PBT- DRUG TESTING & SUBSTANCE ABUSE Rev 4 03-08-24

Drug Testing & Substance Abuse Overview

Performance Objectives

  • Objective 1: Assess the necessity of detoxification prior to treatment for individuals struggling with substance abuse, considering factors such as the type of substance, duration of use, and individual health status.

  • Objective 2: Explain the detection windows for commonly abused substances through urinalysis, detailing how the timeframe for detection can vary based on the substance, frequency of use, and individual metabolism.

  • Objective 3: Differentiate between aggressive and non-aggressive drug associations; aggressive drugs often trigger violent behavior, whereas non-aggressive substances may lead to detrimental effects without increased violence.

  • Objective 4: Identify signs and effects of drug use/abuse, including physiological symptoms (e.g., changes in appetite, sleep disturbances) and psychological impacts (e.g., mood swings, cognitive impairments).

  • Objective 5: Define the primary goals for drug and alcohol testing programs, emphasizing the importance of deterrence, identifying individuals needing help, and maintaining a safe environment (e.g., workplace safety).

  • Objective 6: Recognize two essential criteria for drug testing selection, including reasonable suspicion-based testing and regular screenings to promote accountability and compliance.

  • Objective 7: Specify the recommended frequency and procedures for conducting urinalysis (UA); for instance, random testing as a method to ensure ongoing compliance and accountability among participants.

  • Objective 8: List common reasons for rejecting a specimen, such as temperature anomalies, insufficient volume, or evidence of tampering or contamination.

  • Objective 9: Describe the confirmation testing procedures, which typically involve more sensitive techniques like gas chromatography-mass spectrometry (GC-MS) to verify initial positive results.

Policies and Procedures

  • Policy Documents: Comprehensive management of substance abuse treatment records, including confidentiality measures, administrative guidelines for testing, and adherence to supervision compliance verifications.

  • Resource Links: Texas Department of Criminal Justice and other relevant agencies that provide information and support concerning substance abuse treatment.

Definitions

  • Substance Abuse/Dependence: Chronic use of drugs when viable alternatives exist or engaging in behaviors that pose a danger to oneself or others, resulting in significant impairment or distress.

  • Cross Dependence: A condition where physical dependence on one drug can be alleviated by using another similar drug, which can complicate treatment strategies.

  • Tolerance: A physiological state resulting in a diminished effect of a drug due to repeated use, often requiring higher doses to achieve the same effect.

  • Cross Tolerance: A phenomenon where the tolerance developed to one drug influences the body's response to a similar drug, posing risks during withdrawal.

  • Denial: An unconscious psychological defense mechanism preventing users from acknowledging their drug dependency, complicating treatment efforts.

  • Relapse: A setback characterized by a return to substance use following a period of abstinence, often resulting from neglecting underlying issues or a lack of support.

  • Recovery: The process of lifestyle change aimed at overcoming addiction, including engagement in support groups and therapeutic interventions.

  • Withdrawal: A set of abnormal physical and mental symptoms experienced after stopping a drug to which one has developed a dependence.

  • Addiction: A chronic condition marked by compulsive drug-seeking behaviors, persistent use despite harmful consequences, and neurobiological changes.

  • Types of Addiction: Addiction can manifest in physical forms (e.g., dependence leading to withdrawal symptoms) and psychological forms (e.g., cravings and compulsive behaviors).

Signs of Use and Abuse

  • Indicators Include: New legal troubles (e.g., arrests), familial relationship problems, decreased compliance with parole or probation, changes in living situations, declining physical health and personal hygiene, noticeable shifts in personality, and job loss or decreased performance at work.

Drug Classifications and Effects

Drugs Identified by Urinalysis (UA)

  • Amphetamines: Commonly known as crystal or speed, associated with aggressive behavior; detoxification is generally not required but should be evaluated on a case-by-case basis.

  • Barbiturates: Also known as downers, users may experience mood swings and slurred speech; a detoxification process is strongly recommended due to potential withdrawal symptoms.

  • Benzodiazepines: Such as Xanax, typically associated with non-aggressive behaviors and lower severity of offenses; can lead to dependence if used long-term.

  • Cocaine: Particularly crack cocaine, which can induce aggressive behavior; no detoxification requirement exists but counseling and support are crucial.

  • Opiates: Including heroin and morphine, typically associated with non-aggressive behaviors; detoxification is essential due to intense withdrawal symptoms.

  • PCP: Known as angel dust, it can lead to extreme anxiety and should be detoxified, particularly if there is a history of violent behavior.

  • Marijuana: Commonly referred to as pot; considered non-aggressive with no detoxification needed, typically associated with minor offenses.

  • Alcohol: Consumption may lead to aggressive behavior; detoxification is typically required based on the severity of alcohol dependence.

Synthetic Drugs and Usage

  • Commonly Used Synthetics: Include K2, Bath salts, Molly, LSD, and synthetic opiates like Fentanyl, which can have unpredictable and dangerous effects.

Signs & Side Effects of Synthetic Drugs

  • Health Risks Include: Life-threatening outcomes such as heart attacks, severe liver failure, heightened paranoia, overwhelming anxiety, sedation, hallucinations, and respiratory distress.

Supervision Goals

  • Core Objective: Ensure that clients are encouraged to enter treatment and remain engaged, irrespective of their honesty regarding substance use, by establishing supportive structures and monitoring systems.

Substance Abuse Counseling Program (SACP)

  • Program Levels:

    • Level I: Focus on Relapse Prevention.

    • Level I-B: Primarily educational objectives.

    • Level II: Outpatient treatment focusing on flexible scheduling and client needs.

    • Level III: Intermediate Sanction Facility offering more structured support and monitoring.

  • Focus Areas: Rapid referrals, creation of robust support systems, managing cravings, and developing comprehensive relapse prevention plans tailored to individual needs.

Testing Procedures

  • Testing Setup: Ensure proper collection techniques and observe clients during specimen collection to mitigate risks of tampering and ensure integrity of the sample.

  • Specimen Rejection: Criteria include temperature discrepancies, insufficient sample volumes, or observed contamination by external substances.

Results Management

  • Positive Results Handling: Implement clear protocols for managing positive drug tests, including proper admissions processes, confirmation testing requirements, and follow-up interventions.

Essential Interventions

  • Consider measures such as increased reporting requirements, regular additional meetings for support, compliance-focused counseling, and case conferencing to enhance support for compliance with treatment protocols.

Common Errors to Avoid

  • Emphasize the importance of accurate documentation of testing statuses, timely submission of confirmation reports, and the necessity of providing detailed comments regarding drug testing results to ensure clarity and accountability.