25 Years of Drug Testing and its Technical and Clinical Future
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This document discusses the history and future of drug testing over the past 25 years. It notes that drug testing has increased from 12 million annual tests in 1992 to over 200 million now, with 15 million being mandatory. Testing can now be done via saliva, urine, or hair, each detecting drugs over different time periods. New technologies like instant urine tests and various drug testing kits are now used alongside traditional lab testing. The document outlines various drugs that are tested for like opioids, cocaine, and marijuana. It recommends best practices for drug testing including hair/saliva/urine screens, instant tests in treatment settings, varying the drugs tested, and using new technologies like LC/MS/MS.
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25 Years of Drug Testing and its Technical and Clinical Future
- 1. David Martin, Ph.D. 25 Years of Drug Testing and its Technical and Clinical Future
- 2. www.questdiagnostics.com 25 Years of Drug Testing and its Technical and Clinical Future
- 3. Drug Testing Emerging Technologies 20121992 12 MILLION DRUG TESTS 5 MILLION MANDATED DRUG TESTS FRAGMENTED AND NON-CENTRALIZED IT 200+ MILLION DRUG TESTS 15 MILLION MANDATED DRUG TESTS
- 4. SalivaSaliva Urine Saliva-Urine-Hair Drug TestsSaliva-Urine-Hair Drug Tests Time:Time: Cut off Hair HoursHours DaysDays Months
- 6. Instant Urine Drug Testing KitsInstant Urine Drug Testing Kits ALERE TOXICOLGY SYSTEMS PRINCETON BIOMEDICA (PBM) SYVA RAPID TEST ACCUSIGN STATUS ABI TESTCUP BIO SITE TRIAGE > 70 KITS ON MARKET
- 7. Saliva Drug Testing SIMILAR TO BLOOD IMPAIRMENT TESTING INSTANT TESTING LABORATORY TESTING
- 9. BREATH ALCOHOL TESTING • Breathalyzer - Uses a chemical reaction involving alcohol that produces a color change • Intoxilyzer - Detects alcohol by infrared (IR) spectroscopy • Alcosensor III or IV - Detects a chemical reaction of alcohol in a fuel cell NHTSA • Urine, Hair, Blood Spot –urine ETG/ETS for zero tolerance, PeTH binge monitoring,
- 10. SPORTS PRESCRIPTION DRUG ABUSE
- 11. “COCAINE PLUS” Additives • PHENACETIN: a cancer causing pain reliever • DILTIAZEM: a cardiac medicine • ANFEPRAMONA: similar to amphetamine • BENZOCAINA: a local anesthetic • LIDOCAINA: a local anesthetic • LEVAMISOL: used to expel parasitic worms • HYDROXYZINE: an antihistamine • “HEROIN PLUS”, “METH PLUS”, “MARIJUANA PLUS”…… 11
- 12. EXTENDED 10 DRUG CLASS PANEL • Amphetamines – Amphetamine – Methamphetamine – MDA – MDMA – MDEA • Cocaine • Opiates – Codeine – Morphine – Hydrocodone – Hydromorphone – 6-MAM • Oxycodone – Oxymorphone • PCP • Marijuana • Barbiturates – Butabital – Amobarb – Pentobarb – Secobarb – Phenobarb • Methadone • Propoxyphene • Benzodiazepines – Oxazepam – Nordiazepam – Temazepam – Lorazepam – Flurazepam – Nitrazepam – Triazolam – Alprazolam – Flunitrazepam – Midazolam – Clonazepam
- 14. SUMMARY • BEST PRACTICES: LAB ON ADMISSION, BAC • HAIR, SALIVAAND URINE= DRUG HISTORY • INSTANT IN TREATMENT, PASSES AND OUTPATIENT • PRESCRIPTION MEDICATION, SYNTHETICS • VARY THE DRUGS TESTED - LAB AND INSTANT • NEW TECHNOLOGIES LC/MS/MS, NANO, CLOUD • TREAT PATIENT NOT THE TEST
Editor's Notes
- This is an overview of positive drug tests in the first 12 years of the US program. There has been a steady decline in positives from almost 14% to 5% which it is holding steady at for the last decade. These 5% positives are most likely the most addicted and the decrease is probably due to the shift to drugs not tested for like prescription drugs, synthetic designer drugs and OTC. But there is another reason for the decline in positives…..
- There is a multi million dollar market of anti-drug testing products…some work some do not. Clean urine can be bought over the internet and there is even male prosthetic devices that look physiologically normal and have a battery powered heater to bring the urine to body temperature. Dilution is the most often used adulterant but a wide range of chemicals and treatments are available. But case studies of companies that have a drug testing program consistently show better productivity, less accidents, less theft and use of health benefit. Drug users go to companies that do not have drug testing policies. Here are two case histories of companies that have put in drug testing programs and the cost savings they have realized.
- The silver nitrate is a catalyst, a substance that makes a reaction go faster without participating in it. The sulfuric acid, in addition to removing the alcohol from the air, also might provide the acidic condition needed for this reaction. During this reaction, the reddish-orange dichromate ion changes color to the green chromium ion when it reacts with the alcohol; : Intoxilyzer This device uses infrared (IR) spectroscopy, which identifies molecules based on the way they absorb IR light. The fuel cell has two platinum electrodes with a porous acid-electrolyte material sandwiched between them. As the exhaled air from the suspect flows past one side of the fuel cell, the platinum oxidizes any alcohol in the air to produce acetic acid, protons and electrons. · FC10/20: Check calibration (Verify) every 30 days and as soon as convenient after a positive result. Calibrate every 12 months. · PHOENIX: Check calibration (Verify) every 30 days and as soon as convenient after a positive result. Calibrate every 12 months. How can I verify that my professional breath tester is accurate in two, three, or five years from now? We recommend that the FC Series testers and the Phoenix tester are checked every two years in a certified factory diagnostic inspection. Simply contact Breathalyzer.net and ship your tester to the factory service site. If any problem is found, we will provide an estimated service price. Certified Diagnostic checks are $85 for the FC-10 and $95 for all other professional units.