Examination of Firearms Review: 2007 to 2010 - Interpol

2.5% percentiles bear a high risk of misinterpretation, and gender-specific and
creatinine-adjusted decision limits are suggested to differentiate urine
adulteration. Two drug normalization procedures based on specific gravity and
creatinine to compensate for excessive hydration were applied to urine
specimens collected from three distinct groups (pain patients, heroin users,
and marijuana/cocaine users) [ 125 ]. By applying this normalization, an
increase in percent positives was observed, particularly for marijuana/cocaine
users (2- to 38-fold increases).
A literature review of the influence of poppy seed foods on opiate drug tests
revealed that the possibility of false-positive opiate drug tests after poppy food
ingestion is genuine and that there are no unambiguous markers available to
differentiate poppy food ingestion from heroin or pharmaceutical morphine use
[126]. Capsule and drink type detox agents were evaluated for their ability to
alter the elimination of MA in rats, and no significant differences was found
between the control and detox-dosed groups in the amounts of MA and AP
excreted into urine or in the volume of excreted urine [127].
2.3.2 Alternative specimens
The addition of accurate and reliable workplace drug testing using hair, oral
fluid, and sweat patch specimens can complement urine-based drug testing,
and aid in combating products intended to subvert drug testing through
adulteration, substitution, and/or dilution. In 2004, significant revisions of the
U.S. Department of Health and Human Services (HHS) drug testing standards
were published defining, standardizing, and requiring specimen validity testing
on Federal employee donor urine specimens [128].
2.3.2.1 Oral fluid
Oral fluid offers multiple advantages as an alternative matrix for drug
monitoring and therefore has an increasingly important role in DUID, treatment,
workplace, and criminal justice programs. A review has outlined oral fluid
testing advantages and limitations, and the progress in oral fluid testing in the
last 5 years with respect to the collection of oral fluid and subsequent
screening, confirmation, and results interpretation for cannabinoids, opioids,
amphetamines, cocaine, and benzodiazepines [27]. In another review, it was
noted that significant developments have occurred; i.e., new pharmacokinetic
studies have been conducted, optimal cutoffs have been proposed, and the
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