The Value of Innovation Chain of Custody and

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The Value of Innovation Chain of Custody and Adulteration © by DOA_Consulting

The Value of Innovation Chain of Custody and Adulteration © by DOA_Consulting

The Value of Innovation Definition ç Reproduceability and Traceability of all Actions related to

The Value of Innovation Definition ç Reproduceability and Traceability of all Actions related to the Urine Specimen or the analytical Result ç Security of Test Results © by DOA_Consulting

The Value of Innovation Procedures çSample Collection çStorage çTransport çStorage çAnalysis çInterpretation çConfirmation çReporting

The Value of Innovation Procedures çSample Collection çStorage çTransport çStorage çAnalysis çInterpretation çConfirmation çReporting Documentation: Who? , Where? , When? , What? , How? © by DOA_Consulting

The Value of Innovation Sample Collection çCollection under sight if possible çNo jackets, bags,

The Value of Innovation Sample Collection çCollection under sight if possible çNo jackets, bags, etc. allowed at collection site çPatient should wash hands before donation çUse special toilette for urine collection çNo soap at collection site çNo hot water at collection site çLeft hand in the neck çColoured rinse water çLook for possible adulterants at the toilette çSplit B-specimen çImmediate p. H and temperature measurement çSeal collection vessel; patient should sign © by DOA_Consulting

The Value of Innovation Collection Form 1 © by DOA_Consulting

The Value of Innovation Collection Form 1 © by DOA_Consulting

The Value of Innovation Collection Form 2 © by DOA_Consulting

The Value of Innovation Collection Form 2 © by DOA_Consulting

The Value of Innovation Transportation & Storage çStorage: äRestricted Area äCooled or frozen äPhotosensitivit

The Value of Innovation Transportation & Storage çStorage: äRestricted Area äCooled or frozen äPhotosensitivit y of some drugs çTransportation äSealed shipping box äLogbook àID of all Specimen àSignature of Collection site àSignature of Transport àTransport (Batch) ID © by DOA_Consulting

The Value of Innovation Transportation Form © by DOA_Consulting

The Value of Innovation Transportation Form © by DOA_Consulting

The Value of Innovation Co. C Form çPatient Name and/or ID çCollection Information: äName

The Value of Innovation Co. C Form çPatient Name and/or ID çCollection Information: äName of responsible supervisor at collection äName of requesting person äNames of all persons having access to the specimen äComments regarding specimen çLaboratory Information äDate and time on arrival to the Lab äName of person who receives the specimen within the lab äRequested Parameter äName of Person who does the analysis/validates the results © by DOA_Consulting

The Value of Innovation Results Form © by DOA_Consulting

The Value of Innovation Results Form © by DOA_Consulting

The Value of Innovation Co. C Laboratory Procedures çCo. C Form: control for signatures

The Value of Innovation Co. C Laboratory Procedures çCo. C Form: control for signatures and seals çSpecimens to be stored in secured area çFull documentation of specimen entry çLog of calibration data çLog of control data çPatient ID should be coded not identified by Pat. Name çEv. Confirmation analysis (as requested) çIn case of pos. result: store specimen over agreed timeframe © by DOA_Consulting

The Value of Innovation Co. C Reporting Procedures çDeclare reporting options with customer çAvoid

The Value of Innovation Co. C Reporting Procedures çDeclare reporting options with customer çAvoid any transmission of results via phone çUpon transmission via fax, email or network printers: check privacy çDeliver hardcopies in anyway çSend completed Co. C form © by DOA_Consulting

The Value of Innovation Collection Devices çSpecimen Collection Kits ä with implemented temp or

The Value of Innovation Collection Devices çSpecimen Collection Kits ä with implemented temp or p. H control çp. H strips çElectron. Thermo probes / one way thermo-sticks çSeals çLabels çTransport boxes © by DOA_Consulting

The Value of Innovation Drug Testing Programm in your Company ? Yes ? Mary

The Value of Innovation Drug Testing Programm in your Company ? Yes ? Mary Jane Superclean 13 wipes off all dirty results from the Analyser ! Dial: 1 -800 -TEST-CLEAN Radio commercial, Feb. 1994, Cal. , USA © by DOA_Consulting

The Value of Innovation Adulteration - Why? çPurpose of adulterants äA negative result from

The Value of Innovation Adulteration - Why? çPurpose of adulterants äA negative result from a sample that contains drug äTo generate an invalid result äForce a retest, time to “get clean” çSpecimen sources äUrine äHair (cleansing shampoos & conditioners) © by DOA_Consulting

The Value of Innovation Adulteration – Mode of Action çExternal adulteration äCommercial products: Nitrites,

The Value of Innovation Adulteration – Mode of Action çExternal adulteration äCommercial products: Nitrites, Glutaraldehyde äVinegar, soap, lemon juice, Visine, bleach çInternal adulteration äCleansing drinks, teas, powders, herbal capsules, diuretics äVitamin B and Creatine çSubstitution äDrug-free urine (internal/external) © by DOA_Consulting

The Value of Innovation External Adulteration - Products çWater çApple, Lemon Juice çVinegar çSalt

The Value of Innovation External Adulteration - Products çWater çApple, Lemon Juice çVinegar çSalt çVitamin C çBleach çAftershave çKaolin - Pectin çGlutaraldehyde (Urin. Aid) çNitrites (KLEAR) © by DOA_Consulting

The Value of Innovation External Adulteration çInterfere with screening test method äProduce false negative

The Value of Innovation External Adulteration çInterfere with screening test method äProduce false negative àRates lower than cutoff or negative calibrator äProduce invalid result àIncreased Initial absorbance (A 0) àAbsorbance flags / Invalid result flags çInterfere with GC/MS (Nitrites) © by DOA_Consulting

The Value of Innovation External Adulteration - Markers çp. H çPresence of Nitrites or

The Value of Innovation External Adulteration - Markers çp. H çPresence of Nitrites or Glutaraldehyde çSmell çFoaming, when swirled çColor / appearance © by DOA_Consulting

The Value of Innovation Internal Adulteration çUrine dilution çOf greatest benefit in borderline positive

The Value of Innovation Internal Adulteration çUrine dilution çOf greatest benefit in borderline positive samples çMost of these products require drinking a lot of fluids with the product çRefrain from use of “toxins” for 24 -72 hours prior to testing çSelf over-hydration äWater loading çOver-hydration äCarbohydrate-based “detoxification/purification” products äDiuretics - herbal products © by DOA_Consulting

The Value of Innovation Internal Adulteration - Markers çUrine markers for dilution äCreatinine äSpecific

The Value of Innovation Internal Adulteration - Markers çUrine markers for dilution äCreatinine äSpecific Gravity äOsmolality çMost commercial adulterant products contain Creatine and Vitamin B complex © by DOA_Consulting

The Value of Innovation Urine Production Rate After Water Loading 10 9 8 Urine

The Value of Innovation Urine Production Rate After Water Loading 10 9 8 Urine production rate (m. L/min) J J J 7 J J 6 J J J 5 4 Drink 1 L. water 3 J 2 1 0 -60 J J J -30 J J J 30 60 90 Time (min) 120 150 180 J J 210 Baldes and Smirk , 1934

The Value of Innovation Urine Production Rate After Water Loadin 18 J 16 14

The Value of Innovation Urine Production Rate After Water Loadin 18 J 16 14 J J J Urine 12 production 10 rate 8 (m. L/min) 6 J 0 J J 4 2 J J J Drink 2 L. water J 0 50 100 150 200 250 300 Time (min) Macallum and Benson, 19

The Value of Innovation Urine Specific Gravity After Water Loadin 1. 03 1. 025

The Value of Innovation Urine Specific Gravity After Water Loadin 1. 03 1. 025 J 1. 02 Specific 1. 015 gravity J Drink 1 L. water J J 1. 01 1. 005 1 -150 J J -100 -50 0 50 100 150 200 250 Time (min) Gounden and Newall, 198

The Value of Innovation Effect of Water Consumption on Urinary Creatin 200 G 180

The Value of Innovation Effect of Water Consumption on Urinary Creatin 200 G 180 J Drink 0. 5 L water. G) ( Drink 1. 0 L water. J( ) 160 140 G 120 Creatinine 100 (mg/d. L) G J J G 80 60 40 G 20 J G J 0 1 2 3 Time (hr) 4 5 La. Folie et al. , 1991

The Value of Innovation Recommendations ç Observed and controlled collections (EA) ç Minimize time

The Value of Innovation Recommendations ç Observed and controlled collections (EA) ç Minimize time limit for specimen collection - one hour or less (IA) ç Do not allow donor to drink more than one liter of liquid, and preferably not all at once (IA) ç Check the temperature of the urine (Substitution) ç Include testing methods in screening procedure (IA / EA) ä ä ä Creatinine Specific Gravity p. H Nitrites Glutaraldehyde © by DOA_Consulting

The Value of Innovation Adulteration Products ç Substitute drug free urine is available, in

The Value of Innovation Adulteration Products ç Substitute drug free urine is available, in concentrate form ç Most of the adulterants purchased offered money back guarantees, in some cases double your money, upon receipt of official unsatisfactory results ç All claim to work for all drugs, unless otherwise stated such as Whizzies, which only works for THC ç Adulteration products tend to change frequently, while the name remains the same ç All of these products are quite expensive, US$30 -50 © by DOA_Consulting

The Value of Innovation Clear Choice Instant Clean ADD-IT-ive EXTRA STRENGTH ç Appears to

The Value of Innovation Clear Choice Instant Clean ADD-IT-ive EXTRA STRENGTH ç Appears to contain sodium nitrite ä Manufactured by HEALTH TECH ç Instructions: ä “Add entire contents of vial into sample then urinate. ” ä Not for human consumption. ç “Not intended to be used for lawfully administered urine tests. ” is printed on © by outer DOA_Consulting

The Value of Innovation Terminador Pure ç Contains nitrites or glutaraldehyde ä Manufactured by

The Value of Innovation Terminador Pure ç Contains nitrites or glutaraldehyde ä Manufactured by ONE-STOP, Inc. ä Customer service 1 -800 -539 -1926 ç Instructions: ä Just add contents of bottle into 4 oz. Of liquid for Pure to work. ç “Compare to URINE LUCK & WHIZZIES” © by DOA_Consulting

The Value of Innovation A SCIENTIFIC BREAKTHROUGH KLEAR THE ULTIMATE PURIFIER IN 2 MICRO-TUBES

The Value of Innovation A SCIENTIFIC BREAKTHROUGH KLEAR THE ULTIMATE PURIFIER IN 2 MICRO-TUBES ç Clear crystals packaged in two small “microtubes” ç Used to contain sodium nitrite, may be glutaraldehyde now ä Distributed by ITG, Inc. ç For large samples of more than 4 oz, use two tubes ç If kept away from ç Instructions: ä Add contents of one tube of KLEAR to each urine sample. KLEAR dissolves almost instantly. Swirl your urine for a complete mix. ä For best results on urine tests, drink at least a quart of any liquid the day of the test. (Herbal teas are no better than water or coffee). If possible, take a 50 mg B vitamin to turn your urine a nice golden color © by DOA_Consulting and impress the tester.

The Value of Innovation WHIZZIES çIndications for use: çContains sodium Keep on hand for

The Value of Innovation WHIZZIES çIndications for use: çContains sodium Keep on hand for nitrite surprise attacks by piss ä Distributed by ITG, Inc. testers at work ä Manufactured by Smoke Screen çDo not eat WHIZZIES or Laboratories expose to open flame çInstructions: ç“There is a drug war ä Add one vial to 45 going on, and Smoke 60 m. Ls of urine. In case Screen Laboratories of split samples, add guarantees nothing. ” is before specimen is © by DOA_Consulting printed on insert

The Value of Innovation Tommy Chong’s URINE LUCK ç Vial of yellow liquid, looksç

The Value of Innovation Tommy Chong’s URINE LUCK ç Vial of yellow liquid, looksç like Terminador Pure or Clear Choice ç Manufactured/distributed by Spectrum Laboratories ç Photo of Tommy Chong (of Cheech and Chong fame) with a dialogue bubble “It works for me, it will work for you!” ç ç Contains sodium nitrite ç Do not store in sunlight Instructions: ä Urinate 1 -2 times before test. ä Add one vial to 3 -5 oz (90150 m. Ls) of urine. Use half vial for less than 3 oz (90 m. L) of urine. ä Do not use with other detoxifying products, an do not drink more than 16 oz of water on day of test. Mix slightly. Special Note: Please call yearly to obtain the latest product formulation. Older © by DOA_Consulting

The Value of Innovation Resources çWebsites çNORML (National Organization for the Reform of Marijuana

The Value of Innovation Resources çWebsites çNORML (National Organization for the Reform of Marijuana Laws) çInformational pamphlets/publications äUR-INE Trouble äConquering the Urine Tests äSteal This Urine Test äHigh Times Magazine äDrug Test Digest àMany of these distributors have their own newsletters © by DOA_Consulting

The Value of Innovation Websites çwww. peretto. com çwww. urineluck. com çwww. hightimes. co

The Value of Innovation Websites çwww. peretto. com çwww. urineluck. com çwww. hightimes. co m çwww. testclean. com çwww. testingfree. co m çwww. youreclean. co m © by DOA_Consulting