Urine Sample Adulteration and How Averhealth Can Help


Clients will do just about anything to try to “beat” a drug test, including adding things to their urine sample and even swapping out their urine sample entirely. In fact, the USDA estimates at least 10% of all urine samples could be tampered with. Luckily, you can count on Averhealth’s evidence-based protocols to prevent those attempts at deception from impacting the outcome of drug testing, saving you time and money and giving you confidence in testing results.


What exactly are the tricks clients employ to try to avoid detection of new drug and alcohol use? And how does Averhealth prevent these tricks?


Adulterants: Altering Urine Samples 

If you Google “ways to alter a urine drug test,” you’ll get over 100 million pages to read in less than a minute. It is a hot topic because people with substance use disorder are desperate to continue substance use. Some adulterants used by clients are readily available at home, but clients can also buy products online that claim to do the trick — though additives are detected through observation and consumables simply do not work.



 The list of adulterants clients add to urine samples includes: 

  • Surfactants: Adding soap to the urine sample
  • Chromium IV
  • Halogens: Adding chlorine or bromine to the urine sample
  • Glutheraldehyde:
  • Peroxide
  • Iodine: Adding water purification tablets to the urine sample
  • Nitrites
  • pH: Adding hydrochloric acid to the urine sample to alter its pH


Clients also consume products that claim to have the ability to alter the outcome of urine testing. Most of these products are labeled and sold specifically for this purpose. These products direct clients to avoid new substance use for up to seven days before testing and to drink multiple gallons of water prior to providing a sample. While drinking multiple gallons of water just leads to dilution, avoiding new substance use is a surefire way to “trick” a drug test.

 Urine Sample Adulteration and How Averhealth Can Help


Clients often try substituting their urine with something else during the sample collection process. Many products and devices are sold to enable sample substitution, including ways to keep the substitute sample warm to mimic actual urine. Most substitute samples consist of synthetic urine, drug-free urine or liquids that resemble urine, like soda or apple juice.



Finally, clients attempt to hide their drug and alcohol use by diluting their urine sample through drinking excessive amounts of water, called water loading, or by adding water to the sample.

Clearly, some of clients’ adulteration methods are more sophisticated than others. And some of these tricks can actually work — like additives and substitution — unless standards are put in place to catch them.


Averhealth’s Evidence-Based Protocols 

At Averhealth, our best-practice protocols are specifically designed to identify substitution and adulteration. This ensures quality and accurate results as well as saves time and money that could be wasted on unnecessary confirmation testing.  These protocols work together to significantly reduce the probability a sample will be compromised — so you can determine with confidence whether your client has used or not. 

First, our same-gender, direct observations ensure that clients do not attempt sample substitution. Averhealth has honed and refined a process that ensures a rigorous, legally defensible specimen collection, while treating clients with respect and dignity. 

Second, our creatinine test determines whether the client attempted to alter their urine via dilution. Creatinine is a by-product of everyday muscle metabolism that is filtered by the kidneys and only excreted through urine. For the majority of people, creatinine levels remain fairly constant across time, both within a given day as well as from day-to-day. For this reason, a low creatinine level is a red flag to urine sample adulteration because excessive fluid consumption affects creatinine levels in the urine sample. We test creatinine levels on each and every urine sample – this differentiates Averhealth from many of our competitors. 

Finally, because Averhealth’s testing is truly randomized, your clients will not be able to predict when a test will be performed. This has the greatest potential to impact behavior, because they won’t have time to prepare to try to trick the test.