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![Synthetic urine (SU) specimens purchased at the local smokeshops, Oahu, Hawaii. Top row (L-R): Quick Fix, Field Kit, Dr Green's X Agent; Bottom row (L-R): S5 Synthetix, Ultimate Gold, UPASS, XStream [Colour figure can be viewed at wileyonlinelibrary.com]](profile/Victor-Kim-2/publication/327518187/figure/fig1/AS:683741047427072@1540027977633/Synthetic-urine-SU-specimens-purchased-at-the-local-smokeshops-Oahu-Hawaii-Top-row.jpg)
Synthetic urine (SU) specimens purchased at the local smokeshops, Oahu, Hawaii. Top row (L-R): Quick Fix, Field Kit, Dr Green's X Agent; Bottom row (L-R): S5 Synthetix, Ultimate Gold, UPASS, XStream [Colour figure can be viewed at wileyonlinelibrary.com]
Source publication
Synthetic urine (SU), which was primarily utilized by drug testing laboratories as matrix for quality control preparations, are now commercially sold and can be used to “fool” a positive drug test. To determine if SU can pass as authentic urine, we challenged Army urine drug testing collection and testing procedures using eight different commercial...
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Abusing intoxicating substances such as alcohol and drugs in the construction industry poses a serious threat to the safety of workers. It is a pervasive problem that often results in fatal accidents and other relevant risks. This paper aimed to investigate the impacts of substance abuse at job sites, the perception of industry professionals about...
Citations
... LC-MS/MS has been instrumental in distinguishing between authentic and synthetic urine. The technique can identify specific biomarkers, such as polyglycoles and other exogenous compounds, that are typically absent in natural urine [25]. This method is also used to detect a wide range of drugs and their metabolites, making it essential for forensic and clinical toxicology [26]. ...
Urine sample validity testing is critical in medical diagnostics, forensic investigations, and workplace drug screening to ensure accurate and reliable results. The increasing sophistication of tampering methods, such as adulteration and substitution, necessitates the development of advanced testing techniques. This review explores the latest advancements in urine validity testing, including the integration of machine learning (ML) and artificial intelligence (AI) with high-resolution mass spectrometry (HRMS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). These technologies enhance the detection of novel chemical and biological markers, such as unique metabolite profiles, polyglycole patterns, and DNA methylation markers (e.g., TWIST1 and NID2). The identification of new biomarkers and the application of multi-modal analytical approaches provide comprehensive and sensitive detection of tampering. Future directions in the field focus on refining these technologies, ensuring ethical data handling, and expanding regulatory frameworks to protect privacy and enhance the reliability of testing protocols. The advancements discussed promise significant improvements in the detection and prevention of urine sample tampering, ensuring the integrity of testing processes across various applications.
... The side effects of illicit drug use can affect social life, workplace performance, and public safety; for example, the crime rates have increased because of the misuse of drugs. In addition to rising public concerns regarding the harmful effects and consequences of drug abuse and increases in relevant emergency department visits caused by overdoses (Kim et al., 2019;Els et al., 2020;Fu et al., 2019;White et al, 2023), well-trained personnel are at risk if they start using such drugs of abuse. This will markedly damage their productivity and may increase the incidence of accidents at the workplace. ...
... This involves many essential tests, such as measurement of temperature, color, creatinine level, pH, smell, specific gravity, and nitrate level. Moreover, it is difficult to distinguish a genuine urine sample from an adulterated one (Kim et al., 2019;Embers et al., 2019;Vikingsson et al., 2022;Kyle and Kaur, 2020;Goggin et al., 2017). For example, Kim et al. (2019) revealed that the substitution of urine samples with synthetic urine that is currently used in forensic toxicology laboratories for preparing quality control samples can beat WDT, without being able to differentiate gunning from synthetic samples. ...
... Moreover, it is difficult to distinguish a genuine urine sample from an adulterated one (Kim et al., 2019;Embers et al., 2019;Vikingsson et al., 2022;Kyle and Kaur, 2020;Goggin et al., 2017). For example, Kim et al. (2019) revealed that the substitution of urine samples with synthetic urine that is currently used in forensic toxicology laboratories for preparing quality control samples can beat WDT, without being able to differentiate gunning from synthetic samples. Consequently, direct supervision and assessment of sample integrity, especially during illicit drug testing, are becoming increasingly necessary to identify adulterated samples. ...
Workplace drug testing (WDT) is essential to prevent drug abuse disorders among the workforce because it can impair work performance and safety. However, WDT is limited by many challenges, such as urine adulteration, specimen selection, and new psychoactive substances (NPS). This review examined the issues related to WDT. Various scientific databases were searched for articles on WDT for drug detection published between 1986 (when WDT started) and January 2024. The review discussed the history, importance, and challenges of WDT, such as time of specimen collection/testing, specimen adulteration, interference in drug testing, and detection of NPS. It evaluated the best methods to detect NPS in forensic laboratories. Moreover, it compared different techniques that can enhance WDT, such as immunoassays, targeted mass spectrometry, and nontargeted mass spectrometry. These techniques can be used to screen for known and unknown drugs and metabolites in biological samples. This review assessed the strengths and weaknesses of such techniques, such as their validation, identification, library search, and reference standards. Furthermore, this review contrasted the benefits and drawbacks of different specimens for WDT and discussed studies that have applied these techniques for WDT. WDT remains the best approach for preventing drug abuse in the workplace, despite the challenges posed by NPS and limitations of the screening methods. Nontargeted techniques using high-resolution liquid chromatography-mass spectrometry (MS)/gas chromatography–tandem MS can improve the detection and identification of drugs during WDT and provide useful information regarding the prevalence, trends, and toxicity of both traditional and NPS drugs. Finally, this review suggested that WDT can be improved by using a combination of techniques, multiple specimens, and online library searches in case of new NPS as well as by updating the methods and databases to include new NPS and metabolites as they emerge. To the best of the author's knowledge, this is the first review to address NPS as an issue in WDT and its application and propose the best methods to detect these substances in the workplace environment.
... Dependent on the sample cohort group and region, manipulation by substitution is probably the second most urine adulteration method [19][20][21]. Instead of substitution with other fluids like toilet water, fruit juices, and soap, substitution with synthetic urine, aka fake urine or fetish urine, has become more popular over the last years [20,27,29,[32][33][34][35]. ...
... Kim et al. were the first to evaluate the on-site test strips with 116 random urine samples and nine synthetic urine products. They found that the fake urine samples were detected with high sensitivity (9/9) and that diluted specimens could be falsely detected as synthetic urine [34]. ...
In many countries, adherence testing is used to monitor consumption behavior or to prove abstinence. Urine and hair are most commonly used, although other biological fluids are available. Positive test results are usually associated with serious legal or economic consequences. Therefore, various sample manipulation and adulteration strategies are used to circumvent such a positive result. In these critical review articles on sample adulteration of urine (part A) and hair samples (part B) in the context of clinical and forensic toxicology, recent trends and strategies to improve sample adulteration and manipulation testing published in the past 10 years are described and discussed. Typical manipulation and adulteration strategies include undercutting the limits of detection/cut-off by dilution, substitution, and adulteration. New or alternative strategies for detecting sample manipulation attempts can be generally divided into improved detection of established urine validity markers and direct and indirect techniques or approaches to screening for new adulteration markers. In this part A of the review article, we focused on urine samples, where the focus in recent years has been on new (in)direct substitution markers, particularly for synthetic (fake) urine. Despite various and promising advances in detecting manipulation, it remains a challenge in clinical and forensic toxicology, and simple, reliable, specific, and objective markers/techniques are still lacking, for example, for synthetic urine.
... Este método se define como la práctica mediante la cual una muestra de orina de un donador que posiblemente contenga sustancias de interés para el análisis, por ejemplo, sustancias de abuso, se sustituye por orina de un individuo no consumidor de esas sustancias (Moeller et al., 2008) o bien orina sintética (Kim et al., 2019). Actualmente hay algunos procedimientos que se usan para detectar la sustitución. ...
... La orina sintética, es una solución de sales con concentración de creatinina y pH similar a la orina humana, por lo que es difícil de detectar con los análisis de laboratorios comunes. Recientemente, se han comercializado kits que permiten identificarla a través de una reacción colorida dirigida a alguno de sus componentes, sin embargo, los fabricantes no indican el analito al cual está dirigida la prueba (Kim et al., 2019). ...
p>La muestra de orina es una de las más comunes para la determinación de sustancias de interés forense en matrices biológicas debido a su poca invasividad y la relativa facilidad con que se puede realizar en ella las pruebas presuntivas y su preparación pre-analítica para los análisis confirmatorios. Sin embargo, es una muestra que fácilmente puede adulterarse por sustitución, adición de sustancias que alteran el pH, adición de sustancias oxidantes, dilución in vitro o in vivo e incluso con productos caseros como sal de mesa o ablandadores de carne, que se añaden a la muestra con la intención de afectar los resultados del análisis. A pesar de esto, existen métodos para identificar estas adulteraciones, implementar algunos de ellos de forma rutinaria en los laboratorios forenses es importante para incrementar la confiabilidad de los resultados del análisis de sustancias de interés en orina.</p
... Synthetic urine was used to test the fluid absorbance affinity of the electrospun fibers at equilibrium and under pressure. The testing solution was prepared according to a recipe established by Kim et al., [36]. To one liter of distilled water, urea (25g), sodium phosphate (2.5g), sodium chloride (9g), sodium sulfite (3g), and ammonium chloride (3g) were added and stirred for one hour to ensure complete dissolution. ...
Current research targets innovative medical textiles of nanofibrous nature and antibacterial activity to prevent diaper dermatitis. The work is based on electrospun nanofibers from cellulose acetate (CA) and lignin (Lig) polymers. A series of new copper complexes were synthesized and loaded to the CA/Lig solution mix then subjected to electrospinning, giving rise to the tricomponent bioactive mats CA/Lig/Cu-complex. The surface morphology of electrospun nanofiber mats was smooth and homogenous as the concentration of lignin increased in the mixture. The incorporation of lignin improved the electrospinnability of the cellulose acetate; however, it increased the fiber diameter. The water contact angle, absorption underload were significantly improved as lignin content increased. The incorporation of Cu-complex in electrospun CA and CA/Lig fiber mats occurred without any substantial change in the surface morphology, indicating well encapsulation of the complex. The electrospun mats were active against Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus epidermidis, and Streptococcus faecalis. The cytotoxicity, protein leakage, and biological results, together with the above studies, would advocate copper complex loaded CA/Lig fibers as a potential candidate for hygienic applications.
... Various methods to detect tampered samples have been described in literature [14][15][16][17] and are now used in toxicology laboratories to identify manipulated samples [14,18,19]. Drug testing clinical laboratories use synthetic urine to make controls, which are unfortunately now commercially sold and can be used to "fool" a positive drug test [14,20]. ...
Urine drug testing is one of the objective tools available to assess adherence. To monitor adherence, quantitative urinary results can assist in differentiating “new” drug use from “previous” (historical) drug use. “Spikes” in urinary concentration can assist in identifying patterns of drug use. Coupled chromatographic-mass spectrometric methods are capable of identifying very small amounts of analyte and can make clinical interpretation rather challenging, specifically for drugs that have a longer half-life. Polypharmacy is common in treatment and rehabilitation programs because of co-morbidities. Medications prescribed for comorbidities can cause drug-drug interaction and phenoconversion of genotypic extensive metabolizers into phenotypic poor metabolizers of the treatment drug. This can have significant impact on both pharmacokinetic (PK) and pharmacodynamic properties of the treatment drug. Therapeutic drug monitoring (TDM) coupled with PKs can assist in interpreting the effects of phenoconversion. TDM-PKs reflects the cumulative effects of pathophysiological changes in the patient as well as drug-drug interactions and should be considered for treatment medications/drugs used to manage pain and treat substance abuse. Since only a few enzyme immunoassays for TDM are available, this is a unique opportunity for clinical laboratory scientists to develop TDM-PK protocols that can have a significant impact on patient care and personalized medicine. Interpretation of drug screening results should be done with caution while considering pharmacological properties and the presence or absence of the parent drug and its metabolites. The objective of this manuscript is to review and address the variables that influence interpretation of different drugs analyzed from a rehabilitation and treatment programs perspective.
... Kim et al. [108] studied whether commercially available synthetic urine (SU) products can be identified by adulteration and onsite SU test strips. Eight SU products were tested by the specimen validity testing (SVT) and all passed and identified as authentic urine. ...
This review paper covers the forensic-relevant literature in toxicology from 2016 to 2019 as a part of the 19th Interpol International Forensic Science Managers Symposium. The review papers are also available at the Interpol website at: https://www.interpol.int/content/download/14458/file/Interpol%20Review%20.Papers%202019.pdf.
... The use of urine analytics for drug screening purposes has been on a continuous rise since the federal government mandated the screening of all federal employees in 1988. 1 As is often the case, the market to evade this screening protocol, or create a false-negative, has seen a similar growth. [1][2][3] This case report focused on synthetic urines while on buprenorphine and outlines the numerous ways in which a patient attempted to use synthetic urine to create a false negative on her urine drug screen. ...
... Products available include The Whizzinator™, The Urina-tor™, and Butt Wedge. [1][2][3] The Whizzinator™ employs a prosthetic penis to excrete urine. The Urinator™ has a container strapped to the body with a heating unit and a tube placed near the urethra. ...
... Human urine validity for drug testing has been reviewed. 11 Kim et al 14 showed how different synthetic urine products, as well as certain household products, can meet normal laboratory examination standards for valid urine specimens. Goggin et al 15 claim a method for detecting synthetic urine. ...
Abstact
Urine drug testing can be subject to attempts to dilute, adulterate, or substitute the specimen. Substitution may involve the use of commercially available synthetic urine. Current laboratory methods to detect specimen validity often fail to detect these products. We evaluated a new automated assay designed to detect synthetic urine. We determined that the assay met performance requirements and accurately identified 5 commercially obtained products as synthetic urine while not identifying known normal urine as synthetic. However, in a group of 843 patient urines, 40 of the 46 urines identified as "synthetic" were samples with creatinine < 50 mg/dL. 14 of the 40 were actually positive for drugs of abuse. We conclude that the test is analytically valid but clinically limited. We recommend that it be used in conjunction with other indicators of synthetic urine. We suggest a scheme that would achieve this, and reporting terminology that would reflect the limits of the analysis.
