Urine| Hair Follicle | Oral Fluid | Blood | ETG
Hair analysis has become recognized as a vital resource in identifying substance and alcohol consumption. Hair captures a prolonged timeline of alcohol and drug use by embedding biomarkers within the structure of the emergent hair strand. When gathered near the scalp, hair can offer an approximate 3-month detection scope for substances like alcohol and other drugs. Hair collection is straightforward, relatively hard to tamper with, and simple to transport.
A sample length of 1.5 inches, approximately 200 hair strands (about the thickness of a #2 pencil) nearest to the scalp, yields 100mg of hair, the optimal sample size for analysis and validation. For EtG, additional tests, and/or panels exceeding 10, a 150mg sample is preferred. We advocate using a jeweler’s scale for weighing the sample. If head hair is inaccessible, a comparable amount of body hair can be collected. By head hair, we specifically mean scalp hair. Body hair encompasses all other hair types (facial, axillary, etc.).
An Overview of the Process
The principal phases in the lab processing of a drug test outcome include Accessioning, Screening, Extraction, and Confirmation.
Accessioning refers to the preliminary handling of a sample into a lab’s workflow. This process comprises verifying sample integrity for sealing and shipping, generating a random LAN (Laboratory Accessioning Number), and finalizing any pending data entry not already covered by an electronic chain of custody document.
Screening refers to an initial rapid assay for identifying drug abuse. While Screening is an economical method to eliminate drug consumption in most samples, a positive indication necessitates formal validation to be court-admissible. Any samples with a presumptive positive in Screening need further confirmation.
If a specimen shows a presumptive positive during Screening, additional hair is taken from the original sample for Extraction. In this phase, drugs are withdrawn from hair at concentrations much lower than other methods (ex. urine or oral fluid), making hair drug analysis the most intricate method to execute.
Validation of any presumptive positive result follows through GC/MS, GC/MS/MS, or LC/MS/MS techniques. Every presumptive positive specimen is prepped by washing, as required, prior to confirmation. The complete lab process from Accessioning through Confirmation undergoes scrutiny under both the CAP (College of American Pathologists) Hair criteria and ISO/IEC 17025 accreditation standards.
Benefits of hair drug analysis:
Challenges:
Note: While often termed as "hair follicle tests", the evaluation focuses on the hair strand, not the subcutaneous hair follicle.
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