Specimens for Drugs-of-Abuse Testing

A wide variety of body fluid specimens have been utilized for analysis for the presence of drugs of abuse. Urine has been and remains the most widely used body fluid specimen for routine testing for drugs of abuse, but several alternative specimens are establishing their place as suitable for drug testing. Hair, sweat, and oral fluid have reached a sufficient level of scientific credibility to be considered for use in the federally regulated workplace drug-testing programs. Each specimen provides different information about time and extent of use and likelihood of impairment. Some of these specimens (e.g., urine and oral fluid) can even be analyzed with simple on-site, noninstrumented testing devices, as well as through standard laboratory methods. These drugtesting tools, as objective pieces of information identifying drug use, have proven highly useful in addressing our society’s ongoing substance abuse challenges. This chapter reviews the use of these various body fluid specimens for drugs-of-abuse testing, addressing the balances between ease of specimen collection and handling, the ease and accuracy of analytical methods, the capability for sound interpretation of results, and, ultimately, legal defensibility.