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PubMed2005

Oral fluid drug tests: effects of adulterants and foodstuffs.

An on-site oral fluid drug screen, Oratect, was used to investigate the effects of adulterants and foodstuffs on oral fluid test results. Common foods, beverages, food ingredients, cosmetics and hygienic products were demonstrated not to cause false positive results when tested 30 min after their consumption. Evaluations of two commercial oral fluid adulterants, "Clear Choice Fizzy Flush" and "Test'in Spit n Kleen Mouthwash" suggest their mechanism of action is the clearing of residual drugs of abuse compounds through rinsing of the oral cavity. They do not directly destroy the drug compounds or change the pH of the oral fluid. It is also suggested that a common mouthwash would perform similar action.

Beverages↗
PubMed2001

Effects of Stealth adulterant on immunoassay testing for drugs of abuse.

Stealth is an adulterant advertised as being undetectable by adulteration tests. It has been described as peroxidase and peroxide, which, when added to urine samples, are intended to prevent a positive drug test. Characterization of the effect of Stealth on urine samples and immunoassay results was undertaken to assist in detection of this adulterant. Stealth was added to a number of urine matrices, and various parameters were evaluated including pH, specific gravity, color, creatinine, chloride, urea, blood, glucose, and nitrite. Samples were spiked with THC acid metabolite, benzoylecgonine, morphine, secobarbital, PCP, amphetamine, and lysergic acid diethylamide (LSD) then tested by Roche OnLine and Microgenics CEDIA immunoassay reagents. Results of these analyses showed Stealth did not cause the urine sample to exceed any of the monitored parameters including those routinely used in drug-testing laboratories that would indicate adulteration of a sample. It did, however, cause samples positive for the marijuana metabolite (11-nor-delta9-tetrahydrocannibinol-9-carboxylic acid), LSD, and opiate (morphine) at 125-150% of cutoff to screen negative by immunoassay. Adulterating an authentic positive sample provided by a marijuana user caused that sample to screen negative using these immunoassay reagents as well.

Drug Contamination↗
PubMed1998

Determination of five abused drugs in nitrite-adulterated urine by immunoassays and gas chromatography-mass spectrometry.

The adulteration of urine specimens with nitrite ion hasseen shown to mask the gas chromatography-mass spectrometry (GC-MS) confirmation testing of marijuana use. This study was designed to further investigate the effect of nitrite adulteration on the detection of five commonly abused drugs by immunoassay screening and GC-MS analysis. The drugs tested are cocaine metabolite (benzoylecgonine), morphine, 11-nor-delta-tetrahydrocannabinol-9-carboxylic acid (THCCOOH), amphetamine, and phencyclidine. The immunoassays evaluated included the instrument-based Abuscreen ONLINE assays, the on-site Abuscreen ONTRAK assays, and the one-step ONTRAK TESTCUP-5 assay. Multianalyte standards containing various levels of drugs were used to test the influence of both potassium and sodium nitrite. In the ONLINE immunoassays, the presence of up to 1.0M nitrite in the multianalyte standards had no significant effect for benzoylecgonine, morphine, and phencyclidine assays. With a high concentration of nitrite, ONLINE became more sensitive for amphetamine (detected more drug than what was expected) and less sensitive for THCCOOH (detected less drug than what was expected). No effects of nitrite were observed on the results of the Abuscreen ONTRAK assays. Similarly, no effects were observed on the absolute qualitative results of the TESTCUP-5 when testing the nitrite-adulterated standards. However, the produced intensities of the signals that indicate the negative test results were slightly lowered in the THC and phencyclidine assays. The presence of 1.0M of nitrite did not show dramatic interference with the GC-MS analysis of benzoylecgonine, morphine, amphetamine, and phencyclidine. In contrast, nitrite ion significantly interfered with the detection of THCCOOH by GC-MS. The presence of 0.03M of nitrite ion resulted in significant loss in the recovery of THCCOOH and its internal standard by GC-MS. The problem of nitrite adulteration could be alleviated by sodium bisulfite treatment even when the specimens were spiked with 1.0M of nitrite ion. Although bisulfite treatment decomposed all nitrite ions in the sample to recover the remaining THCCOOH by GC-MS, the net recovery of THCCOOH depended on urinary pH and time and conditions of sample storage. The presence of nitrite concentrations that might arise from all possible natural sources, including microorganisms, pathological conditions, and medications, did not interfere with the GC-MS analysis of THCCOOH.

Amphetamine↗
PubMed2000

Animal models of addiction: models for therapeutic strategies?

When having a continuous free choice in their home cages between water and alcohol- or drug-containing drinking solutions, rats first develop a controlled consumption of the psychotropic compound and, after several months, lose their control over drug taking. After a long period of abstinence, they reveal an excessive, compulsive drug intake. Adulteration of the drug-containing solutions reduces the doses taken by controlled consumers, but not those of the excessive drinkers, they can therefore be regarded as addicted. These animals show a pre-intake motor restlessness that may be related to craving. In two studies with putative anti-craving agents (the dopamine D2 receptor agonist lisuride and the D2 receptor antagonist flupentixol) we treated alcohol-addicted and non-addicted rats and observed the effects on alcohol taking, alcohol seeking and brain neurotransmission. These two investigations paralleled clinical studies, in both cases the results could be predicted correctly ("pro-craving" effect of both pharmaceutics). Differences between "symptomatic" and possible "causal" therapies are discussed, approaches towards a causal therapy according to an "imprinting"-model of an addition are suggested.

Alcoholism↗
PubMed2005

Spectrophotometric detection of iodide and chromic (III) in urine after oxidation to iodine and chromate (VI).

Tests for oxidizing adulterants in urine are a continuing challenge to the drug-testing program. Iodine was found to destroy morphine and 6-acetylmorphine almost immediately. The effects were less evident on 11 -nor-delta9-tetrahydrocannabinol-9-carboxylic acid (THC-acid). When the urine solution was tested for iodine by a chromogenic substrate, 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS), no iodine was detected. Masking drug and adulterant simultaneously made iodine a preferred oxidizing adulterant for drug abusers. In this study, the reduced iodide was oxidized by sodium nitrite to iodine. The excess nitrite was decomposed by sulfamic acid and the iodine was detected by ABTS. Linearity was 12.7 to 635 mg/L (0.1 to 5 mmol/L, y = 0.9966x + 0.0016, R2 = 1.0000). Precisions (coefficient of variation) were within +/- 4.1% and quantitative accuracies were within 97% of expected values (n=5). Chromate, iodate, periodate, and persulfate interfered with the method. To alleviate the problem, the positive specimens were tested again by an iodine-specific method. After oxidation, the samples were treated with sodium azide and ammonium thiocyanate. In presence of thiocyanate, the azide reduced iodine to iodide almost immediately, and the solutions showed negative response to ABTS. The results were compared with that of a control group tested without thiocyanate. When iodine was present, the ratios of thiocyanate to control were less than 6%. Chromate was also found to destroy THC-acid in urine, and during storage most of the chromate changed to chromic (III). In this study, chromic was oxidized to chromate by hydrogen peroxide and sodium hydroxide and detected by 1,5-diphenylcarbazide. Linearity was 5.2 to 156 mg/L (0.1 to 3.0 mmol/L, y = 1.0285x - 0.0034, R2 = 0.9998). Precisions were within +/- 8.5% and quantitative accuracies were within 92% of expected values (n=5). The test was not interfered by other oxidizing agents. Both iodide and chromic oxidation methods showed urine backgrounds less than 1.27 and 0.52 mg/L, respectively (< 0.01 mmol/L). It indicated that a response more than 10 times of the background could be considered as oxidant contamination or adulteration of urine specimens.

Chromium↗
PubMed1993

Phenytoin toxicity from smoking crack cocaine adulterated with phenytoin.

Drugs of abuse often are adulterated with agents designed to lower cost or alter the intoxication. Recently, we began to hear of the intentional addition of phenytoin to crack cocaine. We report the cases of five patients with measurable phenytoin levels attributable to smoking crack cocaine adulterated with phenytoin. Three of these patients presented with signs, symptoms, and phenytoin levels consistent with phenytoin toxicity. Clinicians should be aware of this practice when faced with cocaine users with altered mental status, ataxia, or nystagmus.

Adult↗
PubMedDate not supplied

Impact of adulterants on RIA analysis of urine for drugs of abuse.

The effect of various adulterants on radioimmunoassay (RIA) tests for amphetamine, cannabinoids, cocaine (metabolite), phencyclidine (PCP), barbiturate, and morphine was evaluated. A total of 16 readily available agents, at concentrations ranging from 1 to 25%, were tested with negative and positive urine samples. The results demonstrate that both false positive and false negative RIA results can be produced by easily achievable levels of different agents in urine specimens. Of the RIA tests evaluated, the one for cannabinoids was most sensitive to the presence of adulterants, whereas the PCP assay was most resistant. Although the presence of some adulterants could be detected by measuring the pH or specific gravity of the urine, other agents, at concentrations sufficient to alter the RIA results, could not be as easily detected. Gas chromatography/mass spectrometry (GC/MS) analysis of adulterated samples with false positive RIA results showed no detectable drug, indicating that the adulterants interfered with the RIA test itself. In contrast, GC/MS analysis of samples with false negative RIA results confirmed that at least some adulterants acted by reducing the drug concentrations in the specimen.

Drug Contamination↗
PubMedDate not supplied

Papain: a novel urine adulterant.

The estimated number of employees in the United Stated screened annually for illicit drugs is approximately 20 million, with marijuana being the most frequently abused drug. Urine adulterants provide an opportunity for illicit drug users to obtain a false-negative result on commonly used primary drug screening methods such as the enzyme multiplied immunoassay technique and the fluorescence polarized immunoassay technique (FPIA). Typical chemical adulterants such as nitrites are easily detected or render the urine specimen invalid as defined in the proposed SAMHSA guidelines for specimen validity testing based on creatinine, specific gravity, and pH. Papain is a cysteine protease with intrinsic ester hydrolysis capability. The primary metabolite of the psychoactive chemical in marijuana, 11-norcarboxy-Delta9-tetrahydrocannibinol (THC-COOH), was assayed by FPIA in concentrations ranging from 25 to 500 ng/mL, at pH values ranging from 4.5 to 8, over the course of 3 days with papain concentrations ranging from 0 to 10 mg/mL. FPIA analysis of other frequently abused drugs: amphetamines, barbiturates, benzodiazepines, cocaine, opiates, and phencyclidine, along with gas chromatography-mass spectrometry (GC-MS) of THC-COOH and high-pressure liquid chromatography-ultraviolet detection (HPLC-UV) of nordiazepam was performed in order to determine if the mechanism of urine adulteration by papain was analyte specific. Control and adulterated urine specimens (n = 30) were assayed for creatinine, specific gravity, and pH to determine if papain rendered the specimens invalid based on the proposed SAMHSA guidelines. There was a direct pH, temperature, and time-dependent correlate between the increase in papain concentration and the decrease in THC-COOH concentration from the untreated control groups (p < 0.01). The average 72-h THC-COOH concentration decrease at pH 6.2 with a papain concentration of 10 mg/mL was 50%. Papain did not significantly decrease the concentration of the other drugs analyzed with the exception of nordiazepam. GC-MS of THC-COOH and HPLC-UV of nordiazepam revealed a 66% and 24% decrease in concentration of the respective analyte with 10 mg/mL papain after 24 h at room temperature (approximately 23 degrees C). No adulterated specimens were rendered invalid based on the SAMHSA guidelines. Immediate FPIA analysis is suggested to minimize the interfering effects of papain with regards to primary drug screening.

Chromatography, High Pressure Liquid↗
PubMed1988

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.

Acetates↗
PubMed2002

Toxicological screening for drugs of abuse in samples adulterated with household chemicals.

OBJECTIVES: Urine samples that tested positive for two drugs of abuse, namely cannabis and methaqualone, were reassayed in the presence or absence of common household chemicals: Jik (sodium hypochlorite), Dettol (chloroxylenol), G-cide Plus (glutaraldehyde), Perle Hand Soap, ethanol, isopropanol and peroxide (20 volumes). These chemicals are frequently used for the adulteration of urine samples. SETTING: Department of Pharmacology, University of Stellenbosch. METHODS: Household chemicals, at three different concentrations, were added to urine samples that tested positive for methaqualone and cannabis. Samples were reanalysed on an ETS Plus Analyser (Syva Company, San Jose, Ca.) using Emit drugs-of-abuse urine test reagents. RESULTS: Most of the chemicals tested influenced the outcome of positive toxicological screening results for these drugs. G-cide (glutaraldehyde) and Perle Hand Soap had the largest effect (false-negative) on the methaqualone test. Dettol (chloroxylenol) and Perle Hand Soap had the largest effect on the cannabis test. Higher concentrations of the adulterant were not always an indication of the extent of modification of the test result. The addition of certain chemicals (ethanol, isopropanol and peroxide) to the urine samples tested for methaqualone interfered with the test to such an extent that it gave invalid test results.

Adult↗
PubMed1984

Adulterants in heroin/cocaine: implications concerning heroin-associated nephropathy.

Heroin-associated nephropathy (HAN) is a complication of the intravenous use of heroin or cocaine. It has been postulated that one of the substances used to adulterate these drugs may be responsible for the renal injury. We examined data provided by the Drug Enforcement Administration (DEA) concerning the laboratory analysis of 12 366 samples of heroin/cocaine. These street-grade drugs were analyzed for the presence of various adulterants or secondary substances. Eleven adulterants were identified with a frequency of occurrence that exceeded 5%. Quinine, mannitol, lactose and procaine were the non-narcotic compounds most commonly found. Other substances found included caffeine, inositol, lidocaine, starches, methapyrilene, sucrose, acetylprocaine and dextrose. No specific substance including heroin or cocaine has yet been definitely implicated as causative of HAN. These data suggest that further animal research is needed to determine the effects of repeated intravenous injections of each of these commonly found substances on the kidney.

Cocaine↗
PubMedDate not supplied

Negative experiences on Ecstasy: the role of drug, set and setting.

Similar to other sociological studies of Ecstasy use, the authors' research suggests that Ecstasy users tend to report positive effects of the drug. However, we also observed that most users experienced at least one adverse psychological outcome while using Ecstasy. The present study examines those negative experiences within the context of drug, set and setting. Data were collected through in-depth interviews with 98 current or former users of Ecstasy. The results indicate that, in general, negative experiences with Ecstasy did not deter people from using the drug again. The findings suggest that most negative experiences with Ecstasy can be attributed to the interaction between two or more factors, nearly always involving set or setting. Although various analyses have shown that the same "brand" of Ecstasy can contain varying degrees of MDMA, other drugs and adulterants, results from the present study suggest that users' expectations of the drug's effects appear to be related to the brand or label of Ecstasy that is consumed. The role of individual disposition in producing negative drug experiences is less clear; it is possible that this factor might interact with user set or friends' set in contributing to the overall drug experience.

Animals↗
PubMed2002

Toxic heavy metals and undeclared drugs in Asian herbal medicines.

Asian herbal medicines are currently used by large sections of the population. Because they are not regulated as medicines and are freely available to everyone, serious safety concerns might be associated with these herbal medicines. In this article, evidence suggesting that some Asian herbal medicines contain toxic heavy metals or undeclared prescription drugs is reviewed. In particular, Indian and Chinese preparations have been implicated. Although adulteration with drugs is by definition fraudulent, the inclusion of heavy metals could be either intentional for alleged medicinal purposes or accidental. Evidence from various countries implies that toxic heavy metals and undeclared prescription drugs in Asian herbal medicines might constitute a serious health problem. However, the majority of the data is anecdotal and insufficient to define prevalence figures. Ways ought to be found to maximize consumer safety.

Consumer Product Safety↗