Hair follicle drug testing is a method used to detect evidence of drug use or misuse by analyzing a hair sample. This type of testing has a longer window of detection compared to other drug tests, making it valuable for identifying chronic drug use patterns and confirming periods of abstinence. While hair follicle drug tests are more commonly used to detect illicit drugs, they can also be used to detect alcohol consumption.
During a hair follicle drug test, a small hair sample is collected using scissors. Hair follicle drug tests identify drugs or drug metabolites in a sample of hair. When a person consumes drugs or alcohol, these substances enter the bloodstream and circulate throughout the body. As the body breaks down these substances, drugs and drug metabolites enter the core of the hair through the hair follicle, sweat glands, and oil glands on the scalp. The drugs and drug metabolites remain in the hair as it grows, which occurs at a rate of approximately one-half inch per month.
The length of time that drugs or alcohol remain detectable in hair is known as the window of detection. Hair follicle drug testing has a longer window of detection than other types of drug tests. While drug use and misuse may not appear in the hair until 7 to 10 days after drug exposure, once it enters the hair, it can remain for weeks, months, or even years. However, a standard sample of hair from the scalp is typically 1.5 inches long and provides information about approximately 90 days of past drug exposure.
In most cases, alcohol will appear in a hair strand test for 1 to 6 months. It will take several weeks after drinking alcohol for it to show up in a test. Alcohol can then be detected for several months.
Several factors influence the window of detection, including:
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Alcohol hair tests look for ethyl glucuronide (EtG) markers. EtG is a direct marker of alcohol consumption, and it’s present only when a person has consumed alcohol or has had increased blood alcohol levels. When it comes to detecting alcohol consumption, most people are familiar with urine, blood, or breath tests, but hair testing is another method that is used for drug and alcohol screenings. While alcohol isn’t typically tested through hair follicles as commonly as drugs like cocaine or marijuana, it is possible to detect alcohol in hair samples, especially if the individual has been drinking regularly or heavily over a prolonged period.
Ethyl Glucuronide (EtG) is a direct metabolite of beverage alcohol (ethanol). Its presence in urine may be used to detect recent alcohol consumption, even after ethanol is no longer measurable. With urine EtG alcohol testing there is about an 80 hour lookback period, with hair follicle EtG alcohol testing detection is up to 90 days. EtG tests are commonly used for individuals on court ordered probation, child custody proceedings and persons in a substance abuse treatment program. The EtG test, properly known as Ethyl Glucuronide is a metabolite produced from drinking alcohol and is used to detect alcohol levels in urine. It is being used by courts and probation departments as a way of testing if people are drinking. EtG is a reliable indicator of alcohol consumption as the metabolite can be found in urine for up to 80 hours after drinking.
Although hair follicle testing is an accepted form of drug testing, the results of this test can be affected by a variety of factors, including environmental exposures, hair composition, use of hair products, and even hair color. Additionally, some drugs attach to the hair more easily, like nicotine and heroin, while other drugs are more difficult to detect in hair.
Inaccurate results can occur due to environmental exposure to drugs or alcohol. For example, during exposure to secondhand smoke from cocaine or tobacco some of the smoke or vapor can enter the hair and lead to a positive test result. There may be alcohol vapor in the air as a result of disinfectants and cleaning agents.
Hair color can also lead to inaccurate or biased results of hair follicle drug testing. People with darker hair may retain more alcohol metabolites compared to those with lighter hair. Since alcohol metabolites attach to the melanin in hair, those with higher melanin content - dark hair - will have more alcohol metabolites.
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Hair treatments, including shampooing, coloring, relaxing, and bleaching the hair, can affect the concentration of drugs and drug metabolites detected during testing. Although hair treatment does not erase signs of alcohol, it can reduce the levels of alcohol metabolites. EtG is water soluble. Thus, bleaching, dying, straightening, or washing your hair excessively can significantly reduce the levels of EtG in your hair follicles.
Hair follicle drug tests are performed on a sample of hair, usually collected from a person’s scalp. In some cases, the collection of a hair sample will be performed by a trained professional to prevent tampering, contamination, or substitution of the sample. Although there are no special precautions necessary before a hair follicle drug test, patients should inform their doctor of medications or supplements that have recently been taken.
Collecting a sample of hair at a laboratory or at home involves cutting a lock of hair about the thickness of a pencil from the back of the head using scissors. Hair is collected as close to the scalp as possible, near the hair’s root, to provide information about recent drug use. If patients don’t have sufficient hair on their scalp, hair may be collected from the face, armpit, pubic area, or another unshaven part of the body.
Typically, hair strands - roughly 200 - are taken from the back of the person’s head. The hair samples should be 3-6 centimeters long. The Society of Hair Testing, a global network that offers guidance on the testing of drugs in human hair, has created guidelines for where samples should be taken and how they should be handled.
Results of hair follicle drug testing are generally available within a few business days after the laboratory receives the sample. The results of hair follicle drug tests may be reported as positive or negative. Negative test results indicate that no drugs or drug metabolites were detected in the hair sample.
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When interpreting results, it may be helpful to understand the laboratory method used for testing. Laboratory methods used in hair follicle drug testing are similar or slightly modified versions of those used in more common forms of drug testing, like urine drug testing. Initial test methods: Immunoassays are a common method of drug testing but provide only preliminary results. Results include which drug or drug classes were detected above the lab’s cutoff for positive results.
It is important for experts to take the results in context, however. While hair alcohol testing can be used as evidence in court cases and custody disputes, there are privacy considerations.
Because hair alcohol testing is one of the most accurate methods to test for alcohol and drugs, it is used in various applications.
Hair follicle drug testing may be more challenging to interpret than other types of drug tests due to the many factors that may affect the interpretation of test results. It can be difficult to detect low-level or one-time drug use or misuse using a hair sample for drug testing.
Follow-up testing after a hair follicle drug test depends on the test results and the purpose of drug testing. If a drug test result is positive, a health care provider may ask questions to evaluate the patient for a substance use disorder or addiction. The health care provider may ask about the impact of drug use or misuse on a person’s health and social obligations, any history of attempting to reduce or stop taking drugs, as well as whether the patient uses drugs in dangerous situations. Drug test results can be difficult to interpret and patients can ask their doctor or the testing facility about the meaning of test results.
Wondering how long alcohol stays in your system? It depends on how much alcohol you’ve had to drink and whether it’s your urine, hair, blood, saliva, or breast milk being tested. Every type of drink (beer, wine, liquor, etc.) has a different amount of alcohol in it. At a bar, drinks are generally standardized to easily keep track of how much alcohol you’ve had. For example, one beer is 12 fluid ounces, and it contains 5% alcohol. Wine is a much more concentrated drink at 12%. Just 5 fluid ounces of wine is considered one drink. One shot of rum, vodka or gin at 40% alcohol (80 proof) is considered one drink.
Here are the detection windows for alcohol in other body systems:
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