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Limits of Interpreting A Drug Test

Showing: Forensic Technology

11Oct

Limits of Interpreting A Drug Test

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Limits of Interpreting A Drug Test

By: Kelly Hack, Content Writer

There are many variables regarding the analyses of substance abuse testing. Clients will often ask about specifics pertaining to the determination of time, dose and frequency when detecting substance(s) of abuse.

When testing a reservoir matrix- a material or substance, which can accumulate and retain drug and alcohol biomarkers (eg., urine, blood, hair, nail, umbilical cord, or meconium, etc.), the reported quantitation of a drug or its metabolite cannot be used to determine when/if a specific substance was used, how much of a substance was used or how often a substance was used. Test results show only if a substance was detected or not detected.

A specimen’s window of detection provides an estimated timeframe for detecting substance(s) of abuse. Based on extensive research studies, the generally accepted windows of detection for specimens used in our testing are as follows:

  • Scalp Hair- Up to approximately 3 months prior to collection.
  • Fingernail- Up to approximately 3-6 months prior to collection.
  • Umbilical Cord- Up to approximately 20 weeks prior to birth.
  • Meconium- Up to approximately 20 weeks prior to birth.
  • Urine- Up to approximately 2-3 days prior to collection.
  • Blood (PEth)-May be up to approximately 2-4 weeks prior to collection.

It is important to know that the interpretation of drug testing results may be determined by a Medical Review Officer (MRO). A Medical Review Officer is a licensed physician (MD or DO) who has knowledge of substance abuse disorders and has appropriate medical training to interpret and evaluate an individual’s positive test result together with his or her medical history and any other relevant biomedical information.1This is an incredibly important aspect of drug testing. A laboratory can detect substances, but a MRO may be used to interpret what that detection means.

1.Journal of Occupational and Environmental Medicine: (January 2003-Volume 45-Issue 1-p 102-103) Quaifications of medical Review Officers (MRO’s) in Regulated and Nonregulated Drug Testing. Departments: ACOEM Consensus Opinion Statement

What you need to know about meconium collection.

by Michelle Lach, MSIMC

Meconium is the first stool of a newborn infant. It is produced in utero and consists of materials such as epithelial cells, bile, mucous, and more. In most newborns, meconium is generally passed in the first day or so of life, has no odor, and appears as a very dark, tar-like substance. This helps distinguish meconium from the next phase of passage called transitional stool. 

Transitional stool will start to have an odor and present with a more brown, green, or yellow color as the newborn starts digesting milk. When drug testing the meconium of a newborn, it is important to note this difference since only meconium is created during gestation and transitional stool is created after birth. Collection of any stool other than meconium for drug testing purposes may result in a rejected specimen.  

Unlike umbilical cord tissue, drugs are not distributed uniformly throughout the meconium specimen (see Figure 1). Because of this, the collection of the entire mass of meconium is highly encouraged to assure that there will be enough specimen to test, and that the maximum window of drug detection is achieved. It can take multiple passages of meconium before the newborn begins the transitional stool phase. 

We require a minimum of 3 grams of meconium to be able to properly run our tests, so collecting the entire passage of meconium from newborns that have been exposed to substances of abuse is highly critical since they tend to have lower birth weights and create less specimen in the first place. If there is not enough specimen to run the test, the results are reported out as QNS. Quantity Not Sufficient (QNS) is a result of not having a sufficient quantity (volume) of specimen to test for the panels ordered.

Drug Exposure vs. Ingestion: What You Need to Know

19Aug

Substance Vol 7 Iss 2

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06Apr
We Can Help You Help Them with ChildGuard®

When a child is exposed to illegal substance abuse they often also face other coexisting obstacles to a normal life – neglect, abuse, violence, and other vulnerabilities. Substance abuse is a disease, one that often prevents adults from doing what is in a child’s best interests. Our environmental exposure test for children can help.

Our hair environmental exposure test is the only drug test designed to detect passive exposure to drugs and detect both native drugs and drug metabolites in the hair specimen. Drug metabolites are produced in the body only if drugs have been ingested. Children in drug exposed environments are most often not drug users themselves, so drug metabolites are typically absent in child specimens. However, the hair, like a sponge, can absorb non-metabolized drug (native drug) if it is exposed through things such as touching or being in contact with drugs or drug users.

Standard hair tests with other labs will only report a positive exposure result if drug metabolites are detected, even when the native drug is in the child’s hair specimen. Our hair environmental exposure test reports a positive result if either native drugs or drug metabolites are detected.

A hair exposure test can provide evidence of drugs in a child’s environment for the past 3 months. A positive test result suggests that the child has experienced one or more of the following: passive inhalation of drug smoke, contact with drug smoke, contact with sweat or sebum (skin oil) of a drug user, contact with the actual drug, or accidental or intentional ingestion of illegal drugs.

ChildGuard®is the only child hair test designed to detect exposure to native drugs and drug metabolites.

11Mar

Partner With Us

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Partner With Us

12Jan

The Shelter of the Law

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To read the full article by Eric Frazer, Psy.D., and Linda Smith, Ph.D., in our Fall issue of Substance, please click here.

28Dec

Good Ol’ Number 7

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Celebrating 10 Years of Forensic Toxicology Innovation Using LCMSMS Technology

By Joseph Jones, MS, NRCC-FTC

Ten years ago, USDTL, Inc. was a much different laboratory than it is today. Back then, we still had yet to develop fingernail, umbilical cord, or dried blood spot phosphatidylethanol (PEth) testing. We weren’t even testing ethyl glucuronide (EtG) in urine or hair, our most common form of alcohol testing today. But, as it turns out, ten years ago was right at the turning point for us, that moment of tremendous innovation and acceleration that has pushed us to the forefront of forensic toxicology we are at now. One of our biggest leaps forward at that time was adopting liquid chromatography (LC) technology into our methodology and moving from a solely gas chromatography (GC) focused laboratory to an integrated GC/LC facility. We’ve never looked back.

Our first LC instrument was generically dubbed machine Number 7, and it was a gamble for us. We had very little experience with LC methodologies, and we were not actively looking to adopt that technology at that time. In 2005 we were approached by the analytical technology company AB Sciex, who were looking to increase their competitive share of the forensic testing field, specifically with their liquid chromatography tandem mass spectrometry (LCMSMS) instruments. They made us an offer we couldn’t refuse – a new LCMSMS instrument in our lab, assistance in developing a new EtG/EtS urine assay, and six months to develop our market. After six months, they would let us decide whether or not we wanted to buy the instrument, or take a pass and send it back. What growing laboratory would ever say no to that?

As soon as assay development was complete, we starting receiving requests for urine EtG/EtS testing from all over the country.  Major labs such as LabCorp and Witham labs relied on us to do all of their EtG/EtS testing. Six months came and went, and not only could we afford to keep Number 7, but we had built enough business to occupy two machines, and Number 9 was purchased as well. Number 9 passed on to new owners just a few years ago, but good ol’ Number 7 is still chugging away in our lab, having processed well over 100,000 samples in those 10 years. It’s a well-loved work horse to this day.

That offer from AB Sciex came out of the blue without warning, and for us, it was a major shake-up. We could have said “no thank you,” but we didn’t. Even with the generous offer made by AB Sciex, this course of action was a big risk for us. We took a chance on an opportunity to extend our innovation, as well as build a fantastic partnership that has endured these ten years. The net result was a powerful expansion of our instrumental capabilities that has allowed us to bring major innovations to the forensic testing world, such as umbilical cord testing, dramatically improved sensitivity in cannabinoid testing, PEth testing in dried blood spots, and more. Incorporating LCMSMS technology into our methodologies has allowed us to leverage our expertise to create what was previously not possible. It is a key factor in making USDTL first in newborn toxicology and without question the best hair and fingernail testing lab in the U.S.

Ten years on, we raise our glass to good ol’ Number 7, to the past 10 years of pushing the boundaries of forensic toxicology, and to another 10 years and beyond of making a difference in the world around us.