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Match drug test method to goals

June 1, 2009
by Gary A. Enos, Contributing Editor
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Urine screens traditionally have been the favored mechanism for drug testing efforts, whether ordered by an addiction treatment center, a court jurisdiction, or a workplace. Yet an administrator of a drug screening company that works with all of these client groups says his company urges its business partners not to ignore the continuing advances in alternative methods for drug detection.

“There is so much [technology] out there, and we like where this is headed,” says Gary Finger, vice president of operations at Comprehensive Screening Services Inc. (CSS). “Urine testing has always been the tried and true approach, but there's been a deterioration of confidence in it over the years that has really become more evident. It is too easily adulterated; there are too many Web sites about it in the hands of too many people.”

Finger believes addiction treatment centers and other entities that contract for drug screening technology should become more familiar with the multiple options that are out there and be wary of vendors that push only one program for use with all subjects. “You have to be open-minded,” he says.

Identifying testing goals

Sometimes the goal of an organization that wants to employ drug testing makes the selection of a technology easier to determine. An addiction treatment center that is interested only in capturing the client's current circumstances probably isn't going to invest in hair testing or expensive fingernail testing, both of which have the capability to track a longer history of substance exposure.

However, these types of options might be attractive to a program in the justice system that tends to address diverse populations such as the currently incarcerated, those who have been diverted to treatment as an alternative to jail, and probationers/parolees who are seen only periodically.

In general, Finger says, “We don't advocate using only one option.” CSS Inc.'s customized services to clients include a Web-based ordering and result reporting system allowing for convenient viewing of drug testing results.

Even if a treatment center's or workplace's drug testing program cross-checks for adulterants used to beat a urine screen, Finger says those who support cheating the system always appear to be a step ahead with newly found methods of adulteration. He says that as a result, two testing vehicles that he sees as becoming increasingly popular are saliva testing and the sweat patch.

Finger says saliva's window of detection is only two days, but adds that there is nothing a subject can do to adulterate a saliva sample. In addition, although some sources have disputed this, saliva does pick up marijuana use, he says, as long as one is testing for the parent tetrahydrocannabinol (THC) and not THC metabolites.

Drug court programs and juvenile justice agencies have begun to embrace the sweat patch as a deterrent to drug use among individuals in their charge. The patch is hypoallergenic, will not fall off during a shower or exercise, and carries a unique serial number that can be tracked throughout the process of its use and analysis.

“The sweat patch becomes a visible deterrent that drug courts like,” Finger says. “An offender who is wearing the patch can show it to other people and use it to help them refuse drugs. The person can say to others, ‘I'm monitored 24/7.’”

Informed customers

Finger believes that addiction treatment centers that employ drug testing tend to know what they're looking for and are sometimes more informed about their options than many workplaces are. “The clinics want to find those who are currently abusing,” he says. “They're treating the current circumstances.”

Yet he adds that some in the profession still rely heavily on federal data on drug testing trends, which tend to be a couple of years old at best when they are publicly released. For instance, it is still recommended that testing panels in the private sector test for phencyclidine (PCP), even though prevalence of use in the country is relatively small. Conversely, some entities that contract for drug testing haven't realized the importance of testing for methamphetamine in most parts of the country, Finger says.

He says it will continue to be challenging to monitor developments with testing technology. The field probably has not seen the end of the emergence of new testing vehicles. A few years back, it was thought that retinal scans in the eye were to become the next trend in testing, but the difficulty of obtaining reliable baseline markers and other factors contributed to its subsequent exit from the discussion, Finger says.

The field will continue to look to Europe for technological breakthroughs, Finger says. “Our [Food and Drug Administration] clamps down tight in this area,” he says. “I wish we could get faster approvals here.”

Behavioral Healthcare 2009 June;29(6):36

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