Urine| Hair Follicle | Oral Fluid | Blood | ETG
Hair testing is increasingly recognized as an effective method for identifying drug and alcohol consumption. Hair offers a long-term record of substance use by embedding biomarkers within the strands as they grow. When taken from near the scalp, hair can provide up to a 3-month window for detecting alcohol and drugs. It’s easy to collect, relatively hard to tamper with, and straightforward to send off.
A 1.5-inch segment comprising roughly 200 hair strands (similar to the width of a #2 pencil) near the scalp will yield approximately 100mg of hair, which is the ideal amount for both screening and confirmation. For tests related to EtG, additional screenings, and those beyond 10 panels, it's advisable to use 150mg of hair. It's best to weigh the sample on a jeweler's scale. If no scalp hair is available, a comparable quantity of body hair can be used. "Head hair" specifically refers to scalp hair, whereas "body hair" includes all other types, such as facial and axillary hair.
Process Overview
The lab processing of a drug test involves four primary stages: Accessioning, Screening, Extraction, and Confirmation.
Accessioning is the first step, where a sample is logged into the laboratory’s system. This process ensures the sample was securely sealed and delivered, assigns it a random LAN (Laboratory Accessioning Number), and completes any necessary data entry overlooked by an electronic chain of custody system.
Screening provides an initial, quick assessment for substances of abuse. While this stage is cost-effective for ruling out drug use in most cases, a positive result requires confirmation before it can be legally valid. Each sample that tests positive in Screening needs further Confirmation.
If the Screening stage indicates a sample is positive, additional hair is extracted from the existing collection for the Extraction phase. Here, drugs are extracted from the hair at much lower levels compared to other methods (e.g., urine, oral fluid), making hair drug testing the most intricate process to conduct.
GC/MS, GC/MS/MS, or LC/MS/MS techniques confirm any positive screening outcomes. All samples that test presumptively positive undergo washing before confirmation if necessary. The entire transition from Accessioning through to Confirmation is conducted under both CAP (College of American Pathologists) Hair guidelines and accredited per ISO / IEC 17025 standards.
Advantages of hair drug testing:
Limitations:
Note: Although sometimes called "hair follicle tests", the test examines the hair strand itself, not the follicle beneath the scalp.
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