You are on page 1of 27

Covers 1-4 6/13/00 2:13 PM Page 1

U.S. Department of Justice
Office of Justice Programs
Drug Courts Program Office

Drug Courts
Program Office

DRUG COURTS RESOURCE SERIES

Drug Testing in a
Drug Court Environment:
COMMON ISSUES
TO ADDRESS

Prepared by the Drug Court
Clearinghouse and Technical
Assistance Project

Covers 1-4 6/13/00 2:13 PM Page 2

U.S. Department of Justice
Office of Justice Programs
810 Seventh Street NW.
Washington, DC 20531

Janet Reno
Attorney General

Daniel Marcus
Acting Associate Attorney General

Mary Lou Leary
Acting Assistant Attorney General

Marilyn McCoy Roberts
Director
Drug Courts Program Office

Office of Justice Programs
World Wide Web Home Page
www.ojp.usdoj.gov

Drug Courts Program Office
World Wide Web Home Page
www.ojp.usdoj.gov/dcpo

For grant and funding information contact
Department of Justice Response Center
1–800–421–6770

NCJ 181103

This report was prepared by the Office of Justice Programs Drug Court Clearinghouse and Technical Assistance
Project at American University, Washington, D.C. This project is supported by grant numbers 95–DC–MX–K002
and 98–NU–VX–K018, awarded by the Drug Courts Program Office, Office of Justice Programs, U.S. Department
of Justice. Points of view or opinions in this document are those of the authors and do not necessarily represent the
official position or policies of the U.S. Department of Justice.

F. Robinson...C. S.T. D. D.D.. District of Columbia Pretrial Services Agency Drug Laboratory May 2000 . T.C. Deputy Director. Ph..A. Jones. M. Director. OJP Drug Court Clearinghouse and Technical Assistance Project American University Issues Paper Series Drug Testing in a Drug Court Environment: COMMON ISSUES TO ADDRESS Jerome J.S.E. M.A.B.C.F.B. District of Columbia Pretrial Services Agency Drug Laboratory James W..

.Cover images © 2000 PhotoDisc. Inc.

We hope that this document will assist drug court officials in working with forensic experts in the design and operation of the drug testing component of their drug court programs. The authors. This issues paper has been prepared by the OJP Drug Court Clearinghouse and Technical Assistance Project to address the most frequent issues that have been raised by drug court programs regarding drug testing. it is intended to provide an overview for drug court program officials—primarily lay persons—regarding the most critical topics that need to be addressed in developing and maintaining a drug testing capability. research. are forensic scientists and have worked for many years with the application of drug testing technologies in a variety of sectors. The functioning of all drug courts relies on the integrity and accuracy of the drug testing process as well as the immediacy with which drug testing services are accessed and the reliability of results obtained. as they apply to drug testing in a drug court environment. who directs the drug treatment component of most of the Nevada drug courts. Their advice and suggestions have been incorporated throughout the text.Foreword Drug testing is a cornerstone of drug court program operations. including the drug testing conducted by those programs. Although this report is by no means a definitive treatment of all of these issues. are synthesized in this document. of Palo Alto. California. Caroline S. The results of their experience. Director OJP Drug Court Clearinghouse and Technical Assistance Project American University iii . Marr of Las Vegas. and Dr.S. Nevada. Federal court system. We are grateful for the helpful comments and insights of the following individuals who reviewed this document in draft: John N. and training. a biomedical scientist who oversees the drug testing program for the U. Leo Kadehjian. Drug testing is a science that requires the guidance and oversight of appropriately trained forensic scientists. director and deputy director. respectively. Jerome Robinson and James Jones. of the District of Columbia Pretrial Services Agency Drug Laboratory. Cooper.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Determining Appropriate Testing Frequency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Use of Diuretics . . . . . . . . . . . . . . .10 Using Confirmation Testing . . . . . . . . . . .8 Submission of Another’s Specimen . . . . . . . . . . . . . . . . . .6 Considerations in Selecting the Appropriate Testing Method for Individual Drug Court Programs . . . . . . . . . . . . . . . .11 Addressing “Spiking” Situations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Understanding the Drug Use Characteristics in the Local Jurisdiction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Hair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Spot Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Drug Testing Methodologies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Additional Tips . . . . . . Color. . . . . . . . . . . . . . . . . . . . . . . . . . . .12 Determining an Acceptable Error Rate for the Testing Program . Introduction . . . 4 Immunoassay . . . . . . . . . . . .7 Maintaining the Integrity of the Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Chromatography . . . . . . . . . . . . .3 Urine . . . . . . . . . . . . . . . . .7 Ensuring Adequate Staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 v . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Role of Breathalyzers in Drug Testing Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Drug Testing: A Continually Evolving Science . . . . . . . . . . . . . . . . . . . . . . .5 Inhalants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Checking for Temperature. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Establishing Cutoff Levels for the Drug Court Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Blood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Addition of Common Household Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Contents 1. . . . . . . .4 Instrument Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Non-Instrument Testing: Point-of-Contact Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Testing Technologies . . . . .12 Development and Periodic Updating of Procedures Manual Documenting All Aspects of the Drug Testing Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Most Commonly Used Samples for Detecting Drug Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 Tobacco . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Obtaining Accurate and Meaningful Interpretation of Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Testing Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Waterloading . .7 Detecting Adulteration . . . . . . . . . 5 Testing for Special Substances . . . . . . . . . . . . . . . . . . . . . . Critical Components of a Drug Court Drug Testing Program . . . . . . . . . . . . . . . . . .4 Saliva . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Random Testing . .3 Sweat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and Other Evidence of Tampering . . . . . . . . . . . . . . . . . . . . . . . . .8 Screening for Common Methods of Adulterated Specimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Maintaining Specimens for Retesting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Testing Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 Notes . . . . . . . . . . . . .19 Appendix: Drug Test Cutoff Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tips for Promoting an Effective Drug Court Drug Testing Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Frequently Asked Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Estimating Drug Testing Costs . . .15 6. . . . . . . . . . . . . . . . . . . . . . .13 Develop Contracts With Participants That Increase Responsibility for Eliminating Situations That Challenge the Test Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 Document All Policies and Procedures in Writing . . . . . . . . . . DRUG COURTS RESOURCE SERIES Defendant Agreements To Comply With Drug Testing Program Requirements and for Release of Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 7. . . . . . . .13 Anticipate Situations That May Occur . . . . . . . . . . . . . . . . . . . . . .12 4. . . . . . . . . . .22 vi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 Recognize Situations That Can Create Positive Test Results That Challenge the Integrity of the Testing Process . . . . . . . . . . . . . . . . . . .14 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Questions To Ask Drug Testing Equipment and/or Supply Vendors . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 Educate and Train Everyone Involved About the Process and Procedures . . . . . . . . . . . . . . . . . . . . . . . . . .

ance for criminal justice drug testing programs. several years later and developed rapidly after President Reagan’s 1986 directive on drug abuse and drug-free • maintain a high degree of accuracy in test results. or. Even within the criminal justice environment. The development of appropriate drug testing method- ologies and procedures for criminal justice system defendants generally—and for drug court participants in Drug Testing: A Continually Evolving particular—requires a consideration of the purposes of Science the drug testing program and the uses of drug test results. supplies. Although the knowledge gained being tested. through the drug testing activities conducted by DOD ual’s drug usage. monitoring a participant’s 1 . other justice system officials. the tion and assessment of the raw data. The immediately and continuously.S. Workplace testing followed • obtain test results immediately. Defense (DOD) during the late 1960s to deal with the drug testing can be conducted for very different pur- problems of marijuana and heroin use by military per. which is generally policies and protocols. supervision of a defendant’s compli- sonnel in Vietnam. The National Institute on Drug Abuse (NIDA) became the oversight agency involved with fed- Drug testing is a key component of drug court programs erally regulated workplace drug testing and established because it provides readily available and objective infor. treatment personnel.1. As with any scientific test. and caseworkers regarding a partic- ipant’s progress in treatment. and Every professional discipline requires professionally pretrial and probation agencies soon adopted drug test- trained individuals. Drug testing is a complex science and requires the support of a forensic expert regardless of the testing Unlike the drug testing practices conducted by the mili- method that is used. a second and similar set of cutoff standards for various mation to the judge. ing as a component of their supervisory functions. Federal Bureau of Investigation (FBI) also began to use drug testing as a component of its investigations. drug testing in interpretation of a drug test result requires balancing a the criminal justice system has not been accompanied number of factors. Introduction The effective operation of a drug court program is initial developments in urine drug testing technology.. finding) were established. However. every that have frequently required the development of special court should have technical support. the tary and workplace programs. forces began using drug testing. and local agencies becoming involved. premised upon having the capacity to: During this process. During the early 1980s. the criminal justice system also coupled with immediate program responses. with a number of Federal. The value and usefulness of a drug and the Substance Abuse and Mental Health Services testing regime are dependent on the scientific integrity Administration (SAMHSA) has provided useful guid- of the drug testing process and the accurate interpreta. The drug testing process. as is these problems was the driving force that led to the the case in drug courts. Forensic drug testing is no excep. defendants to address their substance abuse problems State. drugs.e. The military’s desire to respond to ance with a pretrial release or probation order. poses: prosecution. workplaces. standards deter- mining the level of drug concentration in the human • conduct frequent (often two to three times per system above which would be deemed a “positive” week) and random drug tests of participants. the physical characteristics of the individual are uniformly enforced. tion. and the nature and length of the individ. Department of system. drug testing’s role in the military or the The large-scale application of drug testing to detect workplace differs from its role in the criminal justice drug use was initiated by the U. and training in this area. cutoff levels (i. Clearly. This is not to say range of applications of drug testing programs in the that every program must hire a pathologist or certified criminal justice environment has raised unique issues lab technician to interpret test results. however. available from the drug testing/chemical companies that provide equipment. including elements directly related to by the establishment of consistent cutoff standards that the test.

on the other. drug testing is conducted pri- marily to monitor a defendant’s progress in treatment— • the biological process that affects the length of time to determine whether he or she has been using drugs different drugs stay in the human body. potential adulteration (e. for a drug court program. • distribution and elimination rates of the drugs in vices. health. a positive or • the effect of other variables. the type and quantity of substances being ingested. requirements. characteristics. physical condition.” in reality. the system is not always a black-and-white determina- tion. on the one hand. if so.. above or below the established cutoff concentration. or reducing treatment service question. responds to them depends upon a complex set of factors requiring an understanding of: For a drug court program. and. tain drug metabolites in the sample at a concentration on the test analysis. such as the individual’s negative result reflects the presence or absence of cer. DRUG COURTS RESOURCE SERIES progress in treatment and compliance with drug court How the laboratory interprets such results and the court program conditions. Drug test results may also indicate a participant’s progress in reducing drug use • the participant’s drug history and other physical when he or she has not eliminated it altogether. and duration of drug use. imposing sanctions and/or enhancing treatment ser. the determi. flushing or water load- nation of the presence or absence of a particular drug in ing) that may affect the test results. Although drug test results are frequently reported in • the capacity of the testing procedures to identify terms of “positive” or “negative. 2 . The drug test result may be used as a basis for • interactions of one drug with another. Ultimately.g.

except Ethanol concentrations Very short timeframe Low to for ethanol correlate with impairment for detection. dose relationships (hair Table 1. only moderate detects volatile compounds Source: Derived from Marilyn A. 3 . regarding the presence of illegal substances. FL: 33 CRC Press. Blood tests can provide discrete most appropriate drug testing strategy to employ. Cannot indicate blood Low to privacy to days established methodologies. powerful instruments for hair is currently the most appropriate method for drug courts analysis has increased interest in hair testing. and saliva. These technologies are further detected by testing a variety of different samples. easy to moderate quality control and certification adulterate Blood Highly Hours Variable Correlates with impairment Limited sample availability. hair. ed. and widely used test. but the invasiveness of the procedure and addition to breath samples. are described below and the potential danger of infection make blood testing compared in table 1. Karch. urine testing The introduction of new. must understand the Testing blood for evidence of drug use is a highly drug use demographics of the region to determine the invasive procedure. difficult and external contamination to high detection to adulterate Sweat Noninvasive Days Screening Longer timeframe for High inter-individual Moderate to weeks cutoffs detection than urine. levels. Medium invasive to days limits of infectious agent to high detection Hair Noninvasive Weeks Variable Permits long-term detection Potential racial bias Moderate to months limits of of drug exposure. Cost assessment provided by Jerome J. Huestis and Edward J. director of drug testing for the Pretrial Services Agency of the District of Columbia. however. however. 431. differences in sweating to high difficult to adulterate Saliva Noninvasive Hours Variable Results correlate with Contamination from smoke. including appropriate cutoff values. Many and most criminal justice agencies for detecting the questions remain unanswered. notably urine. Moderate to days limits to impairment. Urine test. Boca Raton. provides pH changes may alter to high detection estimates of blood levels sample Breath Noninvasive Hours No. most described in the Testing Technologies section.. Each jurisdiction. Robinson. sweat. Cone. Drug Abuse Handbook. p. Blood ing is the most cost effective. blood. The information regarding the degree of an individual’s testing characteristics of the five sample sources. Urine Hair For reasons of both economy and accuracy. Steven B. Generally. Comparison of Alternative Drug Testing Methodologies Source Invasiveness Detection Cutoff Advantages Disadvantages Cost Sample of Sample Time Levels Collection Urine Intrusion of Hours Yes High drug concentrations. in impairment.2. inappropriate for drug court programs. 1997. Both methods use some form of immuno- Detecting Drug Use assay technology to provide an initial determination of The presence of drugs in the human system can be the presence of a drug. urine testing application of hair testing for drug courts. reliable. Drug Testing Methodologies Most Commonly Used Samples for methods fall into two types: instrumental and non- instrumental.

Testing Technologies Evidence of drug use may be present in the urine in the form of the parent drug and/or metabolites. gained in popularity because they are relatively inexpen. smoked. and the route of administration (e.g.g. and blond or bleached hair. how. There are also indications that nicians are able to identify and quantify atoms. (b) detect ever. Both methods of not. blood. injected. and the chemical composition of a given sample. Chromatography testing ence of drugs in the system and the extent of an individ. brown). DRUG COURTS RESOURCE SERIES samples do not provide a correlation between the pres.2 Sweat Testing Procedures Sweat samples. hair analysis can produce biased results. and Saliva samples permit a correlation with the degree of reporting process must be maintained to (a) ensure that impairment and can be easily obtained. such the defendant. oral. or inhaled). They do instrumental and non-instrumental. subject to contamination from smoking or other adulteration. Regardless of the drug testing Saliva method used. isotopes. hair.1 Hair analysis is also subject to potential as a prescription medication. and potential differentiations that can be and can distinguish a specific drug from other sub- produced by differences in hair color and/or ethnicity of stances that may have similar chemical properties. provides precise and accurate documentation. provide a correlation regarding the degree analysis use some form of immunoassay technology to of impairment and they are subject to individual differ. Immunoassay Determination of the length of time that has elapsed between the time of ingestion and the time the test was The most widely used technology for testing the pres. urine testing methods fall into two types: detection and they are difficult to adulterate. the integrity of the collection. provide an initial determination of the presence of a ences in sweat production. confirmatory procedure for most substances in most Americans (black/brown). provides a method that is specific to particular drugs ual’s use). male caucasians (black/ toxicology laboratories. Male African-American hair other samples to determine the presence of drugs and (black/brown) appears to absorb drugs more readily other substances and is currently the most definitive than hair of other groups. can provide results in a quick turnaround time.. They are. The immunoassay drug-screening procedures have dosage. have the advantage of providing a longer timeframe for Generally. an analytical technique that can be used to confirm a and lends itself to convenient storage of samples in the 4 . physical character- Primarily used as a screening test. For example.. metabolizes and eliminates the drug. which are obtained from patches that Testing Methods can be placed on a person for a number of days. such as female African. been introduced that would affect the validity of the results. There are several major suppliers Instrument testing is analysis that involves instrumenta- of immunoassay test kits. and the sensitivity antibodies that specifically bind to drugs and their of the testing procedure. conducted depends upon the rate at which the body ence of drugs in the human system is the immunoassay. immunoassays use istics of the individual’s metabolism. Chromatography Instrumented analysis has the advantage of being auto- Gas chromatography/mass spectrometry (GC/MS) is mated. dark pigmented hair absorbs drugs more readily than GC/MS can be used to analyze urine. heavy doses or infrequent use). the specimen is from the named defendant. tech- external contamination. With this technology. sive. testing. long-term the body has metabolized a drug) in urine and other flu. drug and chromatography to confirm the presence and quantity of the drug. These elements are discussed further in chapter 3. The timeframe also can vary metabolites (the chemical compounds that results after depending on the duration of abuse (e. measure. and have been found to produce highly accurate test results Instrument Testing if properly performed. however. tion (a machine) that will sample. positive initial drug screen. the amount of the daily ids. and (c) ensure that no contaminants have substances. and produce a quantitative result (a numeric amount on a scale). female caucasians (black/brown and blond).

present in only small amounts. however. of Breathalyzers in their local jurisdiction for require- ments such as calibration settings. lifespan in the human system. through both instrumental and non- Point-of-contact testing utilizes a non-instrument device instrumental devices. Cost per non-instrument test tends Testing for Special Substances to be higher than the cost per instrumental test but these Inhalants costs need to be considered in terms of the total volume Testing for inhalants. which can be used with considerable instrument testing are not as expensive as those supplied frequency and at relatively minimal cost. however. These ing. these tests provide alcohol has been consumed. courtroom presentation. can be particu- for non-instrument systems. waste). Trained laboratory staff. fore be a very effective and a relatively low-cost compo- ments provide the equipment at no cost or a nominal fee nent of a drug court drug testing program. water. and the cost of a random urinalysis because of alcohol’s relatively short machine should be prorated over a 5. manufacturers of reagents for these instru. urine is provide the intricate level of information that can be the best specimen to use if one wants to determine if obtained with instrumental readouts. it is often difficult to detect the presence of As with instrument testing. The test must be Thus. consideration must also be given to the initial trained in the use and interpretation of breath alcohol costs for equipment and the need for trained staff.S. Breathalyzers can there- Frequently. results. facili. and the expertise available to administer and/or Non-instrument testing is analysis that involves devices provide training on Breathalyzer testing. Although non-instrument testing does not is more concentrated in urine than in blood. Transportation (DOT) and Health and Human Services (HHS) and/or the State toxicologist. Drug Testing in a Drug Court Environment: Common Issues To Address event that subsequent retesting may be required. method for detecting the presence of alcohol if per- instrumental test devices have improved significantly in formed within the relatively short period following recent years and can be useful if handled by properly ingestion in which it can be detected. although the costs per test are low for instrument administered by breath alcohol technicians who are testing. is of tests being conducted and the alternative costs that more complicated than the process required for detect- would be incurred with instrument testing. are required. that require manual sampling and manual observation to produce a qualitative result (either negative or positive.to 7-year period. is also an accurate and reliable to analyze a sample at the point of collection. Breathalyzer must be calibrated according to certifica- Most. The them. color blind. 5 . and “plant” facility require. no quick point- Relying on a visual detection of a color result can of-contact tests have been devised to detect inhalants. Departments of ing on the use of their drug testing products. color perception. Because alcohol trained staff. interpretation of test Non-Instrument Testing: Point-of-Contact Tests results. Non. To date. The reagents for Breathalyzers. and light- immunoassay technology for initial detection. their local law enforcement agencies regarding the use ments (electricity. This process entails taking a problem if specific provision is not made to address a sample of blood or urine (blood is preferred) and ana- these requirements. quick and relatively accurate results and the supplies are easy to store and use.) Urine testing. staff training is essential inhalants with any consistency because often they are to accurately and consistently interpret test results. a chromatographic process. Local drug court officials may wish to contact ties to house the equipment. tion standards established by the U. including color acuity. if not all. used in if the purchaser agrees to purchase the reagents from conjunction with urine testing for other substances. lyzing the gases emitted. although the initial cost of larly useful in detecting the presence and amount of the instrument may be expensive. manufacturers also provide staff train. lead to misinterpretation of results for a number of rea- Instrumental methods for testing urine rely on sons. Because of the volatility of the vapors. Storage of ing the presence of other substances and must be con- specimens and retrieval of test results may also present ducted by a forensic expert. The test results can also be communicated directly from the machine to a program Role of Breathalyzers™ in Drug Testing Programs management information system. Care must also be taken to ensure that staff are not analyses have increased accuracy and precision in test. Skill in interpretation is required for weak ing results and provide data printouts for review and positives in particular. Refurbished machines alcohol that may not otherwise be detected through are frequently available.

drug tests for defendants under probation supervision and can add the drug court testing component to their Considerations in Selecting the Appropriate existing operations. frequently conduct a high volume of distributors. instrument methodology most accurate for detecting these drugs.. only in situations in which the test result is chal- • the turnaround time needed for obtaining test results. For jurisdictions with limited resources that are con- ducting only a small number of tests (e. consideration might be given to: 6 . • the number of trained individuals available to con- duct the analysis. several factors must be considered. • identifying other entities that conduct drug testing tem for some time depending upon the frequency of use. • the types of drugs being tested for and the non- • the drugs that will be analyzed.000 annually). Testing Method for Individual Drug Court Programs • identifying other agencies that might be willing to join with the drug court in developing a cost- To determine the methodology that best meets the needs effective drug testing capability. the most significant of which include the For jurisdictions that have decided to use non- following: instrument methodologies. DRUG COURTS RESOURCE SERIES Tobacco • using a point-of-contact testing methodology for rou- In many States. consideration should also be given to: • the volume of tests that will be conducted. • special procedures. Testing for tobacco use involves primarily testing for the presence of nicotine. with instrument confirmation and analysis restricting tobacco use by participants who are below conducted by an outside laboratory on an as-needed the age permitted to purchase or use tobacco products.g. from drug testing equipment manufacturers and for example. juvenile drug courts are considering tine tests. and pooling resources to develop the most cost- Drug court officials interested in testing for tobacco effective strategy for meeting these multiagency drug usage by participants should explore products available testing needs (State and local probation departments. basis. • developing policies regarding confirmatory testing (Will confirmations be made for all positive tests or • the availability of automated instruments. • the need for confirmation of test results and the fre- quency of and conditions for confirmation. which can remain in the sys. less than 10. that can be used to • the quantification of levels of drugs required. in addition to those in place for the drug testing process generally. lenged? Who will pay for the test if the positive test result is confirmed? Negated?). detect adulteration. of a particular drug court program.).

including the of the Process submission of observed urine samples. ideally. Such a system requires that each step whom drug tests will be reported and under what cir- cumstances and by which staff member. Upon entry into the drug court program. and program. opinion. testing. collection of the sample. Line are not tested within a few days. custody requirements for the sample. 7 . including ori- integrity.g. cedures of the program as well as in handling common situations that may occur—such as hearing a participant Direct observation of the sample submission is also stating he or she is unable to provide a sample or essential.. from the time the ology used. sample storage. effective techniques must be instituted—and entation for the participant regarding the drug testing practiced—regarding sample collection. A lay wit- ness may be called to testify about objective facts (e. participate in the drug testing program and to the sanc- tions that may be imposed for a positive test result. the test result—be documented. persons to have confidence. The expert witness may be called upon to voluntarily share some specialized knowledge that may • the examination of the sample for signs of tampering aid the court in determining the validity of the testing or adulteration. or frozen. storage is expected. should be staffed by qualified and trained defendant checks in to submit the sample to its final dis- employees who can perform the duties to which they position. The • the review of the results. Critical Components of a Drug Court Drug Testing Program Ensuring Adequate Staffing in the collection process—from specimen collection and transport through the testing process to the validity of The drug testing component. examination of the adulteration detection. monitoring purposes—rather than for prosecution—and drug court participants generally have already agreed to • followup tests that were performed. procedure or interpreting the test results. documented It is important that specimens should be kept in a limit- specimen collection procedures and ongoing training at ed access security area and. questions arise regarding the procedures used to collect and test the specimen. To ensure sample for all aspects of the drug testing process. donor be of the same gender. including: witnesses may be required: lay and expert. however. if they all levels are essential for the drug testing program. policies regarding ensures test results in which the drug court judge can confirmation of test results. who performed the critical functions entailed in the drug ing the testing process and protocols used. ally not asked to interpret test results or to give an • the sample collection. • the client reporting for testing and his or her being the procedures used to collect specimens) and is gener. participants Maintaining the Integrity should execute their agreement to comply with the drug court program drug testing requirements. may be used more frequently if • the recording of the results. refrigerated.3. For this reason. lay witness. Establishment of an airtight sample for signs of tampering or adulteration. checked in. This step requires that the observer and the observing an adulteration. documented in writing. The chain of custody process should document are assigned and are prepared to testify in court regard. Additionally. The reliability of a drug court drug testing system is clearly defined policies and procedures must be in place dependent upon sample integrity. if longer staff must be trained thoroughly in the day-to-day pro. drug testing conducted is primarily for supervision and • the actual testing of the sample. chain of chain of custody system. regardless of the method. staff training. Two types of testing process and when they occurred. The expert wit- ness is rarely used in drug court programs because the • the transportation of the sample to the laboratory.

KLEAR has been aggressively nitrates. that adulteration can occur with any frequency. Drano. and have a slight ammonia odor.2 to 37. should also be taken to detect possible waterloading. free marketed as a product that. fruit juices. dence of tampering at the time of initial collection of the specimen. despite their most con- adulteration techniques observed by drug court personnel. coupled with observations of potential clinical her urine by drinking large volumes of fluids. usually signs of drug use (see table 2). ation detection procedures may not ensure complete There are a variety of other adulteration techniques that detection in every instance. when added to a urine sam. Although adulter. coupled with density of a drop of water to the density of a drop established chain of custody procedures. can be detected through analysis of nitrite levels suspect. tem that has been worn down by years of abuse) gives a duce a false negative. specimens developed and marketed.g. samples outside this range should Other adulteration techniques are being continually be suspect. substitute the urine of another person for his or her own. for technician can detect that it is quite different from the example. Program process. Running parallel tests for creatinine concentra- tion levels (see Submission of Another’s Specimen Standard procedures should be instituted to detect evi- below) can detect waterloading. Use of Diuretics Detecting Adulteration A number of teas. including observing the color and appear- Addition of Common Household Products ance and detecting odor of the sample. urine sample is 90 to 100 degrees Fahrenheit (32.. degree that the presence of drugs falls below drug test- men to achieve an erroneous reading. but an experienced can often detect these adulteration attempts. and other concoctions act as diuretics that can potentially decrease Screening for Common Methods of Adulterated the retention time for drugs in the system. However. careful interpretation of drug test Waterloading refers to an individual’s dilution of his or results. ing cutoff levels. Measures develop new techniques for adulterant detection. milkshakes. are critical to of urine. However.8 degrees Celsius). For example. If the weight of the urine is below a certain 8 . This section provides discussion of common officials need to recognize that. Tampering with a specimen by introducing common ingestion of Vitamin B1 (which some drug court clients household products. Evidence of Tampering imens. and possibly even may also be detected. Publications have been most common methods that may be employed and can written with suggested adulteration strategies. and Other technician is experienced in detecting waterloaded spec. Followup analysis make the urine more basic (less acidic) and may also should then be performed through additional tests for make it unusually warm—even bubbly. ple. will give off a recognizable odor. participant is unable to void). DRUG COURTS RESOURCE SERIES and dealing with common situations that may occur detecting situations in which a participant may attempt to (e. The average temperature of a freshly voided if the confirmatory tests are run immediately. Metal shavings specific gravity. to alter the chemical composition of urine can pro. such as bleach. which compares the person’s provision of his or her specimen. from foreign materials. pH levels. Most of these Specimens products also require the ingestion of large amounts of Even if the specimen collected is the urine of the client. Color. Samples that are colorless or very pale yellow should be however. some adulteration may occur unde- Waterloading tected. Normal urine has a pH of 5 to 8. and significantly enhance the integrity of the drug testing several Web pages are devoted to the topic. and perox. which may result in diluting the urine to such a variety of techniques can be used to adulterate the speci. Carefully designed and documented observation of each • A test for specific gravity. may be taking to rebuild and rebalance their body’s sys- ide. and scientists are trying to above or below this value should be suspect. creatinine. Drano may yellow color of unadulterated urine. The presence of KLEAR. niques and one of the most difficult to detect unless the Checking for Temperature. scientious efforts. It is one of the most common adulteration tech. reduces the likelihood water. Urine should be a light to golden yellow. skilled forensic experts bright yellow color to the urine. Submission of Another’s Specimen Two particular tests may be useful. a water. they can alert staff to the clients use from time to time. produces a negative result. Bleach.

loss of appetite. extreme aggressive behavior. euphoria. depression of heart rate. dilated pupils. nausea and vomiting. lethargy. Retention/Detection Time: Drugs of Abuse* Drug Type Approximate Detection Time Clinical Effects STIMULANTS Amphetamine/ In urine: 1–2 days Increased heart rate. drowsiness Methadone 3 days Central nervous system depression. heart failure. urinary retention. Its concentration in the urine is affected Table 2. depression of brain’s emotional inhibitory centers Ethyl Alcohol In urine: 1–24 hours Intoxication. hallucinations. restlessness. euphoria Phencyclidine (PCP) 14 days Elevated blood pressure. decreased coordination. 9 . apathy. headache. In serum and plasma: 1–12 hours loss of inhibitions. paranoid delusions.) mild depression. nausea and vomiting. dry mouth. intoxicated appearance NARCOTICS/ANALGESICS/OPIATES Opiates (including heroin. reduced respiratory rate Propoxyphene 6 hours to 2 days Blurred vision. lightheadedness. intoxicated Heavy smoker (daily): 10–15 days appearance Chronic use (more than 5 joints/day): 14–30 days LSD 2–5 days Vomiting. In serum and plasma: 2–3 days decreased mental acuity. fatigue In serum and plasma: 12 hours to 2 days Methaqualone 14 days Decreased myocardial contractility. dizziness. etc. euphoria. tremors. hallucinations. nausea and vomiting. impaired performance because of overestima- tion of abilities. euphoria. weakness. flashbacks. Drug Testing in a Drug Court Environment: Common Issues To Address level. drowsiness. 3 days Central nervous system depression. euphoria. euphoria. elevated blood pressure. euphoria followed by anxiety and drug craving. slowed speech Benzodiazepine In urine: up to 30 days Depression. dry Chronic users (1 or more years): 4–6 weeks mouth. depression. seizures. salivation. delusions DEPRESSANTS/SEDATIVES/HYPNOTICS Barbiturate In urine: 2–4 days and up to 30 days Central nervous system depression. panic attacks. dizziness. sedation Cocaine In urine: 2–4 days Central nervous system stimulation. mood elevation. rapid heart rate. elevated temperature.003 should metabolic product normally excreted in the urine by be suspect. suppressed pain sensation. aggressive behavior. heart palpitations. dilated pupils. lightheadedness. paranoia and delusions. appetite suppres- Methamphetamine sion. euphoria. heightened sense of well-being. • A test to measure the creatinine level. nausea. dizziness. the kidneys. headache. sleepiness. Creatinine is a Samples with a specific gravity under 1. visual illusions. inflated self-image. coma * Detection times are based on the use of standard cutoffs. involuntary rapid movements of Chronic users: up to 30 days the eyeball. elevated blood pressure. seizures HALLUCINOGENS Marijuana Light smoker (1–2 joints/week): 2–3 days Increased cardiac output. intoxication. increased pulse rate increased appetite. diarrhea. (Darvon. depression of reflexes. decreased heart rate. lethargy. confusion. insomnia. nausea and vomiting. morphine. euphoria. codeine) May be longer for chronic users sedation. lightheadedness. sweating. depression. it is indicative that the urine has been diluted. Moderate smoker (4 times/week): 5–7 days decreased coordination.

a declining level may still indicate cessation Technologies in chapter 2). that the client may be under the influence of a drug or • the submission of a minimum amount of urine. or required. tics and costs. it cannot be undertaken confirmed. Some drug courts use the same testing methods for spot testing as are used in the regular drug testing • set time limits for providing a specimen (e. for positive half-life will require the capacity to determine the quanti. the program pays. developing a meaningful testing frequency available for a quick. and the avoiding detection. it is indicative that the general framework for determining appropriate testing client consumed large quantities of fluids prior to frequency for specific drugs. 1 hour or program. the tester needs both the drug/ monitor a participant’s progress in treatment. hours to report to a testing center. DRUG COURTS RESOURCE SERIES by fluid intake. simply by looking at instrument-based results. the most courts develop a standard policy regarding drug testing common of which requires a defendant to call in each frequency (e. Persons whose number required frequency on a case-by-case basis for individu. if the test is not interpretation may be possible. that for most drug court programs confirmation test- cult to do in practice because of the key role of dilution. Although such test if the positive test is confirmed.. ing is performed in relatively few instances because the To interpret such test results and determine whether purpose of drug testing in drug courts is primarily to they reflect renewed use. Many quently tested for. results. so that even though a positive test may programs use GC/MS for confirmation (see Testing be the result..g. con- for individual drugs that have a relatively long elimination firmation may be requested. however. However. er. specimen. Values less than 20 milligrams made to the special retention characteristics of drugs per deciliter may be an indication of waterloading. for reasons primarily relating to logis- less from the time of test notification to the time of col. • limited access to fluids prior to providing the the immediacy with which test results are needed. 10 . special attention should be paid to the length of time particular drugs Using Confirmation Testing remain detectable using the selected assay cutoff. Many metabolite levels and the creatinine levels along with programs charge the participant for the confirmation a knowledge of pharmacokinetics. qualitative result. considera- tion should be given to the level of accuracy required. If the creatinine level of a urine sam. alcohol. and subse. In lection) to minimize the possibility of internal dilution. howev- of use. immunoassay testing is readily 2 illustrates. Additional Tips A few additional tips for drug court officials to avert Spot Testing adulteration include requiring: Spot tests are unscheduled tests usually conducted by treatment or case management staff when they suspect • observed monitoring of all submissions. twice weekly during the first phase. Random Testing Determining Appropriate Testing Unless drug testing is conducted frequently—a practice Frequency most programs cannot afford—there is a possibility that Determining the appropriate drug testing frequency for clients could ingest drugs without detection. the testing methodology being used. In developing a drug testing schedule.3 and the volume of testing that will be conducted. or color is chosen are then given no more than 10 to 12 als who need more frequent testing. This assessment of declining levels may be diffi. It should be noted. Others.g. As table For urine drug screens. morning to ascertain whether his or her number or color weekly during the second phase) but also increase the is scheduled for testing that day. A variety of randomized procedures characteristics of the drugs being tested for. particularly if a sanction is to be imposed or tative levels of the drugs initially detected. The retention/detection timeframes in table 2 provide a ple falls below a certain level. Reference should also be giving the sample. the test is to be used for prosecution purposes. Random any drug court program will depend upon the resources testing prevents participants from planning ahead and available. determining how best to conduct spot testing. have adopted special testing methods. Most drug have been instituted by various programs. costs. used in the local community (see Establishing Cutoff Levels for the Drug Court Program).

tion that the individual has used illegal drugs (e. drug testing procedure.C.. For example. The quantitative level of a particular drug must Drug test results are generally reported as positive or be assessed given the creatinine level in the urine. Pretrial Services Agency for testing of defendants in every drug court should establish a policy regarding the D. timeframe for requesting confirmation (see Maintaining This cutoff value should set the quantitative level at and Specimens for Retesting. DOD for military testing. are quantitative values regarding the fail to confirm upon subsequent confirmation testing at amount of drug present in the specimen that set the another laboratory that may not reflect any deficiency in point at which a urine sample is reported as positive. As noted above. The tables Maintaining Specimens for Retesting in the appendix list the various cutoff guidelines used for screening and confirmation by SAMHSA for work- Samples should be kept long enough to reconcile any place testing. drug courts should develop Each drug court must establish the cutoff values to policies regarding confirmation testing. Drug Testing in a Drug Court Environment: Common Issues To Address Although requests for confirmation of positive drug tests levels below 2. The positive or negative finding reflects a can provide an indication of the level of urine concen- determination of whether the specimen is equal to or tration. every program should heroin use). below) and payment responsi.C. ingestion of poppy seeds and not necessarily indicative of nal justice drug testing programs. Positive drug test results the high volume of drug tests conducted by drug courts from passive inhalation or accidental exposure are (significantly higher than for persons under standard pro. thereby resulting in a quantitative increase in the level Establishing Cutoff Levels for the Drug Court of drugs detected even if there has been no resumption Program of use. Given confirmed upon further testing). Addressing “Spiking” Situations quent testing and prompt responses to new drug use. Spiking—a situation in which the quantitative level of a Specimens should be stored at temperatures between drug may appear to increase because of changing con- 2 and 8 degrees Celsius but at –20 degrees Celsius if centration levels of a drug in urine due to the individ- kept longer than 1 week. therefore. and the D. normalization levels taken previously. which negative. particularly if screen out false positives (i. Two weeks to one month should be adequate in a program with fre. ual’s metabolic factors rather than new use—is a phenomenon that must be considered in interpreting drug test results. By looking at the creatinine level as well as the exceeds the cutoff concentration levels that have been drug concentration level.. Superior Court for initial screening and for confirmation testing and the timeframe in which subsequent confirmation.000 ng/ml may be associated with the are generally much less frequent than in traditional crimi. there may be valid reasons for an initial positive test to Cutoffs. Cutoff values have been developed by professionals in forensic toxicology for various organizations. Cutoff levels should therefore be adequate to have the capacity for confirmation testing.g. These cutoff concentration levels must take ratio of the drug level to the creatinine level) for an indi- into account that some small traces of a drug metabolite vidual can be determined and subsequently compared to may be present in a person’s system without a determina. opiate 11 . Setting the appropriate cutoff value should also account However. test results (drug courts are aimed at persons with signifi- cant substance involvement). including the determine whether a test result is positive or negative.e. a normalization value (the established. positives that would not be sanctions may be imposed for positive test results. either the onsite or confirmation laboratory results. It should be noted that positive and below which indicates a negative result. requests for confirmation must be made. any significant frequency of unconfirmed tests for accidental exposure and/or passive inhalation to should signal the need for prompt review of the entire avoid the possibility of false positives. extremely unlikely if the cutoff levels established are bation supervision) and the relative frequency of positive sufficient to screen out trace drug metabolites. legal challenges to the test results. urine may be more con- Obtaining Accurate and Meaningful centrated due to the time of day the sample is taken or Interpretation of Results because of increased physical activity by the participant. above which it is deemed that the test is presumptively bility for the confirmation test.

and should execute a written agreement acknowledging the one blind control specimen that alternates between positive requirements of the drug testing component of the drug and negative. The purpose of having controls 75 percent court program and his or her agreement to comply with below and 125 percent above cutoff is to test the assay’s drug testing program requirements. Challenge the Test Results in chapter 4). cedures.0 urine. for Uniform guidelines can be developed regarding cutoff lev. or automated analyzers). and acidity levels (which can be detected with commonly available in the locale. the normalization levels. and steps for interpreting the test results. low creatinine levels (which can be measured in the locale remain in the human system.6 tration. Testing Program The procedures manual should also include the required The integrity of a drug testing program depends upon reli. The requirements ability to identify positive tests that are close to the cutoff. one specimen at 125 percent of cutoff value. which take into with the following results: account the relative concentration of the Test 1 cocaine level: 200 mg Creatinine level: 100 mg Normalization level = 2. the drug use history of dipsticks. Policies the individual user. Test 2 cocaine level: 160 mg Creatinine level: 100 mg Normalization level = 1. Although the normalization levels Test 3 cocaine level: 200 mg Creatinine level: 300 mg Normalization level = 0. screening tests should be run periodically (ideally daily) to include one negative. Programs must adopt guidelines regarding the period periodically. but each program must conduct research on its local (which can be measured using temperature strips or ther- population to determine how long specific drugs available mometers). and waiver Development and Periodic Updating of of confidentiality claims to the test results insofar as their transmittal to the drug court judge is concerned. reviewed with staff—initially and regularly—and updated 12 . Procedures must be in place. compliance with observed testing protocols. should include required submission of urine samples. and procedures should also be articulated for handling common situations that may occur. Proficiency The program’s error rate—the rate of false positives as testing should be conducted periodically to ensure that the well as the frequency with which the presence of drugs is entire drug testing process is operating as intended. for Release of Information one strong positive. with test samples conducted to ensure that the testing procedures are both Defendant Agreements To Comply With detecting the presence of drugs and not falsely reporting Drug Testing Program Requirements and the presence of drugs. to detect samples with low or high temperatures els. applicable quality control pro- able test results in which the court can have confidence. this decline does not necessarily rule out new drug use. Testing methodologies should be checked daily. Every step of the drug testing process must after which a continued positive reading is indicative of be documented in the policy and procedures manual. manual should be used to orient new staff members as well as to train staff periodically. and the user’s physical size. The new use. example. This retention with both automated instrumental and non-instrumental period is frequently affected by the strength of the drugs devices). not accurately detected—should be extremely low. For example.67 appear to be declining. pH meters. one specimen at 75 percent of cutoff Each participant who enters the drug court program value. such as participants Determining an Acceptable Error Rate for the who state they are unable to provide a sample. The policy and proce- Understanding the Drug Use Characteristics in dures manual should also be referenced on an ongoing the Local Jurisdiction basis as questions arise. The Procedures Manual Documenting All agreement should require the participant to disclose any Aspects of the Drug Testing Process prescription or other medications he or she is taking (see also Develop Contracts With Participants That A complete policy and procedures manual that describes Increase Responsibility for Eliminating Situations That the entire drug testing process should be prepared. indicate a steady decline in concen. DRUG COURTS RESOURCE SERIES EXAMPLE Although the cocaine level detected in test 1 in the example remained the same in test Three successive drug tests are conducted on the same individual 3. reagents for each drug tested.

(1) from being in environments where drugs are used scribe nonnarcotic medications. and any medications that can produce a positive test result should be identified.. because passive smoke could affect their results. over-the-counter can produce true positive test results (e. everyone involved with the drug court asthma. prescription positive. a claim that a positive drug drug users to avoid difficulties in distinguishing test resulted from inhalation or ingestion of other (legal) between residual use and new use. Information regarding and any significant implications they may have for jus. The Physicians’ Desk Reference 13 . experts who can assist drug court officials in learning about these possibilities and interpreting any question- able results. Tips For Promoting an Effective Drug Court Drug Testing Program Educate and Train Everyone Involved provides a list of more than 350 medications that may produce positive test results for amphetamines. or other products) that could create a false prescription cough syrup or pain relievers. Complying with such a provision would amphetamines for obesity or attention deficit hyperac. and (3) from participating Prescription medications when used as instructed in activities (e. or an individual providing a sample that is might include increased monitoring of participants and clearly adulterated. would obviate the potential ambiguities in drug test results that can occur when specimens are Integrity of the Testing Process voided later in the day (see chapter 3). Participants should be required to dis. ranging from cough suppressants In addition to staff training regarding program policies and antihistamines to antibiotics and medications for and procedures. decrease the chances of false positives. The drug court contract that participants sign should cians to alert them to the participants’ involvement with also include a provision stating that they agree to refrain the program and their addiction and ask them to pre. and other issues that may assays’ package inserts and is well known to testing surface as the drug testing program becomes operational. These strategies substances. Everyone involved with the drug testing program should be aware of procedures for responding to situations that Strategies must also be developed to expedite the flush- may frequently occur. and irregular heart- program should be informed about drug testing policies beat. PCP. For example. hypertension. About the Process and Procedures cocaine. such as an individual being ing of the system of defendants who have been chronic unable to provide a sample.4. Some over-the-counter medications may produce and procedures. stricter procedures regarding the scheduling of drug court specimen collection. these various medications is usually detailed in the test tice system or treatment staff. using toiletries.g.. Develop Contracts With Participants Many of these situations can be anticipated and avoided. a number of prescription drugs can cause That Increase Responsibility for a positive result. For example. lymphomas. scheduling defendants to provide urine specimens only in the morn- Recognize Situations That Can Create ing. Eliminating Situations That Challenge close at the time of program entry all medications they the Test Results may be taking—prescribed as well as over the counter. Drug court program officials should consult with physi. The medical history of each participant Anticipate Situations That May Occur should be carefully reviewed. codeine in medications. factors that need to be considered in positive test results when misused or taken in amounts interpreting results. or opiates.g. if possible. (2) from eating poppy seeds. Situations can occur that may result in positive drug tests that potentially do not reflect illegal drug use. tivity disorder). drug test result patterns emerging above the recommended dosage. when their urine should be at its highest level of Positive Test Results That Challenge the concentration.

As tions that are made. Areas where the drug court program. their counsel. in Writing A written summary of the drug testing program and Every aspect of the drug testing program should be salient policies and procedures. should be clearly explained. such as spot testing. should also be explained to partici- new situations arise. pants. DRUG COURTS RESOURCE SERIES Document All Policies and Procedures discretion may be exercised. 14 . they and their appropriate respons. including any modifica- documented in the policy and procedures manual. and others who may be involved in es should be included in the manual.

Additional costs for sup- get is being prepared. tions should be made after considering many factors. Currently the costs of supplies to plies need to be budgeted for each test. raise with distributors of drug court supplies for point- of-contact systems are listed in chapter 6. Like any contractual service. maintain a point-of-contact testing process and the costs of instrument analysis vary because of many factors. training. ed strategy for developing a drug testing budget is ing should keep in mind that although the cost for provided in the response to question 1 in the Frequently procuring equipment to produce instrument analysis Asked Questions chapter. Preliminary questions to the vendor in the local community. should therefore be based on costs at the time the bud. may initially appear substantial. taking into account the volume of tests to be officials should investigate the degree to which alterna- conducted and the degree to which the drug court drug tive processes meet the drug court’s needs. Budget estimates for drug testing smaller table-model types (see question 1 in chapter 7. over both the testing activities provide a marketing opportunity for short term and the long term. additional costs including different pricing structures used by different for staffing. and costs for pur- to procure the most cost-effective urine monitoring chasing new Breathalyzers should be considered. Regardless of the type of methodology. and local vendors. A Breathalyzer is also a critical opportunities for conducting drug testing of participants component of drug testing programs. Frequently Asked Questions). and a suggest- Jurisdictions exploring the feasibility of instrument test. as are realized through the purchase of used equipment or associated costs. Determining the appropriate costs for drug testing func- Drug testing costs are not necessarily fixed price ser. vices. facilities. system for its program. Estimating Drug Testing Costs Drug testing technology is changing rapidly. and storage of specimens manufacturers. the specific costs Relative costs are not the sole indicators of the quality for drug testing should be negotiated with prospective of the process for the drug court’s purposes. Each drug court should consider all should be calculated. some economies can be 15 .5.

etc. store supplies and samples. • Is the test more accurate for some types of drugs than • What supplies are needed to conduct the drug for others? testing? What are their costs? • What type of confirmation process is required? • What staff and facilities will be needed to conduct Suggested? the testing. drug testing process need to be budgeted? ing is needed? How are test results recorded? How are test results reported to the court? • How many drugs can the methodology test for at once? • How quickly can test results be obtained? 17 . Questions To Ask Drug Testing Equipment and/or Supply Vendors The following is a list of suggested questions to guide • What potential for error is associated with producing drug courts in their initial inquiries with vendors of drug drug test results? Reading the test results? testing equipment and/or supplies.6.? • How much does each test cost? What does this cost • What is the methodology used to produce the test include? What additional costs associated with the results? Who interprets the results? What staff train.

Other criminal jus- 3. as well as health departments. Response: Generally.500 to $49. requests for confirmation of positive drug tests are generally more infrequent than in traditional criminal justice drug Instrument Testing testing programs. random testing should occur es depending upon the volume and capabilities of the twice or more each week in the initial phase of a client’s 19 . point-of-contact system is used. you will drug testing program because they identify the level conduct approximately 3. you will need to consider the following: Several manufacturers have special incentive pro- grams for instrument purchases or leases. • staff to conduct the drug testing program. (some fit on a tabletop). If.500 for drug testing supplies if a systems. and require only distilled water or other readily accessi. cost-effective testing results than a dipstick method. These a. If determining the degree of intoxication is + (32 weeks x 50 persons) = 3. for example. you should also consider contacting to budget (the cost per screen currently runs between other nearby agencies that either are conducting drug $5 and $20) testing or are in the planning stages. whereas most urine testing techniques only detect the presence or absence of (2 tests x 17 weeks x 50 persons) alcohol. degree to which they have stopped using drugs. At a very rough estimated cost of $5 to $15 per To determine the most appropriate drug testing strategy specimen for a full (5 to 7) test panel. b. Used machinery is also available. Private organizations may keep them for a year or more. are easy to work with.000 and increas. you conduct 2 tests each week per Additional costs for alcohol testing person for the first 120 days and then weekly for the next 8 months and you have approximately 50 per.7. How many tests will you be doing monthly or manufacturers should be consulted regarding current weekly? market prices. They do not require much space in which requests for confirmation testing can be made. Question 3: How frequently should we drug test? ble reagents. businesses. • facilities for sample collection and analysis. and other entities may be interested in pooling resources Non-Instrument Point-of-Contact Testing to develop a drug testing program that can take advan- tage of the cost savings provided by high-volume $16. Question 2: How long should we keep samples? Additional costs for the following must also be included: Response: Samples should be retained as long as there is a possibility of a challenge or a hearing on a result. you will need for your program. of alcohol in the system. a Breathalyzer should be used together the year. How much system. Frequently Asked Questions Question 1: We are a small community. Each drug court program should develop a policy regarding a reasonable period for Instruments geared to perform a small volume of retaining samples that is consistent with the timeframe tests are available.500 to $49. Response: To determine the costs for drug testing. tice agencies. Most manufacturers provide staff training.500. The purchase cost for these instruments usually begins at approximately $20. Breathalyzers are an important component of your sons in the program during this period. Because drug testing in drug courts is used primarily to • training of staff conducting the drug testing and monitor participants’ progress in treatment and the for educating others involved in the program. Some programs retain samples for 14 to 30 days. should we budget for drug testing? These instruments generally provide more reliable.300 tests during the year. with a urine test.300 drug tests x $5 to $15 = $16.300 tests during important.

DRUG COURTS RESOURCE SERIES participation in a drug court program and decrease to Question 5: What special issues should we be once weekly if the client demonstrates progress in treat. Determination also should be made of immediately. some States permit minors over a specified age or matu- Testing methodologies should be checked daily to rity level to consent to medical procedures without ensure that the testing procedures are both detecting the parental consent. The types of drug used or detected. Question 4: What is an acceptable error rate for a however. Hair and court program? sweat patch testing may be useful after prolonged abstinence. mental health. implement a juvenile drug court should review applica- be as close to 100 percent as possible for the court and ble State statutes concerning who must consent to med- others involved in the drug court program to have confi. Response: The testing process for juveniles is identical to that for adults. special procedures drug court drug testing program? may apply to testing for inhalants or for high volumes of over-the-counter medications that juveniles may use Response: With a well-managed testing system. The mature minor rule of dence in the drug testing program and its results. therefore. regarding drug testing of juveniles concerns require- ing program begins operation. concerned with when testing juveniles in a drug ment and improvements in drug test results. whether drug testing is considered a medical procedure under State statute. or of drugs. ical procedures for juveniles. The level of accuracy for ments for parental consent. may differ. If false positives should occur. 20 . they should sexual activity. The other principal issue errors should be detected and reconciled before the test. Jurisdictions planning to drug test results in any given program should. Other States limit these provisions to presence of drugs and not falsely reporting the presence health care relating to substance abuse. For example. all more regularly than adults. Still other States require the consent of a be promptly tracked and the underlying reasons for parent or legal guardian prior to any medical treatment the false positive should be identified and addressed of a minor.

000 ng/ml 300 ng/ml Phencyclidine 25 ng/ml 25 ng/ml 25 ng/ml Marijuana 15 ng/ml 15 ng/ml 15 ng/ml Methadone 300 ng/ml 300 ng/ml Benzodiazepine 200 ng/ml 200 ng/ml Barbiturates 200 ng/ml 200 ng/ml LSD 500 ng/ml 500 ng/ml‡ Propoxyphene 300 ng/ml ng/ml = nanograms per milliliter. 21 .C. Drug Test Cutoff Values Developed by Different Organizations: Confirmation* Drug SAMSHA DOD D. * Levels established for confirmation are lower than levels established for screening because two entirely different testing methods are used.000 ng/ml 1. Pretrial Amphetamine 1. Pretrial Amphetamine 500 ng/ml 500 ng/ml 500 ng/ml Methamphetamine 500 ng/ml† 500 ng/ml† 500 ng/ml Cocaine 150 ng/ml 100 ng/ml 100 ng/ml Opiates 2.C.000 ng/ml 2. † Must also have amphetamines at 200 ng/ml as well as methamphetamine at 500 ng/ml.000 ng/ml 300 ng/ml* Phencyclidine 25 ng/ml 25 ng/ml 25 ng/ml Marijuana 50 ng/ml 50 ng/ml 50 ng/ml Methadone — 300 ng/ml 300 ng/ml Benzodiazepine 200 ng/ml Barbiturates 200 ng/ml 200 ng/ml LSD 200 ng/ml 500 pg/ml Propoxyphene 500 pg/ml 300 ng/ml ng/ml = nanograms per milliliter.000 ng/ml 1.Appendix: Drug Test Cutoff Values Drug Test Cutoff Values Developed by Different Organizations: Screening Drug SAMSHA DOD D.000 ng/ml. ‡ Possible to change to 2.000 ng/ml 2. *Possible to change to 2.000 ng/ml.000 ng/ml Cocaine 300 ng/ml 150 ng/ml 150 ng/ml Opiates 2.

DC: U. 1998. undated. Substance Abuse and Mental Health Services Administration. MN: AACC Press. Department of Justice. Edward J. Slawson. Integrating Drug Testing L. Journal of Analytical Toxicology. January 29. Bruce A. ed.” DC: U. “In Vitro Binding Studies of Drugs to Kimberly P.S. 22 . Nonpigmented Hair by Ion-Trap Mass Spectrometry. Michele J. Testing. 3.. 2. System. with no apparent of Non-Instrumented Drug Tests: Summary Report and consensus on the agreed interpretation of quantitative Recommendations for Purchasing Non-Instrumented results...” Journal of Goldberger.S. Department of Justice.. Paul. “Quantitative Into a Pretrial Services System: 1999 Update. Inc. Robert E. Padger Bureau of Justice Assistance. Prepared Determination of Phencyclidine in Pigmented and by the Pretrial Services Resource Center. Center for Substance Abuse Prevention. Cone. St. Rollin. Denver.Notes References 1. Washington. Diane G.S.. Jerome J. Division of Workplace Programs. “Fool Proofing Drug Test Results. Jr. 20 (October 1996): 350–354. An Evaluation sis of hair for evidence of drug use. May 1998. 20 (October 1996): 338–346. Binding to Caucasoid and Africoid Hair. Tsung-Ping Su. Steinberg. “Specimen Adulteration: Who’s Winning Hair: Influence of Madanim and Lipids in Cocaine the Battle?” Journal of Offender Monitoring. 1995. Administrative Office of the U. 1999.S. Joseph. More than 400 published articles deal with the analy.” Business and Health. Department of Health and Human Services. CO: Duo Research. Washington. Drug Tests. Courts. of water distributed during the 3 hours preceding the Drug Identification and Testing in the Juvenile Justice test. An Evaluation of Non-Instrumented Drug Test Devices. and Cargain. See Matthew H. December 1990. Handbook of Workplace Drug Analytical Toxicology. DC: U. Current HHS and DOT procedures permit 40 ounces Office of Juvenile Justice and Delinquency Prevention. Robinson. Barbara. and Pinkston. Foltz. July 1999. Washington. Wilkins. and Douglas E.