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Drug testing, commonly used in health care, workplace, and
criminal settings, has become widespread during the past decade.
Urine drug screens have been the most common method for
analysis because of ease of sampling. The simplicity of use and
access to rapid results have increased demand for and use of
immunoassays; however, these assays are not perfect. Falsepositive
results of immunoassays can lead to serious medical or
social consequences if results are not confirmed by secondary
analysis, such as gas chromatography–mass spectrometry. The
Department of Health and Human Services’ guidelines for the
workplace require testing for the following 5 substances: amphetamines,
cannabinoids, cocaine, opiates, and phencyclidine. This
article discusses potential false-positive results and false-negative
results that occur with immunoassays of these substances
and with alcohol, benzodiazepines, and tricyclic antidepressants.
Other pitfalls, such as adulteration, substitution, and dilution of
urine samples, are discussed. Pragmatic concepts summarized in
this article should minimize the potential risks of misinterpreting
urine drug screens.
2007-12-18T18:38:33Z
2009-06-30T18:14:22+10:00
2009-06-30T18:14:22+10:00
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Urine Drug Screening: Practical Guide for Clinicians
Urine Drug Screening: Practical Guide for Clinicians
Drug testing
commonly used in health care
workplace
and
criminal settings
has become widespread during the past decade.
Urine drug screens have been the most common method for
analysis because of ease of sampling. The simplicity of use and
access to rapid results have increased demand for and use of
immunoassays
however
these assays are not perfect. Falsepositive
results of immunoassays can lead to serious medical or
social consequences if results are not confirmed by secondary
analysis
such as gas chromatography–mass spectrometry. The
Department of Health and Human Services’ guidelines for the
workplace require testing for the following 5 substances: amphetamines
cannabinoids
cocaine
opiates
and phencyclidine. This
article discusses potential false-positive results and false-negative
results that occur with immunoassays of these substances
and with alcohol
benzodiazepines
and tricyclic antidepressants.
Other pitfalls
such as adulteration
substitution
and dilution of
urine samples
are discussed. Pragmatic concepts summarized in
this article should minimize the potential risks of misinterpreting
urine drug screens.
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