Evasion of True Positive Results

For obvious reasons, drug users are highly motivated to "produce" a clean sample. In response to this need, a black market has emerged to provide products with the sole purpose of creating a false-negative test result. These products include pretested and certified drug-free urine substitution kits, and a variety of adulterants. These include the "Whizzinator" (an artificial penis used to deliver a known drug-free urine under direct observation conditions) and passingpisstest.com, which provides a nontechnical description of how blood and urine drug tests work.

Those who interpret test results should be aware that addicts can be highly creative in their efforts to thwart detection and monitoring. As an example, adulterants are substances placed in a sample to alter the results of a drug test. They accomplish this by physically altering the characteristics of the sample, such as temperature, pH, and specific gravity, which disrupts the mechanisms of the assay. Adulterants range from inexpensive household products, such as soap, salt, bleach, lemon juice, or vinegar, to expensive additives specifically marketed to produce a negative test. One Internet product selling for over $100 comes with a 300% money-back guarantee. As a result of adulterant use, drug testers must now employ techniques to screen for these additives. If the sample does not fall within established physiological parameters at the time of collection, it is voided on the spot, and another sample must be produced, which is then sent to the laboratory for analysis. One "do-it-yourself" kit, available on the Internet, includes a concealed IV bag with tubing (to be strapped to the lower abdomen or upper thigh) and two heating elements with temperature strips, all in an attempt to mask the use of adulterants. One study demonstrated the ability of one adulterant to create false negative tests (Cody & Valtier, 2001).

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