Lesson 12 - Drug Testing Procedure and POCT

Drug Testing

Highest level of modern biotechnology.

therapeutic proteins and other drugs

[Drug Testing]

The most prominent area of biotechnology is the production of ___________ and _________for genetic engineering.

highest standard

[Drug Testing]

Workplace drug testing needs to meet the_____________

high levels of safety and security

[Drug Testing]

Drug testing can have an important role in occupations where we the public are entitled to expect especially _________________________

forensic standard

[Drug Testing]

For medical tests, it is also applied to create the ____________________.

a minimum standard for the forensic examinations

[Drug Testing]

Several scientific working groups for the analysis of seized drugs recommend ___________________________________ of these seized drugs and seek the international acceptance of such standards.

Recent Drug Use
Recent Drug Period

DRUG TESTING DETECTS (2)

Impairment
Addiction
Abuse
Dependence

DRUG TESTING DOES NOT DETECT (4)

Acts as a deterrent to future drug use
Identify folks who need treatment
Identify participants who are maintaining abstinence
Identify participants who have relapsed
Rapid Intervention
Adjunct to treatment frames sanction decisions

GOALS OF DRUG TESTING

Comprehensive Drugs Act of 2002

RA 9165

6 months

[Acts as a deterrent to future drug use]

A person apprehended or arrested, who is found to be positive for the use of any dangerous drug after a confirmatory test, shall be imposed a penalty of a minimum of ________ rehabilitation in a government center for the first offense.

6 years and one day to twelve years.

[Acts as a deterrent to future drug use]

If caught for the second time, he or she will be placed in prison, ranging from ___________ to _________

heart problems and even death.

[Identify folks who need treatment]

Severe drug use can cause ___________ and ___________

True

[Identify participants who are maintaining abstinence]

T or F?

If they are placed in rehab, authorities will check if the protocol has been followed.

it is part of the court's order

[Adjunct to treatment frames sanction decisions]

Some people are mandated to have drug testing because

Urine
Hair
Oral Fluid
Sweat
Breath (for alcohol only now)

COMMON SPECIMENS USED FOR DRUG TESTING

amphetamines

Scientists in Sweden are developing breath tests for ___________ in 2015, but more testing is required before public use

1-7 days

[DRUG DETECTION TIMES]

URINE

7-14 days on the product used

[DRUG DETECTION TIMES]

SALIVA (oral fluids)

up to 90 days

[DRUG DETECTION TIMES]

HAIR FOLLICLE

a few hours

[DRUG DETECTION TIMES]

BREATH ANALYZER

composed of hydrogen and helium

[DRUG DETECTION TIMES]

SWEAT (patch)

Yes or No / Positive or Negative

Screening drug tests are not read quantitatively, but as ___________ using specific cut-offs

Quantitative Reading

only done for confirmatory testing

the limits of the sensitivity

Standard drug test cut-offs are determined by _____________ of the testing technology as commonly used

Sensitivity

the minimum amount of drugs detected that will be positive in the testing methods

negative

Anything below the sensitivity value will turn out as _________

True

T or F?

negative results do not rule out the total absence of the drug

Amphetamines

a cutoff of 500 nanograms/milliliter

True

T or F?

Negative drug tests do not necessarily mean that no drug is present.

present below the cut-off or the testing panel

Other possible interpretations are that a drug is _________________________, but does not include the drug the individual was using

limits of detection (LOD)

As a custom order, laboratories may use ______________ as cut-off

Standard 5-Panel Drug Test

drug test most frequently used by government agencies and private employers.

Marijuana
Cocaine
Amphetamine / Methamphetamine
Morphine / Codeine
Phencyclidine (PCP)

A single kit can detect 5 drugs:

Alcohol

affects everyone differently, but when drunk too much or too often, the chance of injury or accident goes up

Heavy drinking

also can cause liver and other health problems or lead to a more serious alcohol disorder

Alcohol testing

is performed for a variety of reasons, such as in a police investigation or part of an alcohol treatment program

0.02-0.05 g/dL

[BLOOD ALCOHOL CONCENTRATION]

Diminished fine motor coordination

0.05-0.1 g/dL

[BLOOD ALCOHOL CONCENTRATION]

Impaired judgment, coordination

0.1-0.15 g/dL

[BLOOD ALCOHOL CONCENTRATION]

Difficulty with gait and balance

Lethargy

pathological state of sleepiness or deep unresponsiveness and inactivity.

0.15-0.25 g/dL

[BLOOD ALCOHOL CONCENTRATION]

Lethargy; Difficulty sitting upright without assistance

0.25-0.3 g/dL

[BLOOD ALCOHOL CONCENTRATION]

Coma in the nonhabituated drinker

0.3-0.4 g/dL

[BLOOD ALCOHOL CONCENTRATION]

Respiratory depression

blood sample

When being tested in a medical setting for intoxication, doctors are more likely to take a _________

breath test

In a legal setting, such as after an accident, it is likely to be given a __________

0.08 g/dL

breath test legal alcohol limit for drivers

Heroin

White or brown powder or a black, sticky goo

Heroin

Opioid drug made from morphine

Morphine

is a natural substance in the seedpod of the Asian poppy plant

Heroin

It can be mixed with water and injected with a needle

Heroin

All of these ways of taking heroin send it to the brain very quickly

can also be smoked or snorted up to the nose

Miscarriages
Heart Infection
Death from Overdose

Heroin causes

HIV/AIDS and hepatitis.

People who inject the drug are also at risk of getting infectious diseases, including __________ and __________

tolerance

This means users need more and more drugs to have the same effect

Regular use of heroin can lead to ____________

True

T or F?

Drug dependence at higher doses over time the body becomes dependent on heroin

Restlessness
Muscle and bone pain
Diarrhea
Vomiting
Cold flashes and goosebumps

If dependent users stop heroin they will have withdrawal symptoms:

T

T or F?

Sudden withdrawal might even cause death

Blow
C
Coca
Coke
Crack
Flake
Snow

Cocaine is also known as

Cocaine

A white powder

Cocaine

Tropane alkaloid and stimulant drug

Cocaine

Obtained primarily from the leaves of the coca plant native to South America

Snorted up the nose
Mixed with water and injected with a needle
Smoked in a glass pipe

Ways of using Cocaine

It speeds up your whole body

You may feel full of energy, happy, and excited, but then the mood will change

You can become angry, nervous, and afraid if someone's out to get you

After the high, the cocaine wears off, and you can crash, and feel tired and sad for days

You also get a strong craving to take the drug again to try to feel better (drug dependence)

This cycle makes it easy to lose control over cocaine use and become addicted.

Cycle of Cocaine

Teeth grinding
Dry mouth
Dilated pupils
Nosebleeds
Rapid speech
Weight loss
Erratic sleep schedule
Financial issues

Cocaine addiction can cause

Heart attack
Stroke

Some of the common most serious problems:

Marijuana

Green, brown, or gray-mixed of dried, crumbled parts of a marijuana plant

Marijuana

Growing number of states have legalized medical uses of marijuana

Marijuana

A handful of states also allow recreational pot, but in most states it's still illegal

Smoking it like a cigarette or cigar
Mixing it in food and eating it (a pot cookie)
Brewing it as tea
Smoking oils from the plant
Using electronic vaporizers

How people use marijuana

Altered senses
Altered sense of time
Changes in mood
Problems with body movement
Problem with thinking, problem-solving, and memory
Increased appetite

While you are high in Marijuana, you may experience:

Urine

is the most common and most often the preferred test substance because of ease of collection

Urine

It is painless, easy, quick, and cost-effective

urine

Concentration of drugs and metabolites also tend to be high in the____________, allowing longer detection time than the concentration in the serum allows

Site selection
Gather all supplies beforehand
Complete custody control form with client

Pre-collection Preparation

Site selection

to minimize access to water sources, use an area with a scanned floor plan, sink, toilet, faucets

32.5°C and 37.7°C

The collector checks that the temperature strip on the specimen cup reads between _________ and _________. The collector records the in-range temperature on the COC form

Collector

who adds a bluing agent to the toilet, tap faucet, and toilet lids to stop donors from using toilet water as a sample

The donor

(person whose sample is tested) fills up the custody form.

Witnessed

Collector observes urination or sample collection

Collector must be of the same sex

Unwitnessed

The collection of urine sample is not observed

Validity testing must be done to ascertain that the sample is acceptable

30-45 mL
32.5-37.7 C.

appropriate for urine drug test:

volume
temperature

True

T or F?

The specimen must remain in sight of the donor and collector at all times.

True

T or F?

The donor must be present and actively watch when the collector places the ID strip from the COC form to the cap bottle. The barcode from the COC form is detached and placed onto the cap bottle and onto the COC form.

False

The donor signs the bottle seal and finishes the COC form.

T or F?

The collector signs the bottle seal and finishes the COC form.

False

Each time the specimen is handled or placed in storage, each individual must be identified and recorded.

T or F?

Each time the specimen is handled or placed in storage, each individual is not necessarily identified or recorded.

True

T or F?

The COC form must accompany the urine sample at all times and must be distributed to the proper personnel.

Confirmatory Test

Analytical procedure to identify and quantify the presence of a specific drug or metabolite

Confirmatory Test

Independent of the initial test

reliability and accuracy.

Uses different techniques and chemical principles from that of the screening test to ensure ________ and _________

Gas Chromatography/Mass Spectrometry

most common confirmatory for drug testing

Department of Health (DOH)

Reports pertaining to specimens shall be kept by the testing laboratory for a minimum period to be determined by the ________________

15 days

Specimens with confirmed positive test results which are not challenged within ___________ after receipt shall be discarded.

negative or positive

Screening test results shall be reported as ____________ or __________

presence or absence and the identity

A confirmatory test shall report the ________, ___________ and __________ of the drug, metabolite tested, as well as its concentration.

original copy

The _______________ of the test result form shall be given to the donor immediately upon its completion.

positive screening test results

All specimens with ____________ shall be submitted for confirmation before a final report will be issued.

Department of Health (DOH)

Other copies of the said test result form shall be furnished immediately to the _________________ and the requesting agency.

one copy.

The drug testing laboratory shall retain_______

Point of Care Testing

may also be known as:

Near Patient Testing
Bed-Side Testing
Physician's Office Testing
Extra-Laboratory Testing
Decentralized Testing
Ancillary Testing
Alternate Site Testing