ANALYSIS OF SUBSTANCE ABUSE AND THE IMPORTANCE OF URINARY INTEGRITY

Urine samples are usually used for substance dependence tests, which are requested from the alcohol and drug treatment units of hospitals. Urinary threshold levels were defined for these tests. The results over the threshold value are interpreted as positive. Patients may try to mislead the laboratory diluting the urine specimen with water or drinking plenty of water before the test to prevent the positive test result. Adulterant substances such as bleach, lemon, vinegar and soap can be added to urine to disrupt urine integrity and the chemical structure of the analyte. In order to prevent this situation, urine samples are taken under supervision in private toilets. The laboratory should evaluate urine integrity by measuring creatinine (creatinine should be >20mg/dl), pH, nitrite, and density in all urine specimens. Drug tests and urine samples assessed in our laboratory were retrospectively evaluated. In the presence of impurities in the urine, found and expected drug positivity ratio was compared. Chi-square test was performed statistically by SPSS 16 program. For amphetamines, ecstasy, opiate and cannabis tests, the rate of positive results found in urine samples with low creatinine, were found to be significantly lower than expected positive rate (p<0.001)