Urine| Hair Follicle | Oral Fluid | Blood | ETG
Hair testing has garnered recognition as an effective medium for identifying drug and alcohol consumption. Hair delivers a comprehensive historical record of alcohol and drug intake by embedding biomarkers within the hair's growing strand. When collected near the scalp, hair can reveal a substance use pattern spanning up to roughly three months for both alcohol and drugs. The collection of hair is straightforward, relatively resistant to adulteration, and convenient to transport.
A 1.5-inch segment of roughly 200 hair strands (similar to the girth of a #2 pencil) nearest to the scalp provides 100mg of hair, which is the optimal sample for both initial screening and further confirmation. For EtG, additional tests, or those exceeding 10 panels, it is suggested that a 150mg specimen be used. It's advisable to utilize a jeweler’s scale for measuring the specimen. Should scalp hair be unavailable, a comparable quantity of body hair is acceptable. When discussing head hair, reference is made solely to scalp hair. Body hair encompasses all other hair types, such as facial or axillary.
Process Overview
The laboratory processing of a drug test result primarily comprises four stages: Accessioning, Screening, Extraction, and Confirmation.
Accessioning entails the initial integration of the sample into the laboratory's system. This process includes ensuring that the sample was properly sealed and shipped, assigning a unique LAN (Laboratory Accessioning Number), and finalizing any remaining data entry absent from the electronic chain of custody system.
Screening involves a preliminary assessment for drugs of abuse. Though Screening offers a cost-efficient means to exclude drug presence in most samples, only those samples confirmed after a positive screen hold court admissibility. Each sample that is initially presumed positive requires a subsequent confirmation.
Upon a presumptive positive Screening outcome, additional hair is retrieved from the original sample and prepped for Extraction. At this stage, drugs are isolated from hair at notably lower concentrations compared to other methods (e.g., urine or oral fluid), rendering hair drug testing notably challenging.
Confirmation of any positive screening finding employs methods such as GC/MS, GC/MS/MS, or LC/MS/MS. Samples presumed positive receive a washing prior to confirmation, if necessary. From Accessioning to Confirmation, the lab process is scrutinized both under the CAP (College of American Pathologists) Hair standards and ISO / IEC 17025 accreditation.
Advantages of hair drug testing:
Limitations:
Note: Often misnamed as "hair follicle tests", the analysis centers on the hair strand instead of the scalp-located hair follicle.
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