Urine Toxicology and Blood Testing

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Table of Contents

Introduction
Urine Toxicology and Blood Testing Definition
Why and When the Tests Started
Step by Step Procedures of the Tests
Why They are Used and by Whom
Issues That Can Come Up When Using This Tests
Positives and Negatives of the Tests
Conclusion
References

Introduction

Medical tests like urine, blood and stool are essential in disease diagnosis and treatment. The tests are an important tool in health care since they help in risk stratification, choice of therapy and help doctors monitor the disease. Blood and urine are primarily used in laboratories since they are rich in biological disease information. Urine toxicology and blood tests are performed for different purposes and follow a step-by-step procedure. However, issues may arise during the tests, and the two tests have their positives and negatives.

Urine Toxicology and Blood Testing Definition

Urine toxicology is a panel of medical tests that include a physical examination and chemical evaluation of urine using test strips or microscopes. The test is a standard care measure in addiction treatment because it provides accurate, unbiased reports during clinical observations. A toxicology test can screen for Phencyclidine, Marijuana, Cocaine, Amphetamines, and Barbiturates (Doi et al., 2021). A blood test is an examination done on a blood sample to count the various types of blood cells or to check for the number of substances in the blood. They can also be done to look for antibodies, tumor makes, signs or agents of diseases, and to check how the treatment is progressing.

Why and When the Tests Started

Urine toxicology and blood testing were started way back in history by some scientists. Dole and Nyswander did the first urine drug test in 1965 after introducing methane as a treatment for heroin use and abuse (Kapur & Aleksa, 2020). The two checked for the presence of methadone in urine using cation exchange resin paper. They then continued the process with thin-layer chromatography then to paired chromatography testing. Since then, numerous process advancements have evolved, including analytical techniques. Austrian biologist and immunologist Karl did the first blood test in 1901 and proved the existence of three blood types A, B, and C, later named O. It was until 1902 that their colleagues discovered AB as the fourth blood type (Doi et al., 2021). Urine toxicology and blood tests started to help doctors determine substances in patients’ bodies.

Step by Step Procedures of the Tests

The two tests follow different procedures in the lab to get accurate results. For blood tests to occur, blood should be collected from the patient. The patient is usually in a seated or lying position during the drawing of blood. They are then requested to make a fist, and the technician ties a rubber around the patient’s arm. After cleaning the area, a phlebotomist technician uses a needle to take out blood from the vein on the outer portion of the arm near the elbow. After the technician draws enough blood, they place an adhesive bandage on the area, and the patient is asked to press firmly to stop bleeding (Chidambaram et al., 2022). The sample blood is labeled using a patient identification number to avoid confusion. After the lab receives the specimen, its added to the system, and all needed tests are done.

This process is called venipuncture, and there are other methods to do a blood test, including arterial tests, finger prick, and heel stick tests. The arterial blood test is done to measure oxygen levels in the body. The blood for this test is taken from an artery instead of a vein because blood from arteries has higher oxygen levels than veins. A finger prick test is done when a small amount of blood is needed. It is done by pricking a fingertip and is mainly used with home test kits and rapid tests. These tests are easy to do and need no special equipment (Bacârea et al., 2021). Lastly, the heel stick test is mainly done on newborn babies. A healthcare provider cleans the baby’s heel and pokes the heel with a needle, then places a bandage on the area after collecting blood drops.

However, patients are given clear cups to urinate in private rooms for urine tests. Doctors advise patients to clean the genital area before urinating so that the sample provided is not contaminated. A laboratory worker labels the sample after the patient brings it to the laboratory. A microscopic exam is done on the urine to help detect anomalies in the patient’s white or red blood cells, bladder cancer, or kidney disease (Bacârea et al., 2021). Similarly, a dipstick test involves dipping a chemically treated stick into the urine sample to help detect the presence of sugars, proteins, or other compounds. The two tests have one outcome of telling more about the patient’s body and assisting doctors in giving instructions and medication.

Why They are Used and by Whom

Blood tests are ordered mainly by healthcare providers when patients are ill. However, it is not necessarily done due to illness, but some patients do them for routine checkups to monitor their health. Blood tests are used because they can help to monitor diseases like diabetes or high cholesterol. They can also help diagnose bleeding disorders, identify diseases like cancer, and determine how good organs like kidneys, hearts, or liver work (Doi et al., 2021). Blood tests can also help monitor chronic conditions, find variations in hemoglobin, and determine if the immune system has infections.

Urine tests are also ordered by health care providers or emergency room doctors. Healthcare providers can request it if they think the patient has a problem with drugs or alcohol (Chidambaram et al., 2022). An emergency room doctor can ask for it when the patient exhibits strange behavior. Employers can ask for urine tests before hiring employees to ensure that people who take drugs are kept out of jobs requiring alert and focused individuals, such as drivers. People receiving treatment for substances abuse in drug and alcohol rehabilitation centers are tested to ensure that they stay sober. Finally, a urine test can be done at home when partners want to prove they are not using drugs or alcohol or to test if a partner is pregnant.

Issues That Can Come Up When Using This Tests

One can obtain accurate or inaccurate results when performing tests, and some issues may arise. The clinician’s understanding is key to knowing how the test is carried out. Numerous factors can affect the urine test, like a sudden change in medication, exercise and diet. A false positive result may be obtained in a dipstick test when menstrual blood, myoglobinuria, or hemoglobinuria contaminate the urine sample (Bacârea et al., 2021). Similarly, false negative effects can be obtained when urinary density increases and pH exceeds 5.1 (Kapur & Aleksa, 2020). During blood tests, some issues include difficulties assessing results by telephone and non-medical staff communicating the results yet, they don’t have enough knowledge in medicine. Lastly, blood tests are not being performed in the laboratories for various reasons.

Positives and Negatives of the Tests

There are various positive and negative sides of using urine and blood tests. The positive sides of urine tests are that they are easy to store, handle and transport. Additionally, the human resources and materials needed for storage are lesser compared to blood tests. The collection is simple and non-invasive in that the samples can be collected continuously during the process in a simple, timely way. The test is suitable for people like newborns whose blood cannot be drawn due to various reasons. Lastly, the sample collection method is friendly to the patient (Zhang et al., 2022). However, the urine test has its negative side which are many dipstick results are not always completely accurate. The sample can be contaminated when patients don’t follow instructions well, leading to false results (Vikingsson et al., 2022). The test cannot give information on which specific drug has been taken. After the examination, one cannot determine the levels of substances that have been abused.

The blood tests have positive side like the sample cannot be degraded, and patients will not keep going in and out of labs to deliver pieces. Blood tests are better indicators of recently abused substances than urine tests. During therapeutic drug monitoring, the serum is the preferred specimen because its drug concentrations reflect the disposition of the drugs at the time it is collected (Doi et al., 2021). However, the blood test has its negative side because blood is an essential part of the body, and when a large amount of it is drawn in a short time, the patient’s body will have side effects. Doctors can get infections from infected blood samples when they are not used carefully and needles are not disposed of with care. Sometimes there can be excessive bleeding after blood has been drawn, which can cause fainting and dizziness.

Conclusion

Urine and blood tests can disclose the presence of diseases and substances, including drugs. The tests can help diagnose conditions that have no apparent symptoms. Urine toxicology and blood tests examine urine and blood samples for medical reasons. The two tests started way back in history, whereby urine test began to monitor the presence of methadone in urine while blood test was done to identify the different types of blood. A urine test is done by first obtaining a patient’s urine sample and taking it to the laboratory to conduct the test. The blood test is done by collecting blood from the patient’s arm and labeling and taking it to the laboratory for analysis.

Issues like false positive and false negative results can arise when doing the tests. Urine tests have various positives side, including simple collection methods, easy storage and transport and are suitable for people whose blood samples cannot be drawn from. However, it has its barriers like sample contamination, lack of accurate information on the drug used, and they do not give exact levels to which drugs have been abused. Blood tests have several advantages like samples cannot be degraded and are the best indicators of recent substance abuse. The limitations of blood include excessive bleeding, and the health care givers can easily be infected. For this reason, blood and urine tests participate in routine health checkups for all patients.

References

Bacârea, A., Fekete, G., Grigorescu, B., & Bacârea, V. (2021). Discrepancy in results between dipstick urinalysis and urine sediment microscopy.Experimental and Therapeutic Medicine, 21(5), 1-4.

Chidambaram, S. B., Essa, M. M., & Qoronfleh, M. W. (2022). Introduction to toxicological screening methods and good laboratory practice. Springer.

Doi, D., Vale, R. R., Monteiro, J. M., Plens, G. C., Ferreira Junior, M., Fonseca, L. A., Perazzio, S. F., Besen, B. A., Lichtenstein, A., Taniguchi, L. U., Sumita, N. M., Corá, A. P., Eisencraft, A. P., & Duarte, A. J. (2021). Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study. PLOS ONE, 16(5), 1-10.

Kapur, B. M., & Aleksa, K. (2020). What the lab can and cannot do: Clinical interpretation of drug testing results.Critical Reviews in Clinical Laboratory Sciences, 57(8), 548–585.

Vikingsson, S., Krauss, S. T., Winecker, R. E., Flegel, R. R., & Hayes, E. D. (2022). Update on urine adulterants and synthetic urine samples to subvert urine drug testing. Journal of Analytical Toxicology, 46(7), 697–704.

Zhang, Z., Liu, J., Cheng, Y., Chen, J., Zhao, H., & Ren, X. (2022). Urine analysis has a very broad prospect in the future.Frontiers in Analytical Science, 1.1-10

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