Fingernail Drug Testing For Alcohol And Substances of Abuse

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When choosing a drug test, there are 5 factors that should be considered….

Desired window of detection, specimen type, the substances being tested, the level of adulteration potential and the notice required before collection

Narration:

When selecting a drug testing option, it is helpful to know that each specimen type is most suitable for a particular timeframe or window of detection.

Note: The next 5 slides are to briefly review the specimen widow of detection options. It can be brief, as the point is to position fingernail as the front runner to long-term drug testing compared to all other specimen types available. The specimens are starred in each slide with regard to the note that the slide covers.

Narrative:

Urine, oral fluid and whole blood are the options most suitable for testing recent use because their window of detection ranges between 1-3 days.

Narrative:

Dried Blood Spot testing for PEth, an alcohol biomarker, is most suitable for testing heavy use of alcohol in the last 2-3 weeks.

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Hair testing is most suitable for testing heavy use of alcohol or SOA in the past 3 months.

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Fingernail testing is most suitable for testing heavy use of alcohol in the past 3 months or heavy use of other SOA in the past 6 months.

Understanding the time frame that you want to test for will help you be able to better choose the most suitable test for your needs

Narrative:

So, why does fingernail work so well for testing long-term biomarkers compared to other specimen types?

Narrative:

The answer lies within the nature of the fingernail.

Fingernails are made of keratin, the fibrous structural protein of hair, nails, horn, hoofs, wool, feathers, and of the epithelial cells in the outermost layers of the skin.

The polypeptide chains of keratin are arranged in parallel sheets held together by hydrogen bonding.

Narrative:

These keratin sheets stack on to of each other giving the nail thickness and length, making adulteration of the specimen difficult.

Narrative:

As the nail grows in thickness and length, biomarkers from alcohol and other substances of abuse build up in the nail at the germinal matrix and along the nail bed.

A biomarker is a measurable substance whose presence is indicative of ingestion or exposure to substances of abuse (SOA).

Biomarkers become trapped in the keratin fibers.

Narrative:

Biomarkers can be found in nails as early as 1-2 weeks after alcohol or other substances of abuse are ingested.

The time period during which drug or alcohol ingestion can be detected depends on the substance used, the amount used, and personal metabolism.

Narrative:

What are we talking about with heavy alcohol use and how can self report be deceiving?

Narrative:

A standard drink is any beverage that contains 14 grams of pure alcohol.

Amounts vary depending on the percentage of Alcohol By Volume or ABV.

So, 12 ounces of beer, 8 to 9 ounces of malt liquor, 5 ounces of table wine, and 1.5 ounces of hard liquor are all equivalent to 1 standard drink.

Note: see shot glasses at the bottom of the image if you want to point out the numbers

Narrative:

But, these days, having a “drink” can be deceiving.
The alcohol content can vary drastically from one drink to the next.

It is easy to see how someone can report 1 or 2 drinks a night, but actually be drinking 8-10 standard drinks.

Narrative:

Nail keratin is 4 times thicker than hair and often captures more of a biomarker

Additionally, hair growth is relatively slow compared to fingernails, which can be grown in as little as 1-2 weeks.

Some notice may be needed for the donor to refrain from clipping their nails in preparation for a test.

Narrative:

Hair is not always available
Hair is a great specimen type, but there are some disadvantages:
Pigmentation, or color of the hair, has a large influence on biomarker absorption.
Dark hair absorbs more substances than blonde or red hair.
Chemical treatments, such as bleaching, perming, straightening, and dying can washout biomarkers more rapidly.
Hair growth is relatively slow compared to fingernails, which can be grown in as little as 1-2 weeks.

Some notice may be needed for the donor to not clip their nails in preparation for a test.

Narrative:

Fingernail is simple to collect, ship and store.

Samples are clipped and collected by the donor in front of a trained collection staff member.

A clipping of 2-3 mm long (about the width of a quarter) from all ten fingernails will provide about 100 mg of sample, the ideal amount for screening and confirmation.

Narrative:

Since hair and fingernail are both created from keratin protein, the drug testing panels available for each test are identical.

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We understand that forensic drug testing has the potential for numerous outcomes, that can sometimes be difficult to navigate. We offer support services to give users a better understanding of what their drug testing options are.
Discussion of tests and cutoffs, litigation support, expert witness testimony, and examples for use in court cases.

Note: feel free to include your number. I thought it might be easier if they called Client Services first, and not your direct line.