5 Ways Teens Might Cheat on Drug Tests—and How to Catch Them

These tricks are out there on the Web, so parents need to be informed.

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Google "beat drug test," and the search engine spits out page upon page of ploys and products that can make incriminating urine seem drug free. All it takes is a computer-savvy teen to access them. The ease of cheating, in fact, is one of at least seven reasons parents shouldn't try to test their kids for drug use. Instead, experts say, they should seek out a professional assessment.

"Cheating remains the Achilles' heal of drug urine testing in all settings," says Robert DuPont, president of the Institute for Behavior and Health Inc. and former director of the National Institute on Drug Abuse. With increasing opportunities for testing—by prospective employers, schools, and parents—experts worry that teens may have more impetus than ever to try. Last week, at the American Association for Clinical Chemistry's annual meeting in Washington, D.C., toxicologist Amitava Dasgupta of University of Texas-Houston medical school demonstrated various ways that employees try to beat workplace drug tests—and how experts foil these schemes in the laboratory. There's nothing to stop kids from using the same tricks, and there's no guarantee that parents will be able to catch them at home.

Here are five ways—some of them downright dangerous—that teens may try to cheat drug tests. They're all described elsewhere on the Internet, so parents should be aware of them.

1. Tampering. A sprinkle of salt or a splash of bleach, vinegar, detergent, or drain cleaner is all that's needed to muck up a urine specimen. These and other household substances are all too often smuggled into the bathroom and used to alter the composition of urine, making the presence of some illegal substances undetectable, says Dasgupta. Same goes for chemical concoctions sold all over the Internet. Sometimes these additives or "adulterants" will cloud or discolor urine, easily casting suspicion on the specimen, but others leave the sample looking normal. Laboratory toxicologists employ simple tests to catch these cheats. For example, a few drops of hydrogen peroxide will turn urine brown if it's been mixed with pyridinium chlorochromate, an otherwise-imperceptible chemical designed to foil drug tests.

2. Water-loading. Gulping fluids before providing urine, a long-standing tactic, is still the most common way that teens try to beat tests, says Sharon Levy, a pediatrician and director of the Adolescent Substance Abuse Program at Children's Hospital Boston. Whether cheats use salty solutions to induce thirst, flushing agents that increase urine output, or just plain old H20, their aim is to water down drugs so they can't be detected. Some testing facilities may check urine for dilution and deem overly watery samples "unfit for testing." But consuming too much fluid too quickly can occasionally have dire consequences. "Water intoxication" reportedly killed a woman following participation in a radio show's water drinking contest, says Alan Wu, a professor of laboratory medicine at the University of California-San Francisco.

3. Switching drugs. Perhaps most alarming, says Levy, is that teens bent on defeating drug tests will sometimes switch their drug of choice to an undetectable (or harder to detect) substance that's considerably more hazardous. Inhalants, for example, include numerous types of chemical vapors that typically produce brief, intoxicating effects. "You don't excrete [inhalants] in your urine," says Levy, but "inhaling is acutely more dangerous than marijuana." Indeed, inhalants can trigger the lethal heart problem known as "sudden sniffing death" in otherwise healthy adolescents, according to the National Institute on Drug Abuse. The tragic case of young David Manlove is an example.

4. Popping vitamins. Perhaps it's because niacin (aka vitamin B3) is known to aid metabolism, or perhaps it's because Scientologists are said to take it in excess to flush their bodies of toxins. Whatever the reasons, some teens got the idea that extreme doses of this vitamin would erase any trace of their illicit drug use. Instead, it almost cost them their lives. In two separate incidents, emergency physician Manoj Mittal of Children's Hospital of Philadelphia has found adolescents who downed at least 150 times the daily recommended dose of niacin (15 mg) to cheat drug tests. (He described the cases last year in the Annals of Emergency Medicine.) Both kids were vomiting, had low blood sugar, and had "significant" liver toxicity when they arrived at the ER. And the niacin didn't even do what they'd intended; both tested positive for illicit drugs. "People might think that since [niacin] is a vitamin it's harmless," says Mittal. "But these cases suggest that our bodies have limits."