Yöntem

3. Results of the quality assurance

Practical results
Here you can download a summary of the results as a PDF.
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Improved security regarding falsification through the marker system
Within the context of development of the marker system approx. 120,000 urines have been analysed in our laboratory. In the course of this process several procedures have been exposed in cooperation with the practitioners on site, through in-depth patient interviews but primarily through advanced laboratory analytics (e. g. mass spectrometry), which were supposed to circumvent or interrupt the marker principle:

1. Extreme intake of liquid (internal dilution) or adding of water to the urine sample (external dilution)

Form of manipulation
This form of manipulation is performed with the intention to dilute drug concentrations to a point below the medical detection limit („cut off“), thus making a detection impossible. This falsification procedure is not exclusive to marked urines. However, this method of falsification was increasingly used within the context of the application of marker substances, e. g. in prisons, since other falsification methods were no longer available due to the marker application.

Laboratory strategy
In our laboratory we routinely check the creatinine concentration and the extinction of the urine. Creatinine is a substance which is naturally present in the body and which is released from the organism in a quantity of approx. 2 g / day. Upon values below 0.1 mg / ml we are certain to assume a manipulation. We recommend to regard such urines like positive urines. Within the limit range between 0.1 – 0.3 mg / ml the urines are analysed with a method providing significantly more sensitive verification limits than the medical cut off. This makes it possible to reliably verify drugs even in such diluted urines.

2. Spitting into the urine

Form of manipulation
The test person hides a sponge in their mouth which absorbs a part of the marker while drinking the marker solution. The contents of this sponge is then squeezed into „clean“ urine which had been brought along. Thereby the urine is marked. In particular in the beginning of marker application this method is tried in every collective of patients.

Laboratory strategy
Our laboratory applies the marker together with substances which are certain to be destroyed upon passage through the intestine (saccharose, i. a.). Should these substances still be found in the urine it may be assumed that a passage through the body did not occur. Thus the falsification is proven.
As a side effect such manipulations have been discovered as well where patients injected the methadone solution they were provided instead of drinking it. Based on our results it was possible to reveal that many of the drug-related deaths in the methadone programmes are to be attributed to this wrong form of methadone application.

3. Falsification of the urine through chemical substances

Form of manipulation
There are many substances available on the market – primarily offered by internet-based companies in the USA – which offer formulas to supposedly manipulate urines in such a way that either the drug molecules themselves are destroyed or their detection is disturbed by immunological procedures: „Hempusa“, „Peretto“, Urineluck“, etc. This falsification procedure is also not exclusive to marked urines. However, this method of falsification was increasingly used within the context of the application of marker substances since the use of the marker made other falsification methods impractical.

Laboratory strategy
Most formulas offered for fraudulent manipulations of this kind are fraudulent in themselves, i. e. non-effective. According to the analyses performed by our laboratory only the oxidising substances („urine luck“, stealth“) may cause an effect.
A chemical verification reaction (sample check) has always been performed in our laboratory which is suited to detect chemical urine manipulations. However, this does not allow for the clarification of the effect of stealth, which consists of a peroxidase plus hydrogen peroxide, on the verification of cannaboids (hashish, mariuhana). Therefore we developed a specific and very sensitive verification for peroxides (modified Trinder reaction“ which will show a contamination of the sample even in lowest concentrations.

4. Conclusion

Approximately 120,000 urines have been analysed in approx. 3 years with the new verification methods. Since that time we received no information at all from our customers indicating undiscovered manipulations or inconsistencies.
However, all customers do inform us that the rate of persons tested positive under the marker procedure increases significantly (see also the report by Prof. Doz. Dr. Backmund, Munich).