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  • Michael Burk

Mind Over Bladder: The Drug-Testing "Donor Fear Factor"

The human body is an ever-studied wonder: a network of synergistic systems that work together to keep you, the person, going. Some of the systems employ organs that have simple causes and effects on your bodily functions, i.e. the urinary system. You drink water or coffee, and later you urinate. The brain, however, is complex and can cause measurable effects on another system’s ability to function. You know that you are required to submit a urine specimen, and your bladder is sufficiently filled, but your brain is causing a psychological response to keep you, the donor, from going…into that cup. It’s a completely normal and prevalent response even if there’s nothing to hide. This response is known as the “donor fear factor,” and here are some of the most common

instances that exist, why, and how collectors help overcome them.

The 300ml Rule

Like the stomach, the bladder sends a message to the brain when it is full. Healthily functioning bladders usually don’t tell the brain that the body is able to urinate until it is filled with 300 milliliters (ml) of urine. For drug-testing purposes, most labs only require 45ml to 60ml for a full specimen. Normally, if the donor has not urinated 15-20 minutes prior and is not dehydrated, the bladder should be sufficiently filled with an adequate amount. However, the bladder and brain connection dynamic sends the message to the donor that they “cannot go” and that they should wait, which can waste time. Most collectors curtail this by having the donor provide a sample immediately, and having the donor stand by and drink liquids if the specimen quantity is insufficient. Note also that if a specimen’s quantity is insufficient, collectors are NOT allowed to add to the original specimen and must collect a fresh specimen with each attempt.


Shy Bladder

Shy Bladder occurs when the donor’s bladder is filled and they feel like they can urinate, but they are not able to void a specimen because of psychological factors. Maybe they are indeed shy, or they feel pressured by the process, but some people must get over a hurdle in order to provide a personal bodily fluid to another person. In this case, the donor is given a 3-hour time frame in order to provide a specimen. During that time, the collector will allow the donor to be calm and drink water and will also answer questions that the trepidatious donor may have about the process. Some collection facilities invest in a mini waiting room fountain, which serves the purposes of soothing the donor and inspiring the donor’s bladder to void in tune with the sounds of trickling water.


Fear of the False Positive

“So, I ate a poppy seed muffin for breakfast, my neighbors smoke weed all the time, and I took ibuprofen and vitamins. What if I’m positive?” Concerns of false positives are legitimate and can cause anxiety to a donor whose job may be on the line. Thankfully, there are measures in place in laboratory testing to prevent false positives. Laboratories institute drug metabolite cutoff levels in which factors such as poppy seeds and second-hand marijuana smoke won’t register at a high enough level to be considered “positive.” Collectors are educated about drug metabolite cutoff levels in standard testing panels and can answer questions and provide information to address any donor concerns.

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