In the testing for misused drugs, adulterants present a new challenge. Routine specimen integrity testing (involving pH, creatinine, specific gravity, temperature) is insufficient for identifying the presence of recent adulterants such as Urine Luck, Klear and stealth. If the misused drugs are present in the concentrations (100%, 150% of cut off concentrations), then they can potentially affect the GC-MS confirmation step. Additionally, they can cause false-negative results in immunoassay screening steps. Consequently, if such agents are used for adulteration then the actual presence of a drug can easily be unnoticed and unseen.

For this reason, many dipstick tests and spot tests have been introduced and are accessible for authorization of specimen integrity. Moreover, studies are required for mouthwash products for causing negating saliva testing for misused drugs and hair shampoo, for showing false-negative results in hair drug tests.

Laboratory professionals must be familiar with the fact that consumption of poppy seed cake and hemp oil leads to true-positive results, including opiate and THC assays. The laboratory and collection site have specific components to identify invalid specimens. For example; the urine temperature must be between 90.5°F to 98.9°F. Specific gravity should be between 1.005 and 1.030 and the pH should be between 4.0 and 10.0. Creatinine concentration should be between 20 to 400 mg/dL. If the creatinine is less than 20 mg/dL and the specific gravity is less than 1.003, then a specimen is classified as diluted. Laboratory must perform pH and creatinine analysis of all specimens for drugs-of-abuse testing. Other than that, more tests are recommended to identify the presence of other adulterants.