Urine| Hair Follicle | Oral Fluid | Blood | ETG
Hair testing is recognized as an effective method for identifying alcohol and drug consumption. Hair retains a long-term record of substance use by embedding biomarkers within the fibers of the hair as it grows. When collected near the scalp, hair can reflect a detection span of roughly three months for both alcohol and drugs. Hair collection is straightforward, tampering is challenging, and it is easily shippable.
A sample measuring 1.5 inches and comprising about 200 hair strands (approximately the size of a #2 pencil) located closest to the scalp yields 100mg of hair, which is the ideal quantity for screening and confirmation. For EtG, add-ons, or tests with over 10 panels, a 150mg sample is advised. Using a jeweler’s scale for weighing is recommended. If scalp hair is not available, a similar quantity of body hair can be collected. References to head hair indicate scalp hair, while body hair pertains to all other hair categories (e.g., facial, axillary).
Process Overview
The key steps in lab processing of a drug test result include Accessioning, Screening, Extraction, and Confirmation.
Accessioning entails the initial incorporation of a sample into the lab's workflow, ensuring that the sample is sealed and shipped correctly, assigning a Laboratory Accessioning Number (LAN), and completing any extra data recording not included in an electronic chain of custody system.
Screening is a preliminary check for drug abuse. While Screening is an economical means to eliminate drug use for most samples, a positive screen must be verified for legal acceptance. Any presumptively positive samples identified in Screening require a follow-up confirmation.
If the Screening stage indicates a presumptive positive, additional hair is extracted from the original sample and prepared for Extraction. In this phase, drugs are separated from the hair at a notably lower concentration compared to other methods (like urine or oral fluid), highlighting the complexity of performing hair drug screenings.
Confirmatory analysis of positive screenings employs GC/MS, GC/MS/MS, or LC/MS/MS. All samples that show presumptive positives undergo washing ahead of confirmation if necessary. The comprehensive laboratory workflow from Accessioning to Confirmation is reviewed under the CAP (College of American Pathologists) Hair classification and accreditation to ISO / IEC 17025 standards.
Advantages of hair drug testing:
Limitations:
Note: Referred to popularly as "hair follicle tests," this analysis examines the hair strand rather than the follicle beneath the scalp.
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