Transcript Urinanalysis and Other Drug Testing Methodologies.

Saliva Drug Screening in W.A.
Correctional Settings
Hayley Taylor
Kati Kraszlan
Christine Anderton
May – October 2004
Department of Justice
 Feb 2003 DoJ hosted the Drugs Roundtable Forum.
- Justice Drug Plan developed – reduce drug
demand/supply/harm in Prisons.
- Conduct a review of drug testing technologies.
 Oct 2003 the report on alternative drug testing was
completed (Gobetz and Wallengren, 2003).
- reviewed drug testing technologies and determined
those viable for use within correctional settings.
Investigated hair, sweat, saliva, urine.
- the report indicated that the use of saliva for drug
detection may have some validity in a correctional
setting and required further investigation.
Saliva Drug Testing
 Potential advantages of saliva:
- Relatively non-invasive
- Easily accessible
- Unlikely to be susceptible to adulteration
(10 minute saliva turnover rate)
- No requirement for specialised venues
- Either gender can supervise
- On-site results in a matter of minutes
W.A. Saliva Trial
Aims:
1) To establish secure procedures for saliva drug screening
in correctional facilities.
2) To assess the validity of two commercially available onsite immunoassay procedure for the detection of drugs in
saliva.
3) To evaluate the use of saliva drug testing as an accurate
and viable alternative to urinalysis.
Sample Population
 6 month trial commenced May 2004
 1175 random on-site saliva drug tests conducted
across 5 sites:
1) Bandyup - Women’s Prison
2) Hakea – Maximum Prison
3) Wooroloo – Minimum Prison Farm
4) Acacia – Privately-operated Prison
5) Perth Drug Court – Community Setting
 Variation in population and setting
Recruitment
 Drug Court/Acacia – offenders/prisoners participated
in the saliva trial voluntarily. All saliva samples had
accompanying urinalysis results.
 Hakea/Bandyup/Wooroloo – prisoners were randomly
selected to participate in the saliva trial (Regulation
26b of the Prisons Act). Urine samples were only
collected upon the indication of a positive on-site
saliva test or refusal to provide a saliva sample.
*** All of the offenders/prisoners and officers that
participated in the trial completed a brief
questionnaire to determine attitudes towards saliva
drug testing.
Saliva Products
 Of the 1175 saliva samples collected:
 575 saliva samples tested with the Cozart RapiScan®
(Bioscience Ltd, Abingdon Oxfordshire UK)
- 73.7% male
 600 saliva samples tested with the UltiMed
SalivaScreen™
(UltiMed Products GmBh, Ahrensburg, Germany)
- 72.7% male
Product 1 - UltiMed SalivaScreen™
 Detected 5 drugs:
methamphetamine,
cannabis, cocaine,
morphine, methadone
 3-step procedure
 Device does not come with a
suitable storage container
 A second saliva sample had
to be collected for GC-MS
confirmation
Product 2 – Cozart RapiScan®
 Detected 5 drugs:
amphetamines,
benzodiazepines,
opiates, cocaine, cannabis.
 Multiple steps involved
 Suitable storage container
supplied
 Adequate sample for GC-MS
confirmation
Sample Distribution
 Sample target per product: Drug Court (n=200) and
Prisons (n=100)
Drug
Court
Wooroloo
Bandyup Acacia
Hakea
Total
UltiMed
230
115
105
100
50
600
Cozart
200
100
100
75
100
575
Total
430
215
205
175
150
1175
** Hakea/Acacia target was not achieved
UltiMed Positive Test Results (n=113)

No Cocaine positives recorded

Methadone positives were prescription based
A total of 15.5% of saliva tests at DC and 3.02% of saliva tests at
Prisons tested positive for an illicit drug.

Meth
adone
Methamphetamine
Cannabis
DC (n=219)
22
21
9
3
55
Bandyup (n=104)
27
2
0
0
29
Acacia (n=98)
10
0
4
1
15
Hakea (n=49)
4
2
0
1
7
Wooroloo (n=113)
6
0
0
1
7
69
(61%)
25
(22.1%)
13
(11.5%)
6
(5.4%)
113
Total (n=583)
Morphine Total
Cozart Positive Test Results (n=58)
A total of 12.7% of saliva tests at DC and 2.4% at Prisons tested
positive for an illicit drug.

Benzo
Amphet
Cannabis
Opiate
Cocaine
Total
DC
(n=197)
17
6
14
5
0
42
Bandyup
(n=100)
1
0
0
0
1
2
Acacia
(n=75)
0
0
2
0
0
2
Hakea
(n=99)
3
1
2
0
0
6
Wooroloo
(n=99)
3
1
1
1
0
6
Total
(n=570)
24
(41.4%)
8
(13.8%)
19
(32.8%)
6
(10.3%)
1
(1.7%)
58
Positive saliva on-site test results
compared to urinalysis
True Positive
False Positive
UltiMed
n
%
n
%
Methamphet (n=25)
23
92%
2
8.0%
Morphine (n=6)
6
100%
0
Cannabis (n=13)
5
38.5%
8
Cozart
n
Opiate (n=6)
5
Cannabis (n=19)
%
61.5%
n
%
83.3%
1
16.7%
16
84.2%
3
15.8%
Amphet (n=8)
5
62.5%
3
37.5%
Benzo (n=17)
14
82.4%
3
17.6%
Cocaine (n=1)
0
-
1
100%
Negative saliva on-site test results
compared to urinalysis
True Negative
UltiMed
n
Methamp (n=243)
223
Morphine (n=258)
%
False Negative
n
%
91.8%
20
8.2%
242
93.8%
16
6.2%
Cannabis (n=253)
184
72.7%
69
27.3%
Cozart
n
%
n
%
Opiate (n=269)
260
96.7%
9
3.3%
Cannabis (n=258)
209
81.0%
49
19.0%
Amphet (n=267)
248
92.9%
19
7.1%
Benzo (n=258)
209
81.0%
49
19.0%
Sensitivity, Specificity and Accuracy
Sensitivity
(>90%)
Specificity
(>90%)
Accuracy
(>95%)
Morphine
27.3
100
93.9
Cannabis
6.8
95.8
71.0
Methamphet
53.5
99.1
91.8
Opiate
35.7
99.6
96.4
Amphetamine
20.8
98.8
92
Cannabis
24.6
98.6
81.2
Benzodiazepine
22.2
98.6
81.1
UltiMed
Cozart
Time Taken To Collect Saliva Sample
Mean time required to
collect a saliva sample
with UltiMed (sec)
Mean time required to
collect a saliva sample
with Cozart (sec)
36
132.7
Drug Court
29.1
100.5
Acacia
31.7
149.2
Hakea
33.8
155.7
Wooroloo
39.6
131.6
Bandyup
45.7
126.7
Overall
Time Taken To Obtain Saliva Test Result
Mean time required to
obtain a test result with
UltiMed (min)
Mean time required to
obtain a test result with
Cozart (min)
Overall
9.22
12.16
Drug Court
8.43
12.18
Acacia
9.10
12.16
Hakea
9.56
12.14
Wooroloo
10.46
12.16
Bandyup
8.55
12.16
Offenders Attitudes

Attitude data combined for the two saliva products
Easier to
provide
(n=563)
Easier to have
collected
(n=578)
Prefer to
provide
(n=545)
Easier to
tamper
(n=350)
Saliva
88.1%
90.6%
86.1%
15.8%
Urine
6.7%
6.6%
8.4%
73.6%
Both
5.2%
2.8%
5.5%
10.6%
Officers Attitudes
 57 officers participated in the trial:
- 87.7% less time to collect saliva sample compared
to urine sample
- 82.4% prefer to collect a saliva sample rather than a
urine sample
- Advantages of saliva testing: both genders can
supervise, testing is less intrusive, quicker, easier
and negates time involved with strip searches.
- Disadvantages of saliva testing: window of
detection, limited number of drugs detected and urine
still had to be collected.
Cost Analysis
 Current costs for saliva screening and confirmation
tests are considerably more expensive than the
current costs for urinalysis testing.
 When comparing the costs involved with staff time,
saliva testing is currently 67%-70% more costly to
implement than urinalysis. However, this is a
generalised cost as some urine samples take
considerably longer to collect, which would
significantly impact on the costing methodology.
Conclusions
 Prisoners, offenders and prison officers clearly
indicated that saliva testing was less intrusive, less
embarrassing, easier to conduct and less likely to be
tampered with than urinalysis.
 Although the low number of positive results limits
general conclusions, the data clearly indicates that
saliva tests do not currently meet a standard to
replace urines as the primary drug-screening tool.
 The high cost of saliva screening tools currently
makes them financially unviable for wholesale
implementation into correctional settings.
Recommendations
 Urinalysis remains the primary drug-testing tool as the
current saliva-screening tools failed to demonstrate
sufficient accuracy.
 Continue to monitor developments in saliva drug testing as
improvements in technology may make it more viable.
 Continue to investigate alternatives to laboratory-based
urinalysis for drug testing in correctional settings and
examine the optimal approach for drug testing throughout
different settings.
 Investigate the development of a full cost methodology
including costs for drug testing throughout W.A.
correctional settings.
Further Information
Please contact Christine Anderton for any further
information concerning Drug Strategies within the
Department of Justice.
Email: [email protected]
Phone: 9278 1048