Test Catalog

Test ID: ADLTX    
Adulterants Survey, Chain of Custody, Random, Urine

Useful For Suggests clinical disorders or settings where the test may be helpful

Assess the possible adulteration of a urine specimen submitted for drug of abuse testing, as well as for providing the urine creatinine for "creatinine normalization"


This chain-of-custody test is intended to be used in a setting where the test results can be used definitively to make a diagnosis.

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

See Adulterant Survey Algorithm in Special Instructions.

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Specimen adulteration is the manipulation of a sample that may cause falsely negative test results for the presence of drugs of abuse. Common adulterants that may affect testing are water, soap, bleach, vinegar, oxidants, and salt. The adulteration testing includes assessment of creatinine concentration, pH, urine specific gravity, presence or absence of an oxidant, and presence or absence of nitrite.


Chain of custody is a record of the disposition of a specimen to document who collected it, who handled it, and who performed the analysis. When a specimen is submitted in this manner, analysis will be performed in such a way that it will withstand regular court scrutiny. Chain of custody is required whenever the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that it was under the control of personnel involved with testing the specimen at all times; this control implies that the opportunity for specimen tampering would be limited.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Cutoff concentrations

Oxidants: 200 mg/L

Nitrites: 500 mg/L

Interpretation Provides information to assist in interpretation of the test results

See Adulterant Survey Algorithm in Special Instructions.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. MRO Guidance for Interpreting Specimen Validity Test Results. Washington, DC: Office of the Secretary of Transportation, US Department of Transportation, September 28, 1998. Memorandum

2. Substance Abuse and Mental Health Services Administration (SAMHSA) Division of Workplace Programs: Specimen Validity Testing. In Mandatory Guidelines for Federal Workplace Drug Testing Programs. Federal Register April 13, 2004 (69 FR 19644), effective November 1, 2004. Memorandum posted: February 2005

Special Instructions Library of PDFs including pertinent information and forms related to the test