When people think of drug tests, they usually think of urine drug testing, though this isn’t the only option. In my office, where I prescribe buprenorphine to treat opioid addiction, I use both urine and saliva drug testing. I’ve rarely recommended hair drug testing, because it has limitations.
Urine drug testing has been around for some time. This type of testing is reliable and accurate, though it’s possible to falsify a urine drug test in several ways: by adding something to the urine sample, and by ingesting a compound and then drinking plenty of water to dilute the concentration of drug in the urine sample. Fortunately, labs that do drug testing use the internet to buy the same items advertised to help people “pass” urine drug screens, to find ways to detect the adulterants. But people are clever, and new ways of falsifying have evolved. The cat and the mouse are ever learning new ways to do their jobs better.
Urine tests have the advantage of being much cheaper than saliva and hair testing.
Saliva testing is difficult, if not impossible, to adulterate. The only way I’ve seen patients try to falsify these tests is by trying not to get enough saliva on the mouth swab. This doesn’t work with the kits I now use, since there must be enough saliva to give 5 drops of saliva, and it that’s not obtained, it’s not a valid test.
Saliva tests are particularly excellent at detecting marijuana and cocaine, because those drugs are concentrated in the saliva. In fact, saliva may detect these drugs at a lower intake level than urine testing. But saliva tests can cost more than twice urine drug tests.
Hair testing isn’t an exact science, and it’s not used for routine testing. Theoretically, drugs are concentrated in the hair shaft as it grows, giving a record of drug use over time. Depending on the length of hair, we can get information for six months or more. But hair testing can be thwarted by hair treatments. Plus, it’s much more expensive.
Then there’s a racial issue. Naturally dark hair concentrates drugs much more than naturally blonde hair. Thus, a blonde Caucasian and an African-American may ingest the same amount of drug, and it’s more likely for the dark-haired African-American to have a positive test, detecting the drug. Most people hesitate to use a racially skewed test like this.
What about these substances advertised to “flush out your system?” They work by dilution. Save your money, because you’d get the same results by drinking large quantities of water. But do be careful, as it’s actually possible to overdose on water. This occurs if you drink so much water that your electrolyte levels drop, and it can be fatal.
The most amusing device I’ve seen used to falsify a urine drug screen is something called “The Whizzinator.” This is a prosthetic penis-type device that contains a heated sample of negative urine, which is funneled through the fake penis and into the collection cup. These are used when observed urines are requested, but also have their flaws.
At one clinic where I worked, the device purchased by the patient was a great deal larger than the real member, and was a different color. This was a give-away that something was amiss, and the patient’s ruse was detected. Apparently the Whizzinator comes in five colors and sizes, so one must be careful to get a fake penis closely resembling one’s own skin tone. And one should take pains to make sure the fake penis doesn’t fall off, as happened to another patient during an observed urine collection.
But why go to all that effort and expense? As I’ve said before, the best way to have a negative drug test is…don’t use drugs.