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myristate ethyl palmitate ethyl oleate and ethyl stearate are used as indicators of the alcohol consumption the amounts found in hair are measured in nanograms one nanogram equals only one billionth of a gram however with the benefit of modern technology it is possible to detect such small amounts in the detection of ethyl glucuronide or etg testing can detect amounts in picograms one picogram equals 0 001 nanograms however there is one major difference between most drugs and alcohol metabolites in the way in which they enter into the hair on the one hand like other drugs faees enter into the hair via the keratinocytes the cells responsible for hair growth these cells form the hair in the root and then grow through the skin surface taking any substances with them on the other hand the sebaceous glands produce faees in the scalp and these migrate together with the sebum along the hair shaft auwärter et al 2001 pragst et al 2004 so these glands lubricate not only the part of the hair that is just growing at 0 3 mm per day on the skin surface but also the more mature hair growth providing it with a protective layer of fat faees nanogram one billionth of a gram appear in hair in almost one order of magnitude lower than the relevant order of magnitude of etg picogram one trillionth of a gram it has been technically possible to measure faees since 1993 and the first study reporting the detection of etg in hair was done by sachs in 1993 37 in practice most hair which is sent for analysis has been cosmetically treated in some way bleached permed etc it has been proven that faees are not significantly affected by such treatments hartwig et al 2003a faee concentrations in hair from other body sites can be interpreted in a similar fashion as scalp hair hartwig et al 2003b presumptive substance testing edit presumptive substance tests attempt to identify a suspicious substance material or surface where traces of drugs are thought to be instead of testing individuals through biological methods such as urine or hair testing the test involves mixing the suspicious material with a chemical in order to trigger a color change to indicate if a drug is present most are now available over the counter for consumer use and do not require a lab to read results duquenois reagent benefits to this method include that the person who is suspected of drug use does not need to be confronted or aware of testing only a very small amount of material is needed to obtain results and can be used to test powder pills capsules crystals or organic material there is also the ability to detect illicit material when mixed with other non illicit materials the tests are used for general screening purposes offering a generic result for the presence of a wide range of drugs including heroin cocaine methamphetamine amphetamine ecstasy mdma methadone ketamine pcp pma dmt mdpv and may detect rapidly evolving synthetic designer drugs separate tests for cannabis are also available 38 there are five primary color test reagents used for general screening purposes the marquis reagent turns into a variety of colors when in the presence of different substances dille koppanyi reagent uses two chemical solutions which turns a violet blue color in the presence of barbiturates duquenois levine reagent is a series of chemical solutions that turn to the color of purple when the vegetation of marijuana is added van urk reagent turns blue purple when in the presence of lsd scott test s chemical solution shows up as a faint blue for cocaine base 39 in recent years the use of presumptive test kits in the criminal justice system has come under great scrutiny due to the lack to forensic studies questioned reliability rendering of false positives with legal substances and wrongful arrests 40 41 42 saliva drug screen oral fluid based drug screen edit saliva oral fluid based drug tests can generally detect use during the previous few days it is better at detecting very recent use of a substance thc may only be detectable for 2 24 hours in most cases on site drug tests are allowed per the department of labor 43 detection in saliva tests begins almost immediately upon use of the following substances and lasts for approximately the following times alcohol 6 12 h 44 marijuana 1 24h a disadvantage of saliva based drug testing is that it is not approved by fda or samhsa for use with dot federal mandated drug testing 45 oral fluid is not considered a bio hazard unless there is visible blood however it should be treated with care sweat drug screen edit sweat patches are attached to the skin to collect sweat over a long period of time up to 14 days 46 these are used by child protective services parole departments and other government institutions concerned with drug use over long periods when urine testing is not practical 47 there are also surface drug tests that test for the metabolite of parent drug groups in the residue of drugs left in sweat an example of a rapid non invasive sweat based drug test is fingerprint drug screening 48 this 10 minute fingerprint test 49 is in use by a variety of organisations in the uk and beyond including within workplaces 50 51 drug treatment and family safeguarding services 52 53 at airport border control to detect drug mules 54 and in mortuaries to assist in investigations into cause of death 55 blood edit drug testing a blood sample measures whether or not a drug or a metabolite is in the body at a particular time these types of tests are considered to be the most accurate way of telling if a person is intoxicated blood drug tests are not used very often because they need specialized equipment and medically trained administrators depending on how much marijuana was consumed it can usually be detected in blood tests within six hours of consumption after six hours has passed the concentration of marijuana in the blood decreases significantly it generally disappears completely within 30 days random drug testing edit can occur at any time usually when the investigator has reason to believe that a substance is possibly being used by the subject by behavior or immediately after an employee related incident occurs during work hours testing protocol typically conforms to the national medical standard candidates are given up to 120 minutes to reasonably produce a urine sample from the time of commencement in some instances this time frame may be extended at the examiner s discretion diagnostic screening edit in the case of life threatening symptoms unconsciousness or bizarre behavior in an emergency situation screening for common drugs and toxins may help find the cause called a toxicology test or tox screen to denote the broader area of possible substances beyond just self administered drugs these tests can also be done post mortem during an autopsy in cases where a death was not expected the test is usually done within 96 hours 4 days after the desire for the test is realized both a urine sample and a blood sample may be tested 56 a blood sample is routinely used to detect ethanol methanol and asa paracetamol intoxication various panels are used for screening urine samples for common substances e g triage 8 that detects amphetamines benzodiazepines cocaine methadone opiates cannabis barbiturates and tricyclic antidepressants 57 results are given in 10 15 min similar screenings may be used to evaluate the possible use of date rape drugs this is usually done on a urine sample 56 optional harm reduction scheme edit drug checks tests also known as pill testing are provided at some events such as concerts and music festivals attendees can voluntarily hand over a sample of any drug or drugs in their possession to be tested to check what the drug is and its purity the scheme is used as a harm reduction technique so people are more aware of what they are taking and the potential risks 58 59 60 occupational harm reduction strategies edit drug and alcohol impairment while at work increases the risk of work place accidents and decreases productivity employers such as the commercial driving and airline industry may conduct random drug tests on employees with the goal of deterring use to improve safety 61 there is some evidence that increasing the use of random drug testing in the airline industry reduces the percentage of people who test positive however it is unclear if this decrease is associated with a corresponding decrease in fatal or non fatal injuries other accidents number of days absent from work 62 it is also not clear if there are other unwanted side effects that may result from random drug and alcohol testing in the workplace 62 commonly tested substances edit recreational substances edit anabolic steroids edit anabolic steroids are used to enhance performance in sports and as they are prohibited in most high level competitions drug testing is used extensively in order to enforce this prohibition this is particularly so in individual rather than team sports such as athletics and cycling methodologies edit before testing samples the tamper evident seal is checked for integrity if it appears to have been tampered with or damaged the laboratory rejects the sample and does not test it next the sample must be made testable urine and oral fluid can be used as is for some tests but other tests require the drugs to be extracted from urine strands of hair patches and blood must be prepared before testing hair is washed in order to eliminate second hand sources of drugs on the surface of the hair then the keratin is broken down using enzymes blood plasma may need to be separated by centrifuge from blood cells prior to testing sweat patches are opened and the sweat collection component is removed and soaked in a solvent to dissolve any drugs present laboratory based drug testing is done in two steps the first step is the screening test which is an immunoassay based test applied to all samples the second step known as the confirmation test is usually undertaken by a laboratory using highly specific chromatographic techniques and only applied to samples that test positive during the screening test 63 screening tests are usually done by immunoassay emit elisa and ria are the most common a dipstick drug testing method which could provide screening test capabilities to field investigators has been developed at the university of illinois 64 after a suspected positive sample is detected during screening the sample is tested using a confirmation test samples that are negative on the screening test are discarded and reported as negative the confirmation test in most laboratories and all samhsa certified labs is performed using mass spectrometry and is precise but expensive false positive samples from the screening test will almost always be negative on the confirmation test samples testing positive during both screening and confirmation tests are reported as positive to the entity that ordered the test most laboratories save positive samples for some period of months or years in the event of a disputed result or lawsuit for workplace drug testing a positive result is generally not confirmed without a review by a medical review officer who will normally interview the subject of the drug test urine drug testing edit urine drug test kits are available as on site tests or laboratory analysis urinalysis is the most common test type and used by federally mandated drug testing programs and is considered the gold standard of drug testing urine based tests have been upheld in most courts for more than 30 years however urinalysis conducted by the department of defense has been challenged for reliability of testing the metabolite of cocaine there are two associated metabolites of cocaine benzoylecgonine bz and ecgonine methyl ester eme the first bz is created by the presence of cocaine in an aqueous solution with a ph greater than 7 0 while the second eme results from the actual human metabolic process the presence of eme confirms actual ingestion of cocaine by a human being while the presence of bz is indicative only bz without eme is evidence of sample contamination however the us department of defense has chosen not to test for eme in its urinalysis program 65 relevant a number of different analyses defined as the unknown substance being tested for are available on urine drug screens spray drug testing edit spray sweat drug test kits are non invasive it is a simple process to collect the required specimen no bathroom is needed no laboratory is required for analysis and the tests themselves are difficult to manipulate and relatively tamper resistant the detection window is long and can detect recent drug use within several hours there are also some disadvantages to spray or sweat testing there is not much variety in these drug tests only a limited number of drugs can be detected prices tend to be higher and inconclusive results can be produced by variations in sweat production rates in donors they also have a relatively long specimen collection period and are more vulnerable to contamination than other common forms of testing 46 hair drug testing edit hair drug testing is a method that can detect drug use over a much longer period of time than saliva sweat or urine tests hair testing is also more robust with respect to tampering thus hair sampling is preferred by the us military 66 and by many large corporations which are subject to drug free workplace act of 1988 head hair normally growth at the rate of 0 5 inches per month 67 thus the most common hair sample length of 1 5 from the scalp would detect drug use within the last 90 100 days 80 120 strands of hair are sufficient for the test 68 in the absence of hair on the head body hair can be used as an acceptable substitute this includes facial hair the underarms arms and legs or even pubic hair because body hair usually grows slower than head hair drugs can often be detected in body hair for longer periods e g up to 12 months most drugs are analysed in hair samples not as the original psychoactive molecules but rather as their metabolytes for example ethanol is determined as ethyl glucuronide while cocaine use is confirmed using ecgonine testing for metabolytes reduces the likelihood of false positive results due to contamination one disadvantage of hair testing is that it cannot detect recent drug use because it takes at least a week after a drug intake for the metabolytes to show up in a growing hair above the skin 66 urine tests are better suited for detecting recent within a week drug use in a practical test hair sample is usually washed with a low polarity solvent such as dichloromethane to remove surface contaminations then the sample is pulverized and extracted with a more polar solvent such as methanol 69 although thousand different substances can be determined in a single gas chromatography mass spectrometry or liquid chromatography mass spectrometry experiment due to the low concentration of analytes practical measurements see...
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