Urine| Hair Follicle | Oral Fluid | Blood | ETG
Hair evaluations have emerged as an effective means for identifying drug and alcohol consumption. Hair archives a prolonged history of alcohol and other substances by embedding biomarkers within the strands during growth. When procured near the scalp, it can offer a detection span of around 3 months for alcohol and drugs. The collection process for hair is straightforward, not easily altered, and convenient for transportation.
A sample of a 1.5-inch section comprising about 200 hair strands (comparable to a #2 pencil's width) taken nearest to the scalp provides 100mg of hair, which is the preferred quantity for both screening and verification. For EtG, additional tests, and/or panels exceeding 10, a specimen amount of 150mg is advised. It is suggested to measure the specimen using a jeweler’s scale. If scalp hair is inaccessible, an equal portion of body hair may be taken. "Head hair" references scalp hair only, while "body hair" denotes all other varieties (facial, axillary, etc.).
Process Overview
The laboratory procedure for obtaining a drug test result entails four primary steps: Accessioning, Screening, Extraction, and Confirmation.
Accessioning is concerned with the initial integration of a specimen into the laboratory's system. This encompasses verifying proper sealing and shipment, assigning a random LAN (Laboratory Accessioning Number), and completing any additional data entry absent in an electronic chain of custody system.
Screening carries out an initial, efficient assessment for substance misuse. Though Screening is a low-cost option to exclude drug usage for most samples, a positive finding necessitates confirmation to be valid in legal proceedings. Samples that test presumptively positive during Screening must undergo further confirmation.
If Screening indicates a presumptive positive, additional hair is extracted from the initial sample for the Extraction phase. Here, drugs are retrieved from the hair at significantly lower concentrations than other techniques (e.g., urine or oral fluid), highlighting the complexity of performing hair drug screening.
Confirmation of positive results from screening is executed via GC/MS, GC/MS/MS, or LC/MS/MS. All presumptive positive samples undergo washing before confirmation as required. The complete laboratory sequence from Accessioning to Confirmation adheres to the standards prescribed by both the CAP (College of American Pathologists) Hair designation and the accreditation to ISO / IEC 17025 standards.
Advantages of hair drug testing:
Limitations:
Note: Although often called "hair follicle tests", the assessment examines the hair strand, not the follicle beneath the scalp
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