of use, the detection times of metabolites have been incorporated into each parent drug. For example, heroin and cocaine can only be detected for a few hours after use, but their metabolites can be detected for several days in urine. In this type of situation, we will report the (longer) detection times of the metabolites.
- NOTE 1: Oral fluid or saliva testing results for the most part mimic that of blood. The only exceptions are THC and benzodiazepines. Oral fluid will likely detect THC from ingestion up to a maximum period of 18–24 hours. Low saliva:plasma ratio continues to cause difficulty in oral fluid detection of benzodiazepines
- NOTE 2: Urine cannot detect current drug use. It takes approximately 6–8 hours or more post-consumption for drug to be metabolized and excreted in urine. Similarly, hair requires two weeks, and sweat, seven days.
Common types of drug tests
Urine drug screen
When an employer requests a drug test from an employee the employee is instructed to go to a collection site. There, the employee’s urine is collected in a specially designed secure cup and sealed with a tamper resistant tape. The cup is then sent by express delivery service to a testing laboratory where it will be tested for several drugs. The first step at the testing site is to split the urine into two aliquots. One aliquot is first screened for drugs using an analyzer that performs immunoassay as the initial screen. If the urine screen is positive then another aliquot of the sample is used to confirm the findings by gas chromatography - mass spectroscopy (GC-MS) methodology. All test results are relayed to an MRO (Medical Review Office) where a medical physician reviews the results. If the result of the screen is negative, the MRO informs the employer that the employee is clean and has no detectable drug in the urine. However, if the test result of the immunoassay and GC-MS are positive, the MRO contacts the employee and tries to determine if there is any legitimate reason for the employee to have a positive result such as a medical treatment or prescription. However, this is problematic for several reasons. First, most employees are not chemists, and are not aware of which substances which might create a false positive test result. Without such knowledge, they may not mention them, leading to the incorrect reporting of a positive result. Furthermore, non-drug users whose results are reported as positive will have no explanation for the error, and will therefore be reported as drug users. Conversely, drug users may understand that they will only be called if the result is positive, and therefore will tell the MRO that they have been cooking with hemp oil, drinking coca tea, or other plausible explanation for the result. If the MRO determines that the positive result may be due to drug use, the MRO then informs the employer of the positive result. Statistics show that about 5% of the urine samples tested in the U.S. turn out positive for drugs.
The efficacy of urine testing is debatable due to systematic cheating as well as its questionable accuracy. In addition to false positive test results, it is widely reported that sample substitution and adulteration occur frequently, and both are effective methods of avoiding would-be positive tests. While most laboratories performing drug screens test for adulterants routinely, they can not keep pace with the various forms of adulterants available.
Adulterants can be classified into two categories. The first category includes classic adulterants comprising household substances and other chemicals such as chlorine bleach, liquid drain cleaner, white vinegar, glutaraldehyde, sodium nitrite, and pyridinium chlorochromate. The second category includes commercial adulterants, which can be purchased from certain specialty stores (so-called “head shops”), through magazine advertisements, or via the Web. This second class of adulterants includes brand names such as Urine Luck version 6.3, Stealth, Clean-X, Klear, Purafyzit, Instant Clean, Krystal Kleen, and UR’n Kleen. Some of the commercial adulterants represent a repackaging of classic adulterants. One adulterant, for example, Klear, is made of nitrite and affects the tetrahydrocannibinol (THC) confirmation process but not the immunoassay process. Urine Luck 6.3 is actually hydrofluoric acid, which is an oxidant not generally available in the classic adulterants category because of its corrosive nature. Stealth is an enzyme system that generates hydrogen peroxide.
People can also drink 1 to 2 liters of water to successfully dilute the concentration of drug metabolites in their urine below detectable thresholds,without risking detection. While this results in clear samples that may be rejected on the grounds of being too dilute, the practice is typically successful. A B vitamin will make urine yellow despite this practice of waterloading. Specific gravity testing can be done to identify whether or not the sample is of dilute nature. Vitamin B3 (niacin) is also frequently used for its reported "flushing" effect, though this is also of disputable adeptness.
Adulteration tests can detect the use of some of these "detox" products. Adulteration tests analyze the properties of the urine to identify if the sample is abnormal. Such properties include the pH and specific gravity of the urine. They also test the level of
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