HFT 2220 Chapter 6 Orientation and Training. Orientation Why do we do it? Why do we do it?
Urine Drug Testing Why we do it When we do it How we do it What do we test for Problems &...
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Transcript of Urine Drug Testing Why we do it When we do it How we do it What do we test for Problems &...
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 • Confirms stability or identifies relapse
therefore enhances safety when giving carries
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
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.
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
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
Point of care testing
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
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
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