As negative drug tests are frequently a condition for employment, some people who use drugs will try to subvert the testing. In this study, systematic web monitoring was used to investigate how drug test subversion is discussed online. Posts pertaining to drug test subversion were obtained from public websites and the dark web (n = 634, July–December 2021). Most information from public websites came from Twitter (65%), and 94% of dark web posts were from Reddit. The posts were manually coded to extract quantitative and qualitative information about drug test subversion tactics. Most posts discussed urine drug tests (85%), followed by hair (11%) and oral fluid (2%), and the most discussed drugs were marijuana (72%) and cocaine (7.3%). Urine drug test subversion mainly pertained to specimen substitution, with synthetic urine or urine from another person. Another strategy was to mask diluted urine by ingesting creatine. Urine adulteration was rarely discussed. Hair test subversion involved harsh treatments with products such as bleach, baking soda, and/or detergent. Hair removal was also discussed. Oral fluid test subversion focused on removing drugs from the oral cavity through vigorous brushing of teeth and tongue as well as the use of mouthwash, hydrogen peroxide, gum, and commercial detox products. This study highlights subversion strategies used by donors. Although little evidence was provided as to the effectiveness of these strategies, this information may help guide future studies and development of specimen validity testing to minimize the impact of drug test subversion attempts.

中文翻译：

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对美国药检颠覆策略的系统网络监控

由于药检呈阴性往往是就业的一个条件，一些吸毒者会试图破坏测试。在这项研究中，系统性的网络监控被用来调查网上如何讨论药检颠覆行为。与药检颠覆有关的帖子是从公共网站和暗网获得的（n= 634，2021 年 7 月至 12 月）。公共网站的大部分信息来自 Twitter (65%)，94% 的暗网帖子来自 Reddit。这些帖子经过手动编码，以提取有关药物测试颠覆策略的定量和定性信息。大多数帖子讨论了尿液药物测试（85%），其次是头发（11%）和口腔液（2%），讨论最多的药物是大麻（72%）和可卡因（7.3%）。尿液药检颠覆主要涉及用合成尿液或他人尿液替代样本。另一种策略是通过摄入肌酸来掩盖稀释的尿液。尿液掺假很少被讨论。头发测试颠覆涉及使用漂白剂、小苏打和/或清洁剂等产品进行严厉的处理。还讨论了脱毛。口腔液测试颠覆的重点是通过大力刷牙和舌头以及使用漱口水、过氧化氢、口香糖和商业排毒产品来清除口腔中的药物。这项研究强调了捐助者使用的颠覆策略。尽管很少有证据证明这些策略的有效性，但这些信息可能有助于指导未来的研究和样本有效性测试的开发，以尽量减少药物测试颠覆尝试的影响。