Frequently Asked Questions
Will synthetic cannabinoids appear as a positive THC result?
Synthetic cannabinoids are not included in the assay due to the many variations in structure and constantly changing trends. The only derivative of THC that will be detected by the assay is the active component delta-9-THC or its metabolites. Therefore, if delta-9-THC were included in the synthetic cannabinoid that was used it could end in a positive THC result. If it is suspected that a synthetic THC product was used, a more comprehensive cannabinoid assay may have to be used for the analysis.
Will second-hand smoke cause a positive nicotine or THC result?
While it is possible for second-hand smoke to result in a positive result, it is very unlikely that the concentration in an individual’s urine would be enough to constitute a positive result. Second-hand smoke from nicotine or THC products does result in the absorbance of a small amount of the active drug into the individual’s system. While it is possible to detect this in urine, the likelihood that the level is above the LLOQ is very small, especially after some time has passed after the initial exposure.
Are “ethyl glucuronide” and “ethyl sulfate” both required for a positive ethanol result?
The presence of both ethanol metabolites at levels above the LLOQ is not a requirement for a positive ethanol result. After the ingestion of alcohol and introduction of ethanol to the body, the analyte metabolizes differently for everyone, resulting in different levels of the metabolites when excreted. Additionally, the involuntary ingestion of ethanol, such as via mouthwash or hand sanitizer, will likely not produce metabolite concentration above the LLOQ of 250 ng/mL. Research shows that the concentrations and ratio of ethyl glucuronide to ethyl sulfate could be used to indicate whether the ethanol ingestion was voluntary; each individual had a different level of the metabolites in urine though all were below the threshold of “deliberate ethanol ingestion”.17
Does the parent compound need to be detected for a positive result?
Many of the analytes included in the assay are metabolites, and corresponding parent compounds that are not included will not be detected. This is due to rapid metabolism of certain drug analytes that are not eliminated in urine as the parent compounds. In these cases, the metabolites often have a longer half-life, meaning they are able to be detected for a longer window of time even after the parent compound has been completely eliminated. Because of the specific metabolism of each analyte, the parent compound is not always the specific structure being detected by the assay; instead, metabolites may be used to determine if certain drugs were used. For example, the opioid and illicit drug heroin has an extremely short half compared to other substances, and only the metabolite 6-MAM is detected in the urine for a positive result.
What does it mean if adulterant analysis results in an “inconsistent” result?
“Inconsistent” IndikoTM analysis results indicate that the urine samples may have been tampered with to the extent that it does not fall within the range of pH, creatinine, oxidants, or specific gravity for average, “normal” urine. While abnormal levels could be due to the medications, diet, or fluid intake, and not contaminants, “inconsistent” urine is flagged for clinicians to have a better understanding of the patient’s analysis.
“Abnormal” urine is also flagged due to the possibility that something may have been added to the urine sample, skewing results, though these values are closer to those of “normal” urine. In this context, “inconsistent” means that it is impossible to reach these adulterant values for human urine without manipulation, even under extreme pathophysiological conditions.