Can you tell me about drug testing with a shy bladder (paruresis)?

First, the diagnosis: of paruesis must be established by a medical professional to the satisfaction of the MRO which can be daunting sometimes. After that a determination needs to be made regarding the necessity of a negative drug screen. At this point jurisdiction dictates the process. Meaning is it Federal mandated or state non-mandated testing. Alternate matrices (saliva and hair) have been utilized.

Depends: on what you mean by a "shy bladder," which is often just internalized guilt/shame over the act of micturition left over from our toilet training days. If you are being watched when you urinate, alternatives are use of a bathroom with a camera, running water while you try to urinate, doing water loading prior to the test (plus caffeine) and other techniques. Some programs will do saliva/oral swabs.