Many alternatives to the industry standard of urine drug testing have emerged over the last few years and at least one of these alternatives is beginning to gain acceptance.

Blood

Although blood drug testing is as accurate as urine drug testing, and it is difficult to alter results, the major concern is the invasive nature of the collection process. Also the cost of collection and analysis is greater.

Saliva

Many experts indicate that they would prefer the analysis of saliva to that of urine. Saliva collection is thought to be less objectionable in nature, and parent drug detection is higher than in urine. Currently, an unfortunate disadvantage to saliva drug testing is the high risk of contamination and false positives by oral and nasal routes. Also, drugs are only detectable for one to two days.

Sweat

The sweat patch, although accurate in the testing for drug use, has one major flaw. The collection process is quite lengthy, in that the donor must have the patch applied, wear the patch for 10 days to two weeks, and then have the patch removed and sent to a laboratory for analysis. Many consider this approach too invasive and others agree that the potential for adulteration is very high.

Fingernail

Although fingernail specimens can accurately detect drugs of abuse, the overwhelming disadvantage is the inability to detect recent drug use. Most fingernail clippings are between five and six months old by the time they can be obtained and would give very little insight as to recent use of drugs. Fingernail use is, however, gaining acceptance in the postmortem setting.

Hair

Unlike urine testing, hair testing can detect drug use for a much longer period. The standard hair test will detect drug use for up to three months. Hair testing's greatest advantage is the ability to create a permanent record of drug use in the strand (shaft) of the hair. All positive screening tests are confirmed using special GC/MS (gas chromatography/mass spectrometry) or MS/MS (tandem mass spectrometry). The collection process involves clipping a specimen from the crown of the head and preparing the specimen through precise chain-of-custody and packaging for shipment to the laboratory for analysis. The appropriate use of the hair test has traditionally been for pre-employment and follow-up situations. The primary reason for this is the fact that it is not possible to get the most recent drug use from a hair specimen since it takes several days for hair to grow out enough to obtain a specimen. The perfect combination is both urine and hair analysis. Such a program will incorporate the testing of both at one laboratory to provide recent and long term use of the five primary drugs of abuse: marijuana, cocaine, amphetamines, opiates and PCP (Phencyclidine).

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What is Hair Screening?

A State-of-the Art method for detecting drugs in hair using enzyme-immunoassay (EIA). EJA measures the drug molecules permanently entrapped in the hair which were incorporated following ingestion.

What drugs are included in a standard Hair screen?

Cocaine, marijuana, opiates, methamphetamine, and phencyclidine (PCP). These drugs were identified as "illegal drugs" in The President's Executive Order 12564 and are the five drugs mandated for testing by the Federal Government.

What time period does a standard hair test cover?

A standard screen covers a period of approximately 90 days. The hair sample is cut as close to the scalp as possible and the most recent 3.9 centimeters are tested.

How fast does head hair grow?

Studies indicate that hair collected at the crown of the head grows on the average approximately 1.3 cm (or 1/2 inch) per month. this growth rate varies among people (estimated at 0.2 cm per month (iSO), consequently the same 3.9 cm length of hair can represent different time periods.

How much hair is needed?

A standard screen with GC/MS confirmation requires 20 milligrams of hair or approximately 60 strands.

How does Hair Testing compare to urinalysis?

The primary difference is the wider window of detection with hair. Cocaine, methamphetamine, opiates and PCP are rapidly excreted and usually undetectable in urine 72 hours after use. The detection period for HAIR is limited only by the length of the hair sample and is approximately 90 days for a standard screen. Additional advantages include non-intrusive collection procedures, virtual elimination of test evasion; greater accuracy through test repetition capability. The combination of an increased window of detection and resistance to evasion makes HAIR far more effective than urinalysis in correctly identifying drug users.

How soon after use can a drug be detected in hair?

It takes approximately 5-10 days from the time of drug use for the affected hair to grow above the scalp.

What is the shortest time period that can be accurately evaluated?

In most situations the minimum time period is approximately one month. Due to variability of hair growth rates, EIA cannot go back in time to determine if an individual used drugs on a particular day or week.

Can hair tests be run on people with little or no hair?

Yes, hair can be collected from several locations on the head and combined to obtain the required amount of hair. In addition, body hair can be used as an alternative to head hair.

Does body hair give the same type of results as head hair?

Yes, body hair can be used to test for the five standard drugs. Body hair growth rates are considerably more variable and slower than head hair. Most body hair is genetically controlled and replaced within one year. Therefore, it is difficult to accurately represent the time period of a standard screen with body hair.

Can hair collected from a brush be used?

No, the Testing Lab requires a hair sample to be collected using proper chain-of-custody protocols that will withstand a legal challenge. The Testing Lab requires that the sample be submitted with Sample Acquisition Materials. The test subject must initial the sample to certify the authenticity of the sample at the time of collection.

How does the Testing Lab establish its cut-off levels?

Cut-off levels are established by the minimum detection levels for GC/MS confirmation.

What are the differences between Hair cut-off levels and urinalysis cut-off levels:

In general, cut-off levels for urinalysis have been established to reduce the possibility of an evidential false positive due to passive inhalation. A true comparison of Hair/urine cut-off levels is impossible, since the time frame differs (90 days vs. 3 days). SAMHSA's (NIDA's) recommended cut-off levels for forensic urinalysis tests are expressed in nanograms per milliliter (ng/ml) of urine. HAIR cut-off levels are expressed in nanograms per milligram (ng/mg) of hair.

Does the Testing Lab perform GCMS confirmation of all positive Hair results?

The Testing Lab provides automatic confirmation for ALL specimens that screen positive screen (opiates, PCP, methamphetamine, cocaine and marijuana).

Can Hair be affected by cross-reacting substances such as over-the-counter medications?

Enzyme-immunoassay antibodies (EIA), similar to those used to test urine, are used for the initial screening test for drugs of abuse in hair; therefore the potential for substances such as over-the-counter medications to cause a false positive screening result does exist. To eliminate the possibility of reporting a false-positive due to cross-reactivity, the Testing Lab automatically confirms by GC/MS all positive results for methamphetamine, opiates, PCP, cocaine and marijuana.

How effective is Hair Testing in detecting drug users?

In side-by-side comparison studies with urinalysis, the cocaine, PCP, opiates, and methamphetamine assays have proven hair analysis far more effective than urine in identifying low-level drug use. The marijuana screen is currently less sensitive than the other drugs in identifying low level drug users but is considered roughly equal to urinalysis in identifying marijuana users.

Does external exposure to certain drugs, like marijuana or crack smoke, affect the HAIR results?

ALL hair samples that produce a positive screening result are washed extensively to remove external contamination and re-screened for the potential positive drug. If the secondary HAIR screen is positive and the ratio of the wash solution is greater than 10% of the confirmation result, the Testing Lab will consider this sample contaminated. If the ration of the wash solution is less than 10% of the confirmation result, the Testing Lab will consider the sample as positive. Marijuana does not follow the wash patterns of the other drugs. To rule out the possibility of external contamination for marijuana, the Testing Lab exclusively detects ONLY the metabolite (THC-COOH) which is only produced by the body and cannot be an environmental contaminant. In addition, the Testing Lab will NOT analyze pubic hair for the presence of the THC-COOH metabolite.

Does treatment of the hair affect test results?

Commonly used hair products (e.g. shampoos, conditioners, sprays, mousses and gels) have no significant effect on Hair test results. In fact, normal hair washing helps to remove external contamination. Extensive bleaching, perming and dyeing may damage the protein matrix of hair allowing a portion of the drug from the hair to be extracted, lowering the final quantitative result with certain drugs. Treated hair can be readily identified from the wash ratios and/or staining procedure. Treated hair results will be reported indicating that the correlation between the extent of drug use and the quantitative result were affected.

What is done with the excess hair that is not tested?

The hair not used from the time period being tested (i.e. three months equals 3.9 cm) and all remaining hair is stored in the chain-of-custody sample acquisition pouch. Negative hair is stored for one month. Positive hair is stored for one year.

How long are positive and negative test result reports kept on file?

All laboratory records and test results are kept for a three year period.

Has the Testing Lab had to defend hair analysis in a lawsuit filed by an employee or applicant?

The Testing Lab has worked closely with customers who have been challenged or named in lawsuits based on action taken from positive hair analysis results. To date, based in part on the Testing Lab's chain-of-custody documentation and ability to provide valid and reproducible re-tests, all threats or lawsuits were dropped.

What other drugs are available to be tested in hair analysis?

Currently, nicotine, methadone, simple benzodiazepines, tricyclic antidepressants, assays and mescaline have been detected in hair. However, many details such as cutoff levels and dose response relationships have not yet been established for these compounds.

What is the basis of the racial bias claims for hair analysis?

Racial bias suggests that different racial groups will incorporate drugs into hair at a different rate as compared to another racial group (Caucasian vs. black African). Hair color is determined by the amount of pigment (melanin) contained in the shaft. Drugs are believed to bind to melanin in a different manner than other cellular structures in the hair.

How do drugs get into hair (what is the basis of hair analysis)

As drugs circulate in the blood stream, they enter and nourish hair follicle cells. As cells grow, they trap the drug molecules within the hair cells and are eventually "sealed" in the keratinized hair shaft. Thus, the amount and time the drug(s) are in the blood stream is proportional to the amount of drug detected in the hair.

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