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How Much Water Will Dilute a Drug Test?

The most common drug test adulteration technique is drinking water to dilute a urine sample. The variation in water expelled in urine from person to person makes it hard to detect and since the urine still comes from the subject’s body temperature strips and observation witnesses cannot detect water dilution. How much water does it take to dilute a drug test enough to pass though?

How Drug Tests Work

The first thing you need to know is how urine drug screens work. They contain antibodies that attach to metabolites in the urine of the person being tested. The test determines if the amount of antibodies which correlate to a drug in the urine are over or under a specified cutoff level.

Other testing methods determine the exact quantity of metabolites as well as several other levels such as creatinine, protein and pH. In these more advanced laboratory tests the creatinine level in the sample is a clear indication of water loading and the sample will either be corrected and normalized based on the creatinine levels in your urine or will be marked a failure for dilution outright.

Past a certain point urine dilution will raise suspicions or lead to a failed test, however for someone that doesn’t drink the recommended daily allowance of water under normal circumstances drinking water can significantly lower the concentrations of metabolites in your urine without turning the urine completely clear and without failing an analysis for low creatinine levels.

Did You Know? The average person urinates between 35-50 ounces every day and makes an average of 4-10 trips to the bathroom.

Federal Recommendations for Drug Test Cutoff Levels

  • THC 50 ng/mL
  • COC 300 ng/mL
  • OPI 2000 ng/mL
  • AMP 1000 ng/mL
  • MET 1000 ng/mL
  • BZO 300 ng/mL
  • MDMA 500 ng/mL
  • MTD 300 ng/mL
  • OXY 100 ng/mL
  • BUP 10 ng/mL
  • BAR 300 ng/mL
  • TCA 1000 ng/mL

How Water Dilution for Drug Testing Works

The average healthy adult has a bladder that will comfortably hold 16 ounces or 2 cups of liquid. Water loading works by increasing the excess water in your body so the bladder will refill with excess water before the normal mixture of byproducts and the normal level of water used to expel these byproducts accumulates back into the bladder.

The timeframe of ingestion matters as much as how much water you drink. It takes between 45-120 minutes for ingested water to start pushing urine out of your body.

 

Urine color chart
Witnesses and technicians will expect to see some tint to your urine sample. A sample that is entirely clear is a big red flag, but even the slightest tint is acceptable in most cases.

 

Since a drug test captures a single photograph of your urine content, the goal of someone trying to adulterate their urine by water dilution is to have the optimum ratio of excess water and normal urine at the time they submit their test.

When it comes to urine dilution you really need to ask yourself 2 questions.

How much water can I ingest without turning my urine totally clear?

How much water will it take to reduce metabolite concentrations under the most likely cutoff levels?

How much water can I ingest without turning my urine totally clear?

It is hard to say exactly how much water you can ingest before your urine starts to come out clear because there are so many variables, but in a 1-2 hour timeframe approximately twice bladder capacity plus the amount of water your body is expelling through sweat and cellular process results in clear urine. Roughly 32 ounces of water in a 1-2 hour period will bring your urine to the point it will start to be completely clear.

A study in the Annals of Pediatric Edocrinology Metabolism found that the maximum amount of water a person should ever drink is between 27-33.8 ounces per hour. This is the maximum amount of water a healthy human body can process without causing harmful effects to electrolyte ratios.

Medical review

How much water will it take to reduce metabolite concentrations under the most likely cutoff levels?

Now that we know the level of each metabolite your urine must be under you need to know the level of the metabolite currently in your urine. You could send a urine sample off for a laboratory gas chromatography and mass spectrometry test but that would be prohibitively expensive. The best most people can do is guess.

In one study Urinary Elimination of 11-Nor-9-carboxy- 9-tetrahydrocannnabinol in Cannabis Users found that out of the 60s subjects admitted to the test they were evenly spread out between the groups of <50ng/ml, 50-150ng/ml and >150ng/ml. The studied showed that higher concentrations took much longer to eliminate detectable levels from their system.

 

THC drug test levels graph
As you can show the metabolite for THC is detectable far longer for heavy users.

 

Users that were under the 50ng/ml cutoff at the beginning routinely started passing drug tests on the first or second day. All subjects that were under the 50ng/ml cutoff had eliminated all detectable THC metabolite (<5ng/ml) by day 8. It took 15 days for half the users between 50-150ng/ml to eliminate detectable THC metabolite. 80% of users that started over 150ng/ml level still had a detectable amount of THC in their urine at the end of 30 days.

The good thing for a user wanting to pass a drug test is that instant drug tests have a 50ng/ml cutoff. That means that light users will pass a normal test in 3-7 days and the average user that starts below 150ng/ml will be able to dilute their urine by half on the 2nd day and pass a test, which is the top of the range of how much water you can ingest without turning your urine totally clear.

Is Water Dilution Illegal or Unethical?

The god news is that the optimum water content of urine to have the best chances of passing a rigorous drug test is also around the normal recommended daily allowance for water. Since you do not want your urine to be totally clear you’re aiming for a pale straw coloration that is indicative of optimum water intake.

Most people do not drink the recommended amount of water, and it also causes their urine to have longer detection times than people that stay well hydrated.

If you drink so much water that your urine is clear and your body is passing urine with low levels of creatinine it is unethical and it could also lead to punishment depending on the circumstances of your drug test. Adulterating a drug test is illegal in many states and some prosecutors would make the argument that urine diluted by drinking an excessive amount of water is a clear case of adulteration.

 

 

 

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Can Drug Tests Detect Gender?

Can a Drug Test Detect Gender

We’ve all heard the stories of a man bringing his wife’s urine to cheat on a drug test and when he asks the doctor about his results the doctor responds “well you’re clean on drugs, but did you know you were pregnant?”. Can drug tests detect gender, or is this an urban legend that is an entertainment trope?

Can drug tests detect gender?

This is actually a complicated question with many aspects. In the simplest terms a drug test itself cannot detect gender. A drug test only tests for the presence of specific metabolites associated with a specific drug.

However urine tests are widely available that detect hCG (human chorionic gonadotropin), a hormone that is produced by the placenta of pregnant women. Many of our clients have a need for testing women for pregnancy because the type of treatment and care changes for a patient that is pregnant. It is relatively cheap to add an hCG strip to testing.

 

hCG Pregnancy Test
A pregnancy test detects levels of hCG in a woman’s urine. The placenta starts to release hCG as early as 14 days after fertilization.

 

In cases where drug tests are sent to the lab a gas chromatography and mass spectrometry instrument breaks down the sample into all its components. For confirmations a lab technician will focus on the analyte associated with the positive test strip, but all of the compounds are identified. A high level of hCG would be recognized fairly quickly.

So it is true that drug testing would identify pregnancy in cases when providers test for pregnancy or samples are sent to a lab. The assays found in drug test cups and used in laboratory immunoassay tests do not detect hCG though.

What Are the Differences in Men and Women’s Urine

In the rare case a lab technician or medical review officer suspects a subject has used a urine sample from someone of the opposite sex the sample can be put through additional analysis to support their suspicions. Even though a drug test itself cannot determine gender, other tests can indicate gender.

The biggest differences in each sex’s urine are trace hormones, but there are indicators that may cause a lab technician to become suspicious and investigate further.

Women

  • Women’s urine can contain hCG (the analyte used to detect pregnancies).
  • Women’s urine can be contaminated by blood during menstruation.

Men

  • Men process alcohol differently. Higher concentrations of dehydrogenaze are present after consuming alcohol.
  • Men have higher muscle mass which can increase creatinine levels.
  • Male samples can contain traces of sperm or pre ejaculate, however females can too for 8-12 hours after sex.

Foreign matter such as blood and semen are good indicators of gender, but are far from definite because men can have blood in their urine and women can have male semen in their urine after sex.

The easiest hormone to identify a person’s gender in urine is testosterone. Men produce less testosterone as they age, but will always excrete significantly more testosterone in their urine. Marijuana has been shown to suppress the production and secretion of testosterone and other androgens.  A study conducted by the Worcester Foundation for Experimental biology found that men excrete 28-250 μg of testosterone in their urine, while women excrete 2.4-8μg.

Testosterone Levels in Urine

Sex / AgeAVG Testosterone Levels
Male 18-28171 μg (range 65–250)
Male 30-3589 μg (range 45–150)
Male 42-5581 μg (range 28–159)
Female 23-376 μg (range 2.4–8)

 

Can Drug Blood & Hair Drug Tests Detect Gender?

It is almost impossible to adulterate or substitute hair or blood samples during a drug test because a subject has to physically present themselves to have samples taken. A technician will confirm the identity of the subject at the time of sample donation. Any anomalies that indicated a different gender would be investigated as a health issue instead of possible tampering.

However, the same hormones that are present in urine are present in a person’s blood, and DNA from human hair can be used to determine a person’s gender.

Hair samples can give an indication of gender simply by the length and treatment when examined under a microscope, but nuclear or mitochondrial DNA would be needed to determine gender with a hair sample definitely.

Considerations When Testing Different Genders

Even though the basic mechanisms of how a drug test works is the same whether you are testing a male or female, there are some differences you may want to account for. For example women process alcohol slower than men. It would be easier for a female to have some drinks at night and still have alcohol passing through their system the next morning.

Another consideration is that women have a much higher body fat percentage than men. A healthy middle aged male has a body fat percentage of 20% while a healthy female of the same age has a body fat percentage of 30%. Drugs or metabolites that bind to fatty tissues can be detected longer in an individual with a higher body fat content.

 

GenderBody TypeBF % Age 20-39BF % Age 40-59BF % Age 60-79
MaleUnderweight<8%<11%<13%
MaleNormal8%-20%11%-22%13%-25%
MaleOverweight20%-25%22%-28%25%-30%
MaleObese>25%>28%>30%
FemaleUnderweight<21%<23%<24%
FemaleNormal21%-33%23%-34%24%-36%
FemaleOverweight33%-39%34%-40%36%-42%
FemaleObese>39%>40%>42%

 

This doesn’t mean that a woman that you should alter results for females, but there are many instances when this knowledge is useful. For example after a failed drug test you can expect women to have a slightly longer detection time for drugs that have an affinity for fatty tissue. It can help with scheduling retests, confirming patient statements, and advising clients about detection times.

Will You Get Caught if You Use Urine From the Opposite Sex to Cheat a Drug Test?

Using urine from the opposite sex to pass a drug test will go unnoticed in the vast majority of drug screens because assays only detect the metabolite they are designed for. A male using a pregnant female’s urine would increase the likelihood of being caught because of the hCG content.

However, you are much more likely to be caught  substituting urine by a witness during screening, a cold temperature strip, suspicion from staff, or a number of other discrepancies that are present when you substitute someone else’s urine for a sample.

 

 

 

 

 

 

 

 

 

 

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Which Drug Test Do Most Probation Offices Use?

Drug Test at probation office

Drug testing parolees and probationers is one of the most complex and specialized instances of drug testing. The consequences are high and the subjects are very clever when it comes to tampering. Probationer officers and parolees alike often want to know which drug test probation offices use.

Which drug tests do most probation offices use?

The 12 Panel Clia Waived drug test is by far the most common test used by probation offices across the country. A 12 panel drug test covers all of the well known illegal drugs such as cocaine, marijuana, heroin and ecstasy as well as pharmaceuticals like opiate painkillers, Xanax, valium and buprenorphine.

Users are always finding new drugs that they can take that won’t show up on a drug test, but a 12 panel drug test pretty much covers the basics for probation office use.

 

Neurontin 800 mg
Neurontin was recently added as a scheduled narcotic after probation officers found their clients were taking Neurontin because it wasn’t on their drug test.

 

Across the United States however testing varies. Probation officers choose tests based on the drug use in their area. Almost all probation offices use instant drug test dip cards or cups, but some use 5 panels and some use 12 panels.

For instance one probation office surveyed in North Carolina used 5 panel tests, but also had alcohol and benzodiazepine tests to use for probationers that used those drugs and to randomly check others. A probation office in Michigan used 12 panel tests but also used an ETG (alcohol) test.

Why 12 Panel Drug Tests?

The main reason probation offices would choose a 12 panel instant test is because it’s the most drugs you can test for in a single device and still have it CLIA waived. A CLIA waived test is important because it takes minimal instruction to use and officers do not need special training.

It is important for probation offices to use instant drug tests because they do a high volume of testing, it is much cheaper and it also allows officers to have immediate results. Positive test results will always be confirmed at a lab, and in most cases your probation officer will wait until those results come back to pursue any punishment.

 

12 Panel Drug Test Cup Strips shown
Probation offices can purchase Drug Test City 12 Panel Drug Test Cups for $2.70, which saves tens of thousands of dollars annually over a drug testing lab.

 

Drug Test Cups are preferred because the price difference is negligible and they’re much more sanitary than using dip cards.

During the last decade probation officers used 5 panel tests that would identify the use of most popular illicit drugs including heroin, marijuana cocaine and methamphetamine. As areas started to see more prescription drug abuse they started to expand to cover the most widely abused prescription medications.

In some regions it is fairly easy to get a prescription to cover this type of drug use, which slowed down agencies from adopting more comprehensive drug tests even more.

Probation Drug Testing Changes on a Regional Level

One probationer that was released from his probation in 2007 said, “I was caught in Minnesota with Oxycontin and charged with felony possession. I was offered a plea bargain that would drop the felony to a misdemeanor in exchange for 1 year on probation, they said I was the first person to ever be caught with pain pills crushed up. Once I checked in at my probation office I noticed they only used a 3 panel drug test, so I continued using prescription painkillers the entire probation”.

States like West Virginia saw an early rise in prescription drug abuse and changed their drug testing programs to reflect that. From 1999 to 2004 deaths from unintentional drug poisoning increased 68% nationwide, while West Virginia experienced the Nation’s largest increase at 550%. West Virginia probation offices were purchasing panels for Oxycodone and other prescription medications as early as 2001.

As prescription drug abuse has increased across the country so has testing for those substances. In 2020 the majority of probation offices are using 12 panel drug tests that are comprehensive, but there are still offices that focus primarily on illicit drugs that have no medical use.

The Future of Probation Drug Testing

Probation officers change with the landscape. Many are already using additional panels to test for alcohol and fentanyl, and some probation offices have started random testing for Gabapentin (Neurontin) because probationers often turn to drugs that aren’t as well known to get high without risking arrest. Other popular replacement drugs are Tramadol, Kratom and designer drugs like spice, K2, Flakka or bath salts.

Most drug tests will include fentanyl after the FDA starts issuing CLIA waivers for those panels. Most 12 panel drug tests have removed PCP and replaced it with Tricyclic Antidepressants in the past few years.

It is a constant game of cat and mouse between probation officers and probationers trying to cheat the system. The only thing for certain is that probation officers will continue to change up and surprise probationers and the only surefire way to keep from getting your probation revoked is to obey the law and practice abstinence from drug use during your sentence.

If you’re a probation officer or probationer we’d love to hear about your drug testing program and which tests you use! Contact us and let us know.

 

 

 

 

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Faint Lines on Drug Tests Explained

It is very common to have faint lines on drug tests. Most at home drug tests explicitly state that a faint line is a negative result, but customers still assume that it means there is some level of the drug present.

Faint Lines on Drug Tests Are Negative

Faint lines are always negative. The purpose of a drug test is to determine whether there is less or more of a certain concentration of metabolite present in the urine. You should interpret all Drug tests on a pass / fail basis. Drug testing cups are not quantitative and cannot indicate the amount of a drug that is present in the sample.

 What Causes Faint Lines on a Drug Test?

Keep in mind on a 12 panel drug test you are actually performing 12 assays at once. Each test uses its own regeant and calibration. THC tests are notorious for having faint lines even for donors that have never smoked in their lives.

 

Faint Line drug test
THC tests are more likely to have faint lines because of components of the test itself as well as more natural substances interacting with the regeant.

 

Tests are designed for consistent results display, but each assay is never going to have identical line darkness. It would be more accurate to compare the darkness of strips testing the same drug than different strips on a multi-panel cup.

Variations in Urine Makeup

Urine is a complex substance that varies in makeup from person to person. The chemical makeup of urine alone can lead to test lines showing lighter or darker from one person to the next. Researchers published a database showing over 3,100 small molecule metabolites that can be found in urine. 1,500 compounds are created by the body alone and an additional 2,300 compounds come from diet, cosmetics, drugs and the environment.

 

Chemical makeup of human urine
This graph shows the components of human urine. In addition to these components there are hundreds of trace substances included in “other” section as well as thousands of trace contaminants.

 

External Variables

There are also dozens of variables that exist outside the laboratory that play into drug testing results.

  • Temperature of the room
  • Temperature of the urine
  • Humidity
  • Urine dilution
  • Age of the test
  • Amount of urine in the cup
  • Amount of time the cup has sat before reading results

Cross Reactivity

There are many substances that can lead to false positives, and in a similar vein many substances can cause a faint line on a drug test. People take more prescription medication, over the counter medication, supplements and vitamins these days. Rapid drug tests are testing for metabolites that those drugs are broken down into and not the drug itself . Our bodies naturally produce about 4 grams of alcohol every day.

Trace Levels

Finally trace levels of the metabolite can cause a minor fading of the assay line. It’s always the first instinct of someone to believe trace levels are what causes faint lines on drug tests, and in some cases that’s true. The target metabolites are far more reactive than any other substance that could be found in the urine. However a faint line is still a line and indicates a negative result.

Addressing Faint Lines on Drug Tests

Even though you will always have to deal with faint lines you can do things to make sure your results are as accurate as possible.

  • Tightly control independent variables during testing and storage, especially temperature.
  • Consistently read results at the 5 minute mark.
  • Discard expired tests.
  • If possible test first thing in the morning before the subject can ingest water.
  • Have subjects report all medications, supplements, and energy drink consumption.

 

 

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What is BUP On a Drug Test?

What Does BUP mean on a drug test

BUP on a drug test stands for Buprenorphine.

When customers purchase a 12 panel drug test they usually recognize most of the abbreviations, but may be confused by the pharmaceuticals.

What is BUP on a Drug Test?

BUP stands for Buprenorphine. Buprenorphine (BUP) is an opioid that is most commonly used to treat chronic opioid addiction. It’s often prescribed as Suboxone, which contains naloxone to discourage misuse. Suboxone is prescribed in a tablet or strip that is menat to be taken sublingually (under the tongue).

Buprenorphine (BUP) is long acting and has a low ceiling compared to its toxic level. This means that at a certain dose taking more won’t make you higher, it just wastes more of your medication. The ceiling is far below the level where the drug becomes lethal due to respiratory depression. On the contrary Heroin hs a high ceiling (the more you take the higher you get) and the level where someone is very high is close to the level where it is lethal.

 

Buprenorphine tablets
An 8mg Suboxone tablet contains Buprenorphine & Naloxone and is dissolved under the tongue.

 

Since the danger is lower and the effects last so long the government has allowed Suboxone clinics to have more relaxed guidelines than Methadone clinics. It’s also subsidized by healthcare. All of these factors has lead to buprenorphine (BUP) becoming the opioid of choice for drug users that are addicted to opiates and don’t have much money to keep up a heroin addiction. Users can get their own prescription for Suboxone or trade for it cheaply on the streets.

In many areas hardest hit by the opioid epidemic users have moved to using cheaper methamphetamine to get high and buprenorphine to fight withdrawals from the oxycodone and heroin they were previously addicted to.

Pregnant mothers are given Subutex, Buprenorphine without naloxone, because it is thought to be less harmful to unborn babies.

Buprenorphine (BUP) was patented in 1965 but wasn’t approved for medical use until the early 1980s.

Buprenorphine (BUP) is a schedule III drug in the United States.

Side Effects of Buprenorphine

  • Respiratory Depression
  • back pain
  • Bladder pain
  • bloating of extremities
  • bloody or cloudy urine
  • blurred vision
  • cough
  • diarrhea
  • painful urination
  • difficulty breathing
  • dizziness
  • fever
  • headache
  • lethargy
  • loss of appetite
  • nausea
  • nervousness
  • pale skin
  • pounding in the ears
  • slow or fast heartbeat
  • stomach pain
  • tightness in the chest
  • tingling of the hands or feet
  • troubled breathing with exertion
  • tunnel vision
  • weight gain
  • weight loss

Additional Precautions

Suboxone is often prescribed in the form of a strip that could be mistaken for something else. As a sublingual medication it can be absorbed easily through the mucous membranes.

The naloxone and Buprenorphine can be very dangerous to someone that hasn’t taken Buprenorphine recently but has taken other opioids. Buprenorphine has a much higher affinity for opioid receptors and can cause immediate withdrawal like effects to the user.

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What is MTD On a Drug Test?

What is MTD on a Drug Test

MTD on a Drug Test stands for Methadone.

When parents and employers purchase drug tests they usually recognize the abbreviations for common illicit drugs such as THC for Marijuana. It is common for one or two abbreviations to stump them.

What is MTD on a Drug Test?

MTD stands for Methadone. Methadone (MTD) is an opioid originally developed as a treatment for pain during World War II by German scientists Gustav Ehrhart and Max Brockmuhl. It was developed as part of a program aimed at easing the demand on the raw materials used in morphine production.

Originally patented under the trade name Dolophine, Methadone (MTD) is still used as a maintenance pain reliever often prescribed in conjunction with other opioids for breakthrough pain. It is  thought to be more effective against neuropathic pain and takes longer to build a tolerance to because of its inactivity on the NMDA receptor.

 

MTD Methadone Wafer Tablet
40 mg Methadone (MTD) Wafer tablet. These tablets are often mixed with 4 oz of water before ingesting.

 

Since the 1970s Methadone (MTD) has been used in detoxification and opiate maintenance programs.

The half life and effects of Methadone (MTD) are significantly longer than other opioids. Persons addicted to heroin or other opiate based painkillers can often substitute Methadone and live productive and fulfilling lives.

Methadone (MTD) is widely used as a detox drug in hospitals. Some Medical Doctors prefer Morphine because Methadone’s withdrawal symptoms are protracted and it’s sometimes harder on the patient. Methadone maintenance programs are controversial, but almost all patients that are successful in a maintenance program say that it has dramatically improved their life.

Methadone (MTD) is a schedule II drug in the United States.

Methadone (MTD) Test Detection Time

In a presumptive urine drug screen the detection time for Methadone can vary from 3-9 days depending on use and the patient’s metabolism.

Side Effects of Methadone

  • Sedation
  • Constipation
  • Flushing
  • Sweating
  • Heat intolerance
  • Dizziness or fainting
  • Light Headedness
  • Weakness
  • Chronic fatigue, sleepiness and exhaustion
  • Sleep problems such as drowsiness,trouble falling asleep (Insomnia),and trouble staying asleep
  • Constricted pupils
  • Dry mouth
  • Nausea and vomiting
  • Low blood pressure
  • Hallucinations or confusion
  • Headache
  • Chest Pain
  • Elevated Heart Rate
  • Abnormal heart rhythms
  • Slow or shallow breathing
  • Loss of appetite
  • Weight loss
  • Weight gain
  • Memory loss
  • Trouble Focusing
  • Stomach pains
  • Itching
  • Difficulty urinating
  • Swelling of the hands, arms, feet, and legs
  • Restlesssness
  • Mood swings
  • Euphoria
  • Disorientation
  • Anxiety
  • Blurred vision
  • Decreased libido
  • Skin rash
  • Seizures
  • Sleep apnea

Additional Precautions

As a drug used in maintenance programs Methadone (MTD) is often prescribed in high dosages and is mixed with water by the dispensing clinic. There have been several instances of children being poisoned by consuming medicine that was meant for their parent.

Methadone can also be prescribed as a liquid. Larger Methadone clinics dispense flavored liquid that is similar to a dose of cough syrup.

Sources:

Nicholson, AB. October 2007. “Methadone For Cancer Pain”