title: Need and utility of a polyethylene glycol marker to ensure against urine falsification among heroin users.
abstract: BACKGROUND
  Deceptive methods of falsifying urine samples are of concern for anyone who relies on accurate urine toxicology results. A novel method to combat these efforts utilizes polyethylene glycol (PEG) markers administered orally prior to providing a urine sample. By using various PEG combinations to create a tracer capsule of unique composition, each urine sample can be matched to that individual. The goal of this study was to determine the effectiveness of using the PEG marker system among active heroin users screening for research studies.
  
  
  METHODS
  Upon each screening visit, participants (N=55) were randomized to provide an unobserved urine sample, or the PEG tracer procedure was used. LCMS analysis was used to distinguish the PEG combinations, and allowed us to provide a unique qualitative analysis of patterns of drug use (N=168, total urine specimens).
  
  
  RESULTS
  The unique composition of the tracer capsules was accurately detected in 83.5% of the urine specimens. Analyses of inconsistencies implicated a number of possible attempts at fraudulence (11.4%) and investigator/lab error (5.1%). Among this sample, the concurrent use of multiple classes of psychoactive drugs was more common than not, though concomitant drug use was often underreported.
  
  
  CONCLUSIONS
  Urine drug testing should be the minimum standard for obtaining information about drug use as self-report was unreliable even in a situation where there were no perceived adverse consequences for full disclosure. In cases where there are significant pressures for individuals to falsify these data, more protective collection methods such as the PEG marker system should be considered.
authors.affiliation: Division of Substance Abuse, New York State Psychiatric Institute/College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York, NY 10032, USA. Electronic address: Jonesje@NYSPI.Columbia.edu.
authors.forename: Jermaine D
authors.initials: JD
authors.lastname: Jones
authors.affiliation: Translational Research Training Program in Addiction at City College of New York & Sophie Davis School of Biomedical Education, 160 Convent Avenue, New York, NY 10032, USA.
authors.forename: Jared J
authors.initials: JJ
authors.lastname: Atchison
authors.affiliation: Division of Substance Abuse, New York State Psychiatric Institute/College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Madera
authors.affiliation: Division of Substance Abuse, New York State Psychiatric Institute/College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Verena E
authors.initials: VE
authors.lastname: Metz
authors.affiliation: Division of Substance Abuse, New York State Psychiatric Institute/College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Sandra D
authors.initials: SD
authors.lastname: Comer
mesh_terms: D015415:Biomarkers / Q000652:urine*; D005260:Female; D005607:Fraud / Q000517:prevention & control*; D006556:Heroin Dependence / Q000652:urine*; D006801:Humans; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000032:analysis; D015813:Substance Abuse Detection / Q000379:methods* / Q000592:standards
chemical_list: D015415:Biomarkers; D011092:Polyethylene Glycols
keywords: Polydrug use; Polyethylene glycols; Sample adulteration; Urine drug testing; Urine toxicology