urine drug testing why we do it when we do it how we do it what do we test for problems &...
TRANSCRIPT
Urine Drug Testing
Why we do it
When we do it
How we do it
What do we test for
Problems & Limitations
Why Test?
• Test to confirm the history of drug use given by the client
• Provides accountability for the client• Provides a way for us to document drug
use or abstinence • Confirms stability or identifies relapse
therefore enhances safety when giving carries
When do we test?
• At admission to the program to document the use of opiate
• Throughout stabilization to document progress
• In maintenance phase to document abstinence as part of monitoring stability to allow carries to be given
• Can identify if ongoing drug use is contributing to persistent difficulties
How Often?
• More frequent e.g.weekly testing while working towards carries
• Less frequent when stable
• Ideal would be random testing
• More practical is testing at apts.
How : Sample Collection
• Take measures to reduce chances of sample dilution, adulteration, or substitution
• Direct observation? - not at AFM• Leave bags, bulky outdoor clothing, empty
pockets• Designated urine sample collection area -
ideally with ‘blued toilet’ & no access to tap water until sample is handed over
• Temperature strip on bottle
Testing Methods
• Immunoassay - drug class specific– Does not identify individual drugs in each
class
GC/MS - gas chromatography/mass spectrometry - can identify a specific drug or metabolite
Point of care testing is easy & quick but costly
Point of care testing
What do we test for?
• Methadone to confirm it’s presence• Opiates including oxycontin• Cocaine• Benzodiazepines• Marijuana? • Alcohol use is important - but not part of urine
drug testing
Problems & Limitations
• “I can’t pee” or I just went• “I haven’t used since the last apt but I
took a Tylenol #1 for a headache yesterday”
• Urine is cold - did they bring it with them? Did they dilute it?
• Urine is negative for everything - including Methadone
Problems & Limitations
• Benzodiazepines & Marijuana persist for several weeks
• All other drugs only test positive for a few days
• Oxycontin does not test positive in most opiate immunoassay tests
• No test for Fentanyl• Clonazepam & Alprazolam test negative on
immunoassay for benzodiazepines