Transcript Urine Drug Testing

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?
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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