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Urine Drug Testing

Urine Drug Testing. Why we do it When we do it How we do it What do we test for Problems & Limitations. Why Test?. Test to confirm the history of drug use given by the client Provides accountability for the client Provides a way for us to document drug use or abstinence

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Urine Drug Testing

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  1. Urine Drug Testing Why we do it When we do it How we do it What do we test for Problems & Limitations

  2. Why Test? • Test to confirm the history of drug use given by the client • Provides accountability for the client • Provides a way for us to document drug use or abstinence • Confirms stability or identifies relapse therefore enhances safety when giving carries

  3. When do we test? • At admission to the program to document the use of opiate • Throughout stabilization to document progress • In maintenance phase to document abstinence as part of monitoring stability to allow carries to be given • Can identify if ongoing drug use is contributing to persistent difficulties

  4. How Often? • More frequent e.g.weekly testing while working towards carries • Less frequent when stable • Ideal would be random testing • More practical is testing at apts.

  5. How : Sample Collection • Take measures to reduce chances of sample dilution, adulteration, or substitution • Direct observation? - not at AFM • Leave bags, bulky outdoor clothing, empty pockets • Designated urine sample collection area - ideally with ‘blued toilet’ & no access to tap water until sample is handed over • Temperature strip on bottle

  6. Testing Methods • Immunoassay - drug class specific • Does not identify individual drugs in each class GC/MS - gas chromatography/mass spectrometry - can identify a specific drug or metabolite Point of care testing is easy & quick but costly

  7. Point of care testing

  8. What do we test for? • Methadone to confirm it’s presence • Opiates including oxycontin • Cocaine • Benzodiazepines • Marijuana? • Alcohol use is important - but not part of urine drug testing

  9. Problems & Limitations • “I can’t pee” or I just went • “I haven’t used since the last apt but I took a Tylenol #1 for a headache yesterday” • Urine is cold - did they bring it with them? Did they dilute it? • Urine is negative for everything - including Methadone

  10. Problems & Limitations • Benzodiazepines & Marijuana persist for several weeks • All other drugs only test positive for a few days • Oxycontin does not test positive in most opiate immunoassay tests • No test for Fentanyl • Clonazepam & Alprazolam test negative on immunoassay for benzodiazepines

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