Specimen Adulteration and Substitution in Workplace Drug Testing.

Throughout the history of workplace drug testing, individuals have attempted to subvert their drug test results to mask their use of illegal drugs. Urine workplace specimens have been subject to tampering, from early attempts involving household chemicals and simple dilution or substitution to current attempts using the multitude of readily available commercial adulteration and substitution products. The manufacturers of such products continue to alter product composition or develop new products to bypass detection procedures and policies implemented by drug testing laboratories and regulatory agencies. This article provides a chronological review of laboratory and regulatory efforts to combat the problem, and presents data from studies on selected commercial adulterant products by the Department of Health and Human Services.