Frequently Asked Questions
Frequently Asked Questions
*Click the green and white plus sign beside each question to view the answer.
Can a hair test be manipulated by the donor?
Can a hair test be used to prove that a previously taken urine test was inaccurate?
Can a hair test determine how much or how often someone is using a drug?
Can a nail test be used to prove that a previously taken hair test was inaccurate?
Can Meconium Testing for FAEE be run in conjunction with testing for panels for illegal drugs?
Yes, Meconium Testing 5-, 7-, 9- and 12-drug panels can all be bundled with Meconium Testing for FAEE.
Can someone test positive in fingernail because of passive or environmental exposure?
Yes, environmental exposure versus ingestion must be resolved when interpreting drug tests using fingernails.
Can someone test positive in hair because of passive or environmental exposure?
Can we use any tube for whole blood collection?
Please use only purple, gray, and green top tubes.
Can you test for alcohol exposure in umbilical cord?
Yes, alcohol exposure can be tested individually or by adding the Umbilical Cord Testing EtG add-on to any of the Umbilical Cord Testing drug panels. The EtG add-on screens for Ethyl Glucuronide, a direct alcohol biomarker, indicating exposure to ethanol (drinking alcohol).
Do doctors know about Meconium Testing for FAEE? Does USDTL have a means of informing doctors of this new test?
Yes and No. Many physicians know about the test from scientific publications and literature from USDTL. There are, however, many physicians that are not yet knowledgeable about the test and have never ordered it. If your local physicians do not have the necessary information to order the test, call Client Services at 1-800-235-2367 and the scientific information will be supplied.
Do we need to spin (centrifuge) whole blood samples?
Does race make a difference in hair testing results?
Does the sample need to be frozen?
Does Umbilical Cord Testing use umbilical cord blood or umbilical cord tissue?
Have meconium results been used in court cases?
Yes. Meconium results, when determined using two separate, validated laboratory procedures based on different scientific principles, are forensically defensible. Our laboratory procedures have been scrutinized by laboratory inspectors, and our test results have been upheld in court.
Have results been used in court cases?
Yes, the analysis of a number of tissue types for the presence of drugs of abuse has been used in every state for decades. Specifically, our umbilical cord testing has been used to provide evidence of drug use by the mother in numerous states. Additionally, the detection of drug in umbilical cord was used as evidence of maternal drug consumption in a murder case in South Carolina and that interpretation was upheld on appeal to the SC Supreme Court.
How are meconium results reported to the hospital?
How can DHS Methamphetamine specialists use information about Meconium Testing for FAEE to improve our protection of children?
Results from Meconium Testing for FAEE give DHS personnel direct information about newborns who have been exposed to high levels of Ethyl Alcohol. Approximately 3 percent of all newborns have been exposed to high levels of alcohol and these newborns’ meconium specimens have FAEE levels greater than 10,000 ng/gram. This “red flag” level represents only one quarter of the total number of alcohol exposed newborns. Three quarters of alcohol exposed newborns were exposed to small or moderate amounts of alcohol and represent lower risks of manifesting signs and symptoms of Fetal Alcohol Spectrum Disorder. The newborns with FAEE levels greater than 10,000 are at higher risk for Fetal Alcohol Spectrum Disorder, as well as a higher probability of living in a chaotic environment where abuse or neglect is more likely.
How can positive drug or alcohol test results be interpreted? If the quantity of drug or alcohol metabolite detected is high could that be an indication that the donor (1) was consuming a large amount, (2) was using recently, or (3) was using frequently?
There are too many variables for anyone to know time of use, dosage, or frequency from the result(s) of a drug test. Reservoir matrices such as hair, fingernail, umbilical cord, and meconium continuously collect drug and alcohol biomarkers. This makes it difficult to determine specific details of use. Because the biomarker is collected over a period of time, the results represent total accumulation that cannot be pin-pointed to specific times/dates/dosages, etc.
How do drugs get into nails?
How do PEth results differ from Urine EtG/EtS results?
How does NIDA and the court system view the validity of Meconium Testing for FAEE?
NIDA (The National Institute on Drug Abuse) actually is NOT the institute that funded the original research for FAEE in meconium. It was the National Institute for Alcohol Abuse and Alcoholism (NIAAA) that provided USDTL with the grant funds to develop Meconium Testing for FAEE. This test has become the de facto standard for laboratory diagnosis of fetal alcohol exposure and is in routine use all over the United States and Canada. Courts have held that Meconium Testing for FAEE meets both the Fry and Daubert standards, and the results are admissible in adversarial proceedings.
How long can drugs be detected in body hair?
How long can drugs be detected in head hair?
How long does the laboratory keep remaining umbilical cord tissue?
How many days until I receive results?
Screen negative results will be transmitted to your secure fax on the same day on which the laboratory receives the sample. Screen positive results will be confirmed using a separate technique and reported 2-3 business days after specimen receipt.
How much blood is required for a PEth testing sample?
5 individual large drops on a collection card.
How much blood is required for whole blood testing?
Requested sample volume is 5 milliliters.
How much breast milk is needed?
How much fingernail needs to be collected?
How much is needed for an adequate urine sample?
How much meconium is needed for the test?
A minimum of 2 grams of meconium (a teaspoon) is normally required, although some tests, such as "confirmatory tests only" can be performed with less. However, for best results, we recommend collection of the entire passage of meconium until the milk stool appears.
How should staff proceed with sending a specimen for testing on premature neonates that often do not stool for 3-5 days?
While these meconium specimens are fine for the routine drugs of abuse, these specimens (due to the delayed passage) should not be tested for FAEE.
How should umbilical cord tissue be stored?
The sample is stable at room temperature for 7 days, can be refrigerated (2-8° C) for up to 3 weeks and frozen (< -10° C) up to 1 year.
Is umbilical cord genetically fetal tissue or tissue of the mother?
Mother tested negative for chemicals on a saliva test, 8 days later, her baby was born and its meconium drug screen showed the presence of methamphetamine and amphetamine. What does this mean?
Please describe the new meconium test for alcohol.
Meconium Testing for FAEE is a test of the non-oxidative metabolites of ethanol called Fatty Acid Ethyl Esters. These metabolites are the chemical combination for endogenous fatty acids present in the blood of a fetus and Ethyl Alcohol. These new compounds, which only form when the fetus is exposed to Ethyl Alcohol, are deposited into the fetus’s meconium and can then be detected and quantified from the newborn’s meconium after delivery. The amount of the Fatty Acid Ethyl Esters found in the meconium is representative of the amount of Ethyl Alcohol the fetus was exposed to during the last half of the pregnancy.
Q: Why are both ethyl sulfate (EtS) and ethyl glucuronide (EtG) included in urine testing for alcohol use, but only EtG in fingernail or hair testing?
A: For urine testing, it is standard practice in the field of toxicology to include both EtS and EtG, because EtG is subject to bacterial production and degradation if a urine sample is contaminated (e.g. when the donor has a urinary tract infection). EtS is not subject to bacterial production or degradation, and provides a second, more reliable alcohol biomarker in these urine contamination scenarios. Other specimens types, such as fingernails and hair, do not have this issue, so only EtG is measured in those sample types.
The umbilical cord was fixed in formalin. May it still be used for the Umbilical Cord Testing?
We are testing a neonate for FAEE and a drug panel; how should we proceed with testing the meconium with the new change in policy?
The ideal collection of meconium is collecting all of it from beginning until it has been excreted. If you are testing the specimen for FAEE, it must be collected within the 18-hour time frame. There is always the option of testing the cord tissue for EtG as a backup.
What are the meconium sample storage requirements?
What does a positive hair test result mean?
What information can you give on testing of meconium and why some experts state that it depends what part of the meconium is sent into labs as to what will test positive?
What is Child Hair Testing, and how is it different from regular hair drug tests?
Child Hair and Nail Testing are a modified hair and nail drug tests designed to increase environmental exposure detection in children. The assays are often used by social service agencies involved in custody cases.
What is FAEE referred to in memo re: meconium collection?
Fatty Acid Ethyl Esters - a long term ethanol biomarker.
What is m-OH-BZE?
Lewis D, Moore C, Becker J, Leikin J. Prevalence of meta-hydroxybenzoylecgonine (m-OH-BZE) in meconium samples. Bulletin of the lnt.Ass.Forens Toxicol 1995;25(3):33-36
What is the detection window for urine?
What is the relationship between alcohol consumed and FAEE levels?
Based on two research studies reported in peer-reviewed literature, the total FAEE levels in excess of 10,000 ng/g show significant ethanol exposure in the newborn. (Moore C, Jones J, Lewis D, Buchi K. Prevalence of fatty acid ethyl esters in meconium specimens. Clin Chem 2003;49(1):133-136)
What is the window of detection for meconium?
What is the window of detection for PEth?
What is the window of detection for whole blood testing?
Whole blood testing for substances of abuse identifies usage over a 2-3 day period.
What is the window of drug exposure for umbilical cord?
When will I receive breast milk results?
When will I receive umbilical cord results?
|Test||Negative Result||Positive Result|
|Umbilical Cord Drug Panel||1 working day||2 working days|
|Umbilical Cord EtOH||2 working days||3 working days|
When will I receive whole blood testing results?
Which phosphatidylethanol species do you measure during PEth testing?
Our PEth testing in dried blood spots measures the 16:0/18:1 PEth species.
Why do we test for EtG in hair and not FAEE?
Why is Umbilical Cord Testing becoming the gold standard in newborn testing over meconium?
USDTL’s Umbilical Cord Testing is groundbreaking in newborn testing because it solves several problems:
- Every newborn has an umbilical cord; meconium is not available for every birth.
- Umbilical cord collection is a one-step procedure; meconium collection requires cumulative collections.
- Umbilical Cord Testing offers improved positivity rates for Methamphetamine, Benzodiazepines and Opiates.
- Umbilical Cord Testing improves the integrity of the chain-of-custody: only one donor and one collector are present during the collection. Meconium has multiple collections and multiple collectors.
- Umbilical Cord Testing improves turnaround time because umbilical cord is ready for transport a few minutes after the birth, while meconium passages can be delayed for days before being sent to the lab.
Why test for fetal alcohol exposure when there is no treatment available?
- Early diagnosis of fetal alcohol syndrome (FAS) and fetal alcohol effect (FAE) allow newborns to be identified and enrolled into early intervention and treatment programs. New programs are showing dramatic improvements in children identified earlier in life.
- Detection of an alcohol affected child can allow help, intervention and treatment to be offered to the mother, so that future FAS and FAE children may be prevented.
- When cocaine- and opiate-exposed newborns were first detected, there was no treatment. As programs, understanding and treatments improve, diagnosis at a very early stage can only help the outcome of the child, mother and family.
Why was one matrix positive and another negative on the same donor?
Why was the mother’s urine positive and the umbilical cord negative?
1. Different specimen types have varying thresholds for positivity. For example a single dose of methamphetamine 12 hours prior to collection is highly likely to produce a positive urine result however less likely to generate a positive result for a specimen type with a longer detection window such as umbilical cord, meconium or hair.
2. The result of any second collected specimen has no bearing on the validity of a first collected specimen. Therefore, a negative result observed for the umbilical cord does not refute a positive result observed on the maternal urine specimen and the reverse is true as well. There are many legitimate reasons for discrepant urine and umbilical cord results.
3. The urine specimen was a screen only result and was not confirmed using an appropriate mass spectrometric method. The screen only urine result is a clinically valid result, however, without an appropriate mass spectrometric confirmation, the urine result has no value in a forensic proceeding.
4. Lastly, some placentas can prevent some compounds from reaching the fetus. There are documented cases of maternal ingestion without in utero exposure.
Will a UTI affect the result of drug and/or alcohol testing?
Will one-time drug use be detected in Fingernail Testing? How many times would they have to use drugs for it to be detected in nails?