Nail testing offers a sensitive, versatile alternative to hair testing, when the latter is not possible.
Samples are processed using Liquid Chromatography with tandem Mass Spectrometry (LC-MSMS), with results provided in 3 days or less following receipt.
Like hair testing, nail testing can be used to detect drug and alcohol use across long detection windows. This is approximately between six and 12 months – according to whether the sample is a fingernail or toenail.
Unlike hair testing, however, nail tests cannot be used to indicate patterns of substance use – only indicating if a substance was used, not when. Nail tests are also not appropriate for detecting one-off drug or alcohol use.
Sample collection is fast and non-intrusive, and can be performed anywhere under the supervision of a trained collector. In this way, nail tests are extremely difficult to cheat.
Sample collection is only possible where fingernails and toenails are long enough, and where they have a normal appearance and are not contaminated with dirt, oil, nail polish or false nails. We take additional care and judgement when collecting from a donor with peripheral artery disease or diabetes.
What you need to know about nail testing:
- A three-millimetre nail sample provides an exposure history of up to approximately eight months.
- The detection window is dependent on the type of nail clipping. A three-millimetre fingernail clipping might offer a six-month exposure history. A three-millimetre toenail clipping might offer a 12-month exposure history.
Substances tested for:
- Alcohol, via EtG alcohol markers
- Drugs, including opiates, cocaine, amphetamines, barbiturates and benzodiazepines. Tests may also cover substances including fentanyl, tramadol and ketamine, given the number of tests commissioned.
- After cleaning their hands and washing under the nails, the donor clips their fingernail or toenail in front of a trained collector. Clippers must be cleaned before use.
- Offers a useful alternative to hair testing, when a donor lacks hair on their head or body.
- Long detection window, for testing over long timeframes.
- Non-intrusive sample collection method.
- Collection can be observed.
- Method cannot be used to detect recent substance use.
- Sample collection is only possible with fingernails or toenails over a certain length.
- Toenail samples must not be collected if the donor suffers from peripheral artery disease or diabetes.
- Unsuitable for confirming one-time substance use.
How does nail testing work?
Ingested substances are broken down into different metabolites inside our bodies, and can therefore be used as evidence of our substance use over time.
These chemical markers pass into nail tissue – keratin – via blood vessels underneath the nail. In turn, the metabolites become ‘trapped’ within the nail. As the nail grows longer and thicker, its layers provide a history of substance use.
Nail tissue can therefore be collected and tested for drug and alcohol use, using immunoassay screening followed by a confirmation test, or with liquid chromatography and mass spectrometry in a laboratory.
As well as testing for EtG (ethyl glucorinide) alcohol markers, fingernail drug tests can confirm the presence of drugs including opiates, cocaine, amphetamines, barbiturates and benzodiazepines with high accuracy. Given the numbers of tests requested, these tests can also cover substances like fentanyl, tramadol and ketamine.
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