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Adult & Child Drug Testing Lab

Fingernail Drug Testing

Highly stable, simple to collect, and easy to ship and store, fingernails provide a test sample that is at the cutting edge of drug and alcohol testing. Fingernails are made up of keratin, the same material that hair is made of. As the nail grows, substances can pass from the blood vessels below the nail into the keratin fibers where they become trapped. Fingernails are four times thicker than the typical strand of hair and often capture more of a substance than hair can. Biomarkers become locked in keratin fibers along the entire length of the nail, and can be detected up to 3-6 months after drug or alcohol abuse. Environmental exposure to illicit substances can be detected immediately in nail samples. When drugs or alcohol are ingested, biomarkers can be found in nails as early as 1-2 weeks after. The time period during which drug or alcohol ingestion can be detected depends on the substance used, the amount used, and personal metabolism. Fingernail samples are clipped and collected by the donor in front of a trained collection staff member. A clipping of 2-3 mm long (about the width of a quarter) from all ten fingernails will give about 100 mg of sample, the ideal amount for screening and confirmation. Larger profiles may require more. We recommend weighing the specimen on a jeweler’s scale.

D/L Methamphetamine Isomer testing is available upon request for specimens that test positive for methamphetamine.

Drug Panels

  • 18 Panel
  • 17 Panel
  • 16 Panel
  • 15 Panel
  • 14 Panel
  • 12 Panel
  • 10 Panel
Amphetamines
amphetamine, MDA, MDEA, MDMA, methamphetamine
Cannabinoids
carboxy-THC
Cocaine
benzoylecgonine, cocaethylene, cocaine, norcocaine
Opiates
6-MAM, codeine, hydrocodone, hydromorphone, morphine, norhydrocodone
Phencyclidine
phencyclindine (PCP)
Benzodiazepines
alprazolam, diazepam, midazolam, nordiazepam, oxazepam, temazepam
Barbiturates
amobarbital, butalbital, pentobarbital, phenobarbital, secobarbital
Methadone
EDDP, methadone
Propoxyphene
propoxyphene, norpropoxyphene
Oxycodone
oxycodone, oxymorphone, noroxycodone
Meperidine
normeperidine
Tramadol
tramadol
Fentanyl
acetyl fentanyl, acetyl norfentanyl, alfentanil, fentanyl, norfentanyl
Sufentanil
norsufentanil, sufentanil
Ketamine
ketamine, norketamine
Buprenorphine
buprenorphine, norbuprenorphine
Zolpidem
zolpidem (e.g. Ambien®)
Kratom
mitragynine, 7-hydroxymitragynine
*Click the green and white plus sign beside each drug class to view the substances within each class.
Add-Ons Available
Diphenhydramine
diphenhydramine
High-Potency Opioids (HPOs)
6-β-Naltrexol (naltrexone metabolite), butorphanol (e.g. Stadol®), nalbuphine (e.g. Nubain®), naloxone (e.g. Narcan®), naltrexone (e.g. Revia®)
EtG (Direct Ethanol Biomarker)
ethyl glucuronide
Propofol Glucuronide
propofol glucuronide (e.g. Diprivan®)

Collection

Collection Instructions
Client Services

By Phone: 1.800.235.2367

Business Hours (CST)

Monday 6am-8pm
Tuesday 6am-8pm
Wednesday 6am-8pm
Thursday 6am-8pm
Friday 6am-8pm
Saturday 8am-5pm

Contact Client Services

Testing Details

Panel Name: Nail Testing

Panel Description: Nail Testing Drug Panel

Type: Profile

Matrix: Nail

Collection Container: Foil in Secure Envelope

Sample Amount: 100 mg = 10 clippings @ 2mm thick (Larger profiles may require more. We recommend weighing the specimen on a jeweler’s scale.)

Storage Conditions: Room Temperature

Transport Conditions: Ambient

Method: Initial screen and confirmation

Turnaround Time: Generally, the standard turnaround time for reporting negative screening test results is the next business day, with an additional 1-2 business days for specimens that require confirmatory testing. Turnaround time begins from receipt of the valid specimen –accompanied by a properly documented valid order– into the laboratory. Some tests require additional time to process and will fall outside the standard turnaround time window.

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Can a second test of a different specimen type be used to prove that a previously taken test was inaccurate?

No. The results of any second collected specimen have absolutely no bearing on the validity of the results of the first collected specimen. Furthermore, each matrix has its own advantages, disadvantages and limits of interpretation.

Can a nail test be used to prove that a previously taken hair test was inaccurate?

No, the result of any second collected specimen has absolutely no bearing on the validity of the result of any first collected specimen because you have no idea what the donor did between time A and time B.

Can I use the reported value (the number) from a hair, nail, meconium, umbilical cord tissue, or urine test to determine how much or how often someone is using a drug (either prescription of illicit)?

No. These specimen types act as reservoir, where drugs and their metabolites may accumulate and/or degrade over time. When testing any reservoir matrix, it is impractical to back-track to determine time, dosage, or frequency. There are too many variables involved. The reported values (the numbers) have no therapeutic or clinical value. You cannot use the number to estimate how much the donor used or to what extent the donor was exposed.

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 the drug test from a maternal specimen (such as maternal hair, nail or urine) differ from the result from a neonatal specimen such as neonatal urine, meconium or umbilical cord tissue?

Yes, the results can be different. Each specimen type has its own advantages, disadvantages, threshold to positivity, and detection time window. One test does not refute the other. The test results are cumulative. For instance, if the maternal urine is positive for cocaine and newborn meconium is positive for methamphetamine, the results do not rule each other out. The appropriate interpretation is that the mother consumed both cocaine and methamphetamine.

Can the reported quantitation of drug or metabolite in hair, nail, meconium, umbilical cord, or urine be used to determine the timing of the drug use, how often the donor uses the drug, or the extent of the donor’s drug use?

No, when testing a reservoir specimen type, a specimen type where analytes tend to accumulate, you may not backtrack to determine time, dosage, or frequency. The result is positive or negative for the appropriate detection window associated with the specimen type.

Does the sample need to be frozen?

No, the sample may be shipped ambient.

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 do drugs get into nails?

Drugs are distributed via the blood supply to the nail cells and the nail bed. Nails grow not only in length but in thickness as well. As the nail grows in thickness, it creates layers of drug history.

How much fingernail needs to be collected?

The optimum amount of nail clippings needed is 100 milligrams. If trimming all 10 fingernails, each clipping must be at least 2 millimeters to 3 millimeters long.

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.

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?

Single doses do not guarantee a positive result. The number of doses required to generate a positive result is highly variable between donors.

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