12.1 - Drug Testing

accessioning

Assigning a unique number for patient identification during testing

GC-MS (Gas chromatography-mass spectrometry)

Gold standard for drug testing; method for confirmatory testing

schedule 1, 2, 3, 4, 5

classification of drugs according to controlled substances

task people structure technology

components of drug testing labs

stimulants

increases alertness (e.g. amphetamine, caffeine, cocaine, shabu)

volatile substances

inhalants, solvents, aerosol bases: moth balls, furniture polish, insecticides, air fresheners

R.A. 10586

Anti-Drunk and Drugged Driving Law; updates from Comprehensive Dangerous Drugs Act are found here

Form DT-002A (donor's copy) Form DT-002B (copy for collection site) Form DT-002C (copy for the lab) note: Form DT-002D (to be filled up by the DTL for confirmatory lab; for positive tests only)

CCF forms to be filled up by donor

R.A. 9165

Comprehensive Dangerous Drugs Act of 2002; safeguards the state and its citizen from dangerous drugs; "drug-free country by 2011"

hallucinogens

affects sensation & emotion (e.g. ecstasy, marijuana, LSD, PCP)

psychotropic substances

any substances under controlled category; pertaining to any drug or agent having a psychological effect on an individual

Bureau of Health Facilities Services (BHFS: DOH)

aside from the requesting agency and the client, to what other agency must the DTL submit a copy of the drug test result?

structure

basic arrangement of people in the laboratory

donor name donor code date of collection time of collection bottle cap w/ donor's signature, time & date ASC initials broken tamper-evident seal if sent to confirmatory lab: must be placed in ziplock with HOL and analyst signatures

bottle labelling for drug tests

natural (raw opium, marijuana, coca bush) synthetic (methampetamine, barbiturates)

classification of drugs according to origin

1. donor is physically unable to go 2. involved in crime scene 3. involved in post-accident 4. critically ill

conditions for unobserved collection

schedule 5

contain small amount of narcotics, least likely to be abused (cough and anti-diarrheal medicine)

1. begin 2.verify donor ID 3. fill up DT forms 4. collect urine 5. seal specimen 6. complete CCF 7. ready for analysis 8. end

drug screening workflow

FDA

drug test kit is registered through this department

DOH

drug test kit validation is the responsibility of this department

1-2 weeks (surface contamination can cause *false positive*)

for collection of a sweat specimen, how long is the patient requested to wear a patch?

1 year from the date of issuance

for how long is a drug test result valid?

separate the serum then freeze

handling and storage of blood specimen for DT

stored at cool and dry place

handling and storage of hair specimen for DT

deep-frozen at least -8 to -10 degrees celsius

handling and storage of saliva specimen for DT

prolonged storage at -20 degrees celsius (stored initially between 2-6 degrees for not more than 1 day)

handling and storage of urine specimen for DT

schedule 2

highly addictive but medically important (cocaine, morphine)

schedule 1

illegal drugs, high potential for dependence and abuse (heroine, marijuana)

within the week

length of detection for urine specimen in drug tests

schedule 4

less likely to produce dependence, requires prescription (diazepam, phenobarbital)

immunoassay and chromatography

methods for screening in drug tests

1. observed (done in the presence of ASC) 2. unobserved (done in the absence of ASC; submitted samples; subject to validity tests)

methods of urine collection

5 ml

minimum required quantity of blood specimen for DT

100 mg

minimum required quantity of hair specimen for DT

2 ml (divided into 1.5 for the primary and the other 0.5 for the challenge)

minimum required quantity of saliva specimen for DT

60 ml in a single container. or 30 ml each of 2 separate containers for split specimen (for confirmatory and validity)

minimum required quantity of urine specimen for DT

marijuana cocaine amphetamine opiates PCP

most common drugs tested

applicants for: - driver's license - firearms license - permit to carry firearms - members of law enforcement agencies (police, military) - any person arrested for violations of RA 9165 - candidates for public office

people that are subject to mandatory drug testing

schedule 3

potential abuse, needs prescription to acquire (aspirin, codein)

task

purpose of the existence of the lab; produces goods and services as an output

Memorandum for the Record

record to document the recovery, corrective and remedial measures to administrative errors; accomplished by ASC

sedative

reduces anxiety and excitement (e.g. alcohol, barbiturates)

designer drug

related to but slightly different from controlled substances; designed by clandestine chemist to produce the high or euphoria

narcotic

relieves pain and induces sleep (e.g. codeine, heroine, morphine)

hair

specimen that is twice more sensitive than urine test; has longest detection and retention time of 1 year; expensive and tedious

saliva

specimen used for drug tests that has short detection time, no reference standards, and no confirmatory testing available

macerated and frozen

storage and handling of tissue specimen for DT

head analyst authorized specimen collector others (clerk, secretary, lab aide etc.)

the people in drug testing laboratories

chain of custody

tracking from point of specimen collection to its final desposition

urine - pre-employment, random, reasonable/suspicion/cause, mandatory saliva - same with urine blood, tissue, nails - reasonable suspicion/cause hair - pre-employment, random, return to duty, follow-up sweat - return to duty, follow-up

type of specimens and reason for test

single and split

types of specimen collection

custody and control forms

used to document security of the specimen, all steps of collection, person who handled the specimen; status and integrity and other pertinent info

NRL

validates the drug test kit

dilution, adulteration, substitution

ways of tampering urine specimen