Transcript Drug and Alcohol Testing Information

Central Iowa Juvenile
Detention Center
Established 1993
Providing the Following Services:
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Detention
Transportation
Tracking
Fiscal
Coordination
Drug Testing
In-Home Counseling
Evaluation Program
A Brief History
• 1994- Began Drug Testing at CIJDC Detention Facility
• 2008- Began contracting with DHS thru local RFP Process
• 2013- Began Statewide Drug Testing Contract for DHS
thru Statewide RFP Process.
• We offer Fixed Sites in 47 counties
• We offer In-Home and Emergency Testing in 99 counties
• CIJDC has over 100,000 collections for DHS clients
Why do we drug test?
“Drug use affects every sector of society, straining
our economy, our healthcare and criminal justice
systems, and endangering the futures of young
people.”
-Office of National Drug Control Policy
Effects of Drug Usage
on Kids
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Higher rates of hospitalization for children with parents who abuse drugs
Higher rates of child abuse and neglect
Higher rates of birth defects
Higher risk for the children to develop substance abuse problems later in life
Higher rate of mental disorders
Higher rate of eating disorders
Higher rate of anxiety and depressive disorders
Higher rate of pathological gambling later in life
Higher rate of sociopathic (Antisocial Personality Disorder) tendencies later in life
Lower performance in school
Children in these homes also experience higher rates of mistrust, guilt, shame, confusion,
ambivalence, fear, insecurity, and conflicts about sexuality
"Effects of Parental Substance Abuse on Children and Families": Source is The American
Academy of Experts in Traumatic Stress www.aaets.org/article230.htm
Drug Usage Stats
$193,000,000,000/yr U.S. Drug Usage Cost
in Productivity, Health Care and Criminal Justice.
$6,120/second (National Drug Intelligence Center U.S. Dept. of Justice)
33%
12%
Drug Usage Reduction since 1970 (SAMHSA)
Percent of Americans Driving, weekend
nights under the influence of an illicit drug (NHTSA)
10 Most Common Drugs
of
Abuse
Per Clinical Reference Laboratory
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Amphetamines
Barbiturates
Benzodiazepines
Cannabinoids
Cocaine
Methadone
MDMA- Ecstasy
Opiates
Phencyclidine
Propoxyphene
Amphetamines
• Screening cutoff: 1000 NG/ML
• Confirmation cutoff: 500NG/ML
• Amphetamines are strong central nervous system stimulants
with high abuse potential. They produce an initial state of
euphoria (high) followed by restlessness, agitation, irritability
and sometimes extreme paranoia. Tolerance develops rapidly
and, although physical dependence has not been proved,
psychological dependence is very high. Amphetamines may be
used in the treatment for obesity, attention disorder,
hyperactivity and narcolepsy, but, because of the high abuse
potential, these compounds are used as a last resort in these
treatments.
Barbiturates
• Screening cutoff: 300NG/ML
• Confirmation cutoff: 300NG/ML
• There is a variety of these major sedative-hypnotic drugs.
However, all are derivatives of barbituric acid. Depending on
the derivation, the particular drug may be long acting, as is
phenobarbital or short acting, as in pentobarbital. The longacting barbiturate phenobarbital selectively reduces the
excitability of rapidly firing neurons and is therefore an
effective anticonvulsant drug. The short and ultra-short drugs
inhibit arousal, hence their sedative and hypnotic effects. Low
doses produce sedation, drowsiness, sleep and also impaired
judgment. At high doses, anesthesia is produced. Very high
doses can cause stupor, convulsions and death.
Benzodiazepines
• Screening cutoff: 300NG/ML
• Confirmation cutoff: 300NG/ML
• Among this group of drugs, the most prominent is Valium.
Benzodiazepines are used therapeutically as so-called minor
tranquilizers. Doses between 2.5 and 10mg produce a calming
effect while higher doses produce muscle-relaxing effects.
Drug addicts utilize Valium in high doses to counter the
excitatory effects of other drugs or as a means of inducing
tranquil states. Acutely, benzodiazepine overdose may produce
somnolence, confusion, seizures, and coma. Rarely,
hypertension, respiratory depression, and cardiac arrest may
occur. Chronically, physical and psychological dependence
occur. Sudden discontinuance of the drug may lead to anxiety,
sweating, irritability, hallucination, diarrhea, and seizures.
Cannabinoids
• Screening cutoff: 50NG/ML
• Confirmation cutoff: 15NG/ML
• Marijuana consists of the dried leaves and flowering tops
of the Cannabis sativa plant and is a source of
psychoactive agents, a major one being delta 9tetrahydrocannabinol (D9-THC). The gastrointestinal
tract and the respiratory system rapidly absorb this drug
after oral or inhalation routes of ingestion. The drug is
extensively and rapidly metabolized and can be detected
in the urine within a couple of hours and for as long as
several days after use. Regular users report feelings of
euphoria, hallucinations, and relaxed inhibitions.
Cocaine
• Screening cutoff: 300NG/ML
• Confirmation cutoff: 150NG/ML
• Cocaine is a central nervous system stimulant. It usually appears in
the form of a fine crystal-like powder, although it can come in larger
pieces called rocks. It may be injected, snorted or smoked as the free
base. The effects of the drug begin within minutes and peak within 15
to 20 minutes. The effects include dilated pupils, increase in blood
pressure, heart rate, breathing rate, and body temperature. The
dangers associated with cocaine use vary depending on how the drug
is taken, the dose, and the individual. Feelings of restlessness,
irritability, anxiety, and sleeplessness are reported by some regular
users. Even low doses of cocaine may create psychological problems.
Use of high doses of cocaine over a prolonged period of time may
lead to paranoia, commonly called cocaine psychosis, which includes
hallucinations of touch, sight, taste, and smell.
Methadone
• Screening cutoff: 300NG/ML
• Confirmation cutoff: 300NG/ML
• Methadone is a nonbicyclic drug, which binds
competitively with morphine to receptors in the brain.
Although it can become addictive, the effects are less
than those of equivalent concentrations of heroin. Thus,
administration of methadone to heroin addicts allows
them to experience the effects of heroin but in a
modulated manner. A gradual lowering of the dose
reduces the physical dependence, however addiction to
methadone can also occur. Methadone is also used as a
pain medication.
MDMA-Ecstacy
• Screening cutoff: 500NG/ML
• Confirmation cutoff: 500NG/ML
• MDMA is 3,4-methylenedioxymethamphetamine. It was originally
manufactured as a weight loss product, but was never marketed
because of its side effects. The white powder/solid is supplied in the
form of capsules or tablets, which are easy to counterfeit, which in
turnleads to contaminated or substituted products being sold as
ecstasy and a true ‘buyers beware’ market. MDMA effects last three
to six hours and the doses are often ‘piggy-backed’, leading to cases
of severe over-heating and cardiac emergencies. Depression, anxiety,
disruption of sleep and paranoia have been reported to occur days or
weeks after use. Symptoms of toxicity can include confusion,
agitation, hallucinations, seizures, hyperpyrexia, coma and
hypotension. Large doses can cause malignate hyperthermia, leading
to muscle breakdown as well as kidney and cardiovascular failure. As
a real capper, MDMA is neurotoxic and can cause irreversible brain
damage
Opiates
• Screening cutoff: 2000NG/ML
• Confirmation cutoff: 2000NG/ML
• Opiates are drugs such as heroin, codeine and morphine, which
can produce a very high physical and/or psychological
dependence by their users. Samples may be tested for codeine
and morphine (a metabolite of both codeine and heroin), and
follow-up testing for 6-acetylmorphine, also a metabolite of
heroin, is allowed on morphine-positive samples. Testing for
the opiates, hydrocodone (Vicodin, Lortabs), hydromorphone
(Dilaudid), is performed on non-regulated samples. Feelings of
euphoria, analgesia, drowsiness, and respiratory depression are
reported by users.
Phencyclidine
• Screening cutoff: 25NG/ML
• Confirmation cutoff: 25NG/ML
• Phencyclidine is almost exclusively seen as a drug of abuse. It
has numerous effects on a variety of different neural pathways
and hence a wide array of bizarre symptoms can be seen in the
same patient. Its physiological effects appear to be analgesic,
anesthetic, and, paradoxically, stimulating. Because of its
varied actions, clinically acute manifestations vary from
depression to euphoria and can induce catatonia, violence, rage
and auditory and visual hallucinations. Vomiting,
hyperventilation, tachycardia, shivering, seizures, coma, and
death are also common occurrences that result from abuse of
this drug.
Propoxyphene
• Screening cutoff: 300NG/ML
• Confirmation cutoff: 300NG/ML
• Propoxyphene is an analgesic drug, which has very
similar pharmacologic properties to those of the opiates
like morphine. A major cause of drug-related deaths is
propoxyphene overdose, either alone or in combination
with CNS depressants like barbiturates and alcohol. Toxic
symptoms are similar to those seen with opiate overdoses
i.e, respiratory depression, cardiac arrhythmias, seizures,
pulmonary edema, and coma.
Standard Cutoff Levels
• A “cutoff” is the concentration of analyte (drug) in a urine
sample at or above which the sample is considered positive for
that drug. The purpose of the cutoff is to insure consistency
and reliability throughout the testing process. The screening
cutoff may be different than the confirmation cutoff when the
screening test is detecting all forms of the drug and the
confirmation cutoff is measuring only one form (metabolite) of
the drug in question. For example, in testing for marijuana the
screening test looks for all forms of cannibinoid while the
confirmation test looks only at the major metabolite D9
THCA. Test results in excess of the confirmation cutoff levels
are consistent with recent ingestion of the analyte or an
analyte-producing medication.
Types of Testing Overview
Urine Analysis(UA)
• Lab-Based: 9-, 9+, 14-, Syn-Can
• Instant:10+, Syn-Can
Pharmchem Patch
Omega Hair
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Patch
Alcohol (ALC)
Amphetamine (AMP)
Cocaine (COC)
Marijuana (THC)
Opiates (OPI)
Phencyclidine (PCP)
Propoxyphene (PPX)
Barbiturates (BAR)
Benzodiazepines (BZO)
Methadone (MTD)
Fentanyl
Meperidine
Nalbuphine
Oxycodone (OXY)
Pentazocine
Hair
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UA
Reten
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PANEL
Lab
9- UA
Lab
9+ UA
Instant
10+
UA
Lab
14- UA
Panel Info & Retention Times
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Up to 1 day
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3-5 days
2-4 days
30 days
3 days
2-8 days
6-48 hrs
1-21 days
3 days
3 days
Synthetic Cannabinoids & Synthetic Amphetamines Retention Time: 2-4 days
Hair Retention Times
1st 1/2 inch= 10-40 days
2nd 1/2 inch= 40-70 days
3rd 1/2 inch= 70-100 days
Patch Retention Times
24 hours before application through removal
Lab-Based UA Types/
Drugs Tested
Drugs Tested in 9- Lab
1) Amphetamines AMP
2) Cocaine COC
3) Marijuana THC
4) Opiates OPI
5) Phencyclidine PC
6) Propoxyphene
7) Barbiturates
8) Benzodiazepines
9) Methadone
Drugs Tested in 9+LAB
Items 1-9 from above AND ALCOHOL
Drugs Tested in 14- test
Items 1-9 from above and the following prescription type drugs
10) Fentanyl
11) Meperidine
12) Nalbuphine
13) Oxycodone
14) Pentazocine
Synthetic Cannibinoid Lab
K2 Spice
Synthetic Amphetamine Lab
Bath Salts
Lab-Based UA Cont.
UA Chain of Custody Form
UA Lab Testing Cup and Vials
Instant UA Tests
Drugs tested in 10+ Instant
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Alcohol(ALC)
Amphetamine(AMP)
Cocaine(COC)
Marijuana(THC)
Opiates(OPI)
Phencyclidine(PCP)
Propoxyphene(PPX)
Barbituates(BAR)
Benzodiazepines(BZO)
Methadone(MTD)
Chem. Compounds Tested in Syn-Can
• JWH-018 Pentanoic Acid
• JWH-073 Butanoic Acid
Omega Hair Test
Drugs Tested
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Amphetamines
Cocaine
Marijuana
Opiates
Phencyclidine
Retention Times
• 10-40 days ago - 1st ½ inch of hair
• 40-70 days ago - 2nd ½ inch of hair
• 70-100 days ago - 3rd ½ inch of hair
Omega Hair Testing Cont.
Hair Chain of Custody Form
Hair Collection Kit and Specimen
Bag
Pharmchem Patch Test
Drugs Tested
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Amphetamines
Cocaine
Marijuana
Opiates
Phencyclidine
Detection Times
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24 hours before application through patch removal.
General Information
• The sweat patch is a non-occlusive, hypoallergenic collection device.
• The sweat patch was approved as a collection device by FDA on 1004-1990.
• The FDA cleared the sweat patch for the detection of cocaine,
opiates, and amphetamine in 1995; for marijuana and phencylidine in
1996.
Pharmchem Patch Cont.
PharmChem Patch Chain of Custody Form
PharmChem Overlay and Patch
Collection Process
• Central Iowa Collector will ensure client’s number was
called for testing
• Clients will present a form of photo ID
• If Client does not have an ID, CIJDC collectors will take
a photo and email to worker to confirm correct person.
• Collector will fill out Chain of Custody Form
• Collector will ask client for list of medication
• Client will sign Chain of Custody Form
• Collection of test will ensue
Techniques Used to Reduce
Probability of
Tampering/Altering of Sample
• Collector will ensure UA temp is within acceptable range
• Sample is Visually inspected for: Temp, Color, Solids, Irregularities
• Security Seals will be affixed on vials of urine
• Opposite gender protocol used for all non-gender matched collections
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Items pulled from pockets, layers are also removed
Colorant added to toilet
No water may be ran
Audio Cues observed
• Collector will seal bag in front of client to show that no tampering has occurred
• Collector will complete the Chain of Custody Form and give the client a copy
Fixed Site Referral
Process
For Client’s with Multiple Tests Scheduled
• Once approved online, Central Iowa Schedulers will begin scheduling these
tests as indicated by the worker on the Authorization form in the county
indicated
• These tests can also be set up at the workers discretion. If you have a specific
dates the clients are coming in, please state these in the comments section of
the authorization or email [email protected]
For Client’s with One Test and Stop
• CIJDC will not schedule these tests unless:
1. The worker states in the comments section when the client is coming to the
fixed site.
2. The worker emails [email protected] or calls 641-858-3852 with a
specific date and location.
In Home Referral Process
• When making authorization, select In Home. Be sure to
include address and phone numbers of clients
• CIJDC will attempt test with in 5 business days after test
is authorized
• If you have any specific instructions, please list them in
the comments section of the authorization
Emergency Referral Process
• When making authorization, select Emergency.
• CIJDC will attempt test within 24 hours
• Please email [email protected] or call 641-858-3832