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Detecting Parental Substance Use Gns 2011


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The strengths and limitations of hair drug and alcohol testing

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Detecting Parental Substance Use Gns 2011

  1. 1. Detecting Parental Substance Misuse Drug and Alcohol Analysis for Child Protection and Custody Cases Graham Sievers August 2011 CGP7450 Ed.001
  2. 2. Profile of Concateno TrichoTech <ul><li>Providing drug testing services since 1993 </li></ul><ul><li>Perform over 100,000 tests every year on over 15,000 samples– and hold the widest range of accredited drug groups in Europe </li></ul><ul><li>Most experienced team of toxicologists and expert witnesses in the UK </li></ul><ul><li>Laboratory located in Cardiff – tighter chain of custody and greater access to expertise and advice than overseas laboratories </li></ul><ul><li>Member of the Concateno group specialising in drug testing </li></ul>
  3. 3. Incorporation of Drugs into Hair <ul><li>After a drug enters the body the drug is absorbed into the blood stream </li></ul><ul><li>Each hair follicle has its own blood supply </li></ul><ul><li>As hair grows drugs are incorporated into the hair </li></ul><ul><li>Drugs will remain in the hair almost permanently </li></ul><ul><li>Sweat and sebum can also contribute to levels detected </li></ul>
  4. 4. Comparison of Drug Use History Hair Urine Oral Fluids Blood 0-3 days 1- 4 days Up to 24hrs Up to 1 year + Days: 0.1 1 10 100 1000 Possibly longer depending on the drug Depending on the drug Depending on the length of hair
  5. 5. Incorporation of Drugs into Hair Epidermis Hair Follicle Sebaceous Gland Biological fluids Drug Notes: as a drug circulates the blood stream it is fed into the core of the hair
  6. 6. Incorporation of Drugs into Hair Epidermis Hair Follicle Sebaceous Gland Biological fluids Drug Notes: as the hair grows out of the body, for example through the scalp, so any drugs absorbed into the hair core will also grow out of the body
  7. 7. Incorporation of Drugs into Hair Epidermis Hair Follicle Sebaceous Gland Biological fluids Drug Notes: it takes about 7-10 days for hair to grow out of the scalp, and along with that the strand, in its core, traces of drugs taken a week ago or more
  8. 8. Incorporation of Drugs into Hair Regular Use Drug Notes: if someone takes drugs regularly then traces of the drugs will be in the core of the hair strand along the length of the hair Epidermis Hair Follicle Sebaceous Gland Biological fluids
  9. 9. Growth Rates & History of Drug Use <ul><li>Hair grows at approx. 1 cm per month </li></ul><ul><li>3cm section = 3 months, (analysed as a whole or sectioned into individual months) </li></ul><ul><li>Consecutive sections provide a retrospective history of drug use </li></ul><ul><li>Drug use history can be attained as long as the hair allows </li></ul><ul><li>e.g. 12cms of hair = 1 year </li></ul>
  10. 10. The Telogen Effect <ul><li>About 90% of head hair is in anagen or actively growing phase </li></ul><ul><li>About 10% of head hair is in telogen or resting phase </li></ul><ul><li>Telogen phase hair will contain drug from an earlier period than anagen phase hair </li></ul><ul><li>Body hair samples have more telogen phase hair – about 40-60% </li></ul><ul><ul><li>- making estimations of time of ingestion less accurate </li></ul></ul>
  11. 11. Hair Analysis: Strengths <ul><li>Unique long window of detection </li></ul><ul><li>Segmental analysis can show trends and patterns for an individual </li></ul><ul><li>Drugs remain locked in hair </li></ul><ul><li>Simple & quick sample collection, easy storage and less evasive than other tests </li></ul><ul><li>Commonly used and accepted in child protection, child residence and family law cases </li></ul>
  12. 12. Hair Analysis: Limitations <ul><li>Not appropriate for the detection of recent use, time line in months. </li></ul><ul><li>Not currently possible to determine specific drug purity, dose used or frequency of use. </li></ul><ul><li>Unable to determine the route of administration. </li></ul><ul><li>Cannot pinpoint use such as what time of day and which day of the week. </li></ul>
  13. 13. Drugs in Hair <ul><li>Class A Controlled Drugs </li></ul><ul><li>Cocaine and Crack Cocaine </li></ul><ul><li>Diacetylmorphine (heroin) </li></ul><ul><li>Lysergic acid diethylamide (LSD) </li></ul><ul><li>Methadone </li></ul><ul><li>Methamphetamines (ecstasy, crystal meth) </li></ul><ul><li>Class B Controlled Drugs </li></ul><ul><li>Amphetamine </li></ul><ul><li>Barbiturates </li></ul><ul><li>Cannabis </li></ul><ul><li>Mephedrone </li></ul><ul><li>Class C Controlled Drugs </li></ul><ul><li>Benzodiazepines </li></ul><ul><li>Ketamine </li></ul>
  14. 14. Sobriety to Excess Alcohol Tests <ul><li>Choose the appropriate testing that best fits the purpose </li></ul><ul><li>Sobriety/Abstinence </li></ul><ul><li>Chronic excessive alcohol abuse </li></ul>
  15. 15. Alcohol in Hair – Excessive Alcohol Use <ul><li>No single test can provide a definitive result </li></ul><ul><li>Two markers: Fatty Acid Ethyl Esters (FAEEs) and Ethyl Glucuronide (EtG) </li></ul><ul><li>Supports the assessment of chronic excessive alcohol consumption </li></ul><ul><li>If FAEE’s & EtG are detected in the hair sample this is consistent with alcohol consumption, recommend in corroboration with blood tests </li></ul><ul><li>International cut-off values and segments 0-3cm up to 6cm also possible </li></ul><ul><li>If FAEE/EtG not detected it is not conclusive that no alcohol consumed </li></ul><ul><li>Head hair only – body hair is not a suitable alternative </li></ul><ul><li>Hair analysis should be used in conjunction with a carbohydrate-deficient transferrin (CDT) test and a liver function (LFT) test </li></ul>
  16. 16. Sobriety Testing <ul><li>Urine analysis for alcohol (ethanol) and EtG </li></ul><ul><li>Time period covers up to 4 days </li></ul><ul><li>Continuous testing (3 times a week) recommended </li></ul><ul><li>Breath alcohol tests also possible to use </li></ul><ul><li>For more information enter ‘sobriety to excess’ into search engine </li></ul>
  17. 17. Case Study 1: Methadone Treatment <ul><li>The mother was a known heroin addict on a methadone treatment programme. </li></ul><ul><li>She insisted that she had only been taking her methadone and regular (once weekly) oral fluid tests had shown this was the case. </li></ul><ul><li>The court wanted to determine whether this was true as the father maintains allegations of heroin use. </li></ul>
  18. 18. Hair Drug Profiling
  19. 19. Case Study 2: Does the father use drugs? <ul><li>A mother made allegations that the father (separated) was using drugs and asked the police to investigate him. </li></ul><ul><li>Police questioned the father and found no evidence of drugs in his home. </li></ul><ul><li>The mother maintained these allegations, and used them as a reason to prevent the father from unsupervised contact with his children. </li></ul><ul><li>The solicitor acting for the father instructed us to perform a hair strand test for drugs. </li></ul>
  20. 20. Conclusion and Outcome <ul><li>The father was tested for a number of different drugs, and the results shown he was not a drug user. </li></ul><ul><li>The father continued to enjoy unsupervised contact with his children. </li></ul><ul><li>If the father had not agreed to have the TrichoTest® , the mother’s allegations could have affected his contact with his children. </li></ul>
  21. 21. Sample Collection <ul><li>Concateno Trained Collectors </li></ul><ul><li>- based throughout the UK </li></ul><ul><li>- fully trained in sample collection </li></ul><ul><li>(incorrect sample collection may delay proceedings) </li></ul><ul><li>- follow strict legally defensible ‘chain of custody’ procedures </li></ul><ul><li>- sample can be collected at a time convenient to you. </li></ul><ul><li>- flexibility in regards to collection location. </li></ul><ul><li>(for example your office, social services office etc) </li></ul><ul><li>Other Collectors </li></ul><ul><li>- GP’s/Nurses. </li></ul><ul><li>- Solicitors/Social Services . </li></ul>
  22. 22. Interpretation of Results <ul><li>Certificate of Analysis </li></ul><ul><li>- provides a concentration value of the drugs detected </li></ul><ul><li>- indicates ‘detected’ or ‘not detected’ </li></ul><ul><li>Expert Witness Report </li></ul><ul><li>- recommended when case may go through court </li></ul><ul><li>- detailed description of the process from collection </li></ul><ul><li>through to results </li></ul><ul><li>- interpretation of results </li></ul><ul><li>Expert Witnesses </li></ul><ul><li>- available to attend court hearings </li></ul><ul><li>- can explain tests in more detail and clarify results </li></ul>
  23. 23. <ul><li>Can body hair be used if no head hair is available? </li></ul><ul><li>What are the effects of bleach and hair dyes? </li></ul><ul><li>Can someone become positive due to passive smoking? </li></ul><ul><li>Can a hair test help in claims of one-off use (“my drink was spiked”)? </li></ul>Frequently Asked Questions
  24. 24. Thank you for listening <ul><li>Graham Sievers </li></ul><ul><li>[email_address] </li></ul><ul><li>+44 (0) 7813 706 759 </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li>+44 (0) 29 2054 0542 </li></ul>