Urine| Hair Follicle | Oral Fluid | Blood | ETG
Hair analysis is increasingly recognized as an effective means for identifying drug and alcohol consumption. Hair captures a prolonged record of substances, as it encases biomarkers within the strands during growth. When obtained near the scalp, hair can reveal drug and alcohol use over a period of up to three months. Its collection is straightforward, manipulation is challenging, and it is convenient to transport.
A sample measuring 1.5 inches with roughly 200 hair strands (equivalent to a #2 pencil thickness) closest to the scalp is optimal, yielding 100mg of hair, ideal for both screening and confirmation. For EtG, additional tests, or when tests exceed 10 panels, a specimen weighing 150mg is suggested. We advise measuring the sample using a jeweler's scale. In the absence of scalp hair, an equivalent volume of body hair can be utilized. References to head hair specifically denote scalp hair, whereas body hair encompasses all other types of hair (facial, axillary, etc.).
Process Overview
The laboratory process for analyzing a drug test result involves four critical steps: Accessioning, Screening, Extraction, and Confirmation.
Accessioning pertains to the primary processing of a sample into a laboratory's workflow. This step involves verifying proper sealing and shipment of the sample, assigning a random Laboratory Accessioning Number (LAN), and completing any further data entry that was not covered by an electronic chain of custody system.
Screening is a quick initial assessment for drugs. Though it is cost-effective for ruling out drug presence in most cases, a positive result from this stage requires confirmation for legal validity. Presumptive positives from Screening necessitate follow-up confirmation tests.
If Screening suggests a positive result, additional hair is extracted from the original sample and prepared for Extraction. During this phase, the drugs are isolated from hair at significantly lower concentrations compared to other methods (such as urine or saliva), making hair drug testing challenging to perform.
Positive screening findings are confirmed using techniques like GC/MS, GC/MS/MS, or LC/MS/MS. Presumptive positive samples undergo washing as part of the confirmation process. The complete laboratory procedure from Accessioning through Confirmation is scrutinized under both the CAP (College of American Pathologists) Hair designation and the ISO/IEC 17025 accreditation standards.
Advantages of hair drug testing:
Limitations:
Note: Commonly termed "hair follicle tests," these assessments evaluate the hair strand rather than the follicle beneath the scalp.
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