On-Site Drug Testing

by Jenkins, Amanda J.; Goldberger, Bruce A.; Finkle, Bryan S.; Golberger, Bruce A.

• ISBN13: 9780896038707
• ISBN10: 089603870X
• Format: Hardcover
• Copyright: 2002-01-01
• Publisher: Humana Pr Inc

Summary

Today on-site drug testing is used widely in the workplace, the justice system (probation and parole), hospital emergency rooms, physician offices, and rehabilitation programs. In On-Site Drug Testing, scientists and forensic toxicologists critically evaluate the on-site devices currently available, their validation studies, and their use in a variety of settings. For each device, the expert contributors discuss its principles, materials and reagents, procedures and interpretation, and performance. The tests applied include both therapeutic drugs (lipid-lowering medications, antithrombotic medications, and anticoagulant drugs) at the point of clinical care and drugs of abuse (alcohol, amphetamines, benzodiazepines, cannabinoids, cocaine, and opiates) in the workplace and the criminal justice system. The well-versed contributors also address critical issues in sample collection and adulteration, and in program standards and legal requirements in workplace testing. Comprehensive and authoritative, On-Site Drug Testing illuminates the state of on-site drug testing today, and provides all those responsible a firm basis for choosing the best test devices and techniques most suited to their purposes.

Table of Contents

Foreword	vii
Bryan S. Finkle
Preface	ix
Contributors	xxi
Clinical Point-of-Care Testing for Drugs of Abuse	1	(10)
Jimmie L. Valentine
General Considerations	1	(1)
Pediatric Clinical Considerations	2	(1)
Adolescent Clinical Considerations	3	(2)
Adult Clinical Considerations	5	(2)
Physiological Considerations for Clinical Testing	7	(1)
Conclusions	8	(3)
References	9	(2)
On-Site Tests for Therapeutic Drugs	11	(14)
Alan H. B. Wu
Rationale for Therapeutic Monitoring and Need for On-Site Drug Testing	11	(1)
On-Site and Point-of-Care (POC) Drug Testing	12	(1)
Direct On-Site Testing Instruments and Devices for Therapeutic Drugs	13	(2)
Indirect On-Site Testing for Therapeutic Drugs	15	(7)
Monitoring of Lipid Lowering Medications	15	(3)
Monitoring of Antithrombotic Medications	18	(1)
Heparin	18	(1)
Oral Antithrombotic Therapy	19	(1)
On-Site Testing for Anticoagulant Drugs	20	(2)
Conclusion	22	(3)
References	22	(3)
On-Site Workplace Drug Testing	25	(12)
David Armbruster
Background	25	(5)
Conducting On-Site Workplace Drug Testing	30	(3)
The Future of On-Site Workplace Drug Testing	33	(4)
References	34	(3)
Program Requirements, Standards, and Legal Considerations for On-Site Drug Testing Devices in Workplace Testing Programs	37	(18)
Theodore F. Shults
Yale H. Caplan
Introduction	37	(1)
What Is ``On-Site'' Testing from a Standards Perspective?	38	(2)
Establishing Federal Standards for On-Site Drug Testing	40	(4)
Drug Testing Advisory Board (DTAB)	40	(2)
Collection Site	42	(1)
Collector/Tester	42	(1)
Collection Device/Test Device	42	(1)
Specimen	42	(1)
Collection Procedure	43	(1)
On-Site Testing	43	(1)
Laboratory Testing	43	(1)
Quality Control/Quality Assurance (QC/QA)	44	(1)
Reporting	44	(1)
Medical Review Officer	44	(1)
The DTAB End Game	44	(1)
The Legal Requirements for Confirmatory Testing in Private Sector On-Site Testing	44	(2)
The Legal Requirements for a Medical Review Officer in Private Sector On-Site Testing	46	(1)
New Liability Risks of Drug Testing Providers and On-Site Drug Testing-Another Factor in Establishing Standards	47	(4)
Conclusion	51	(4)
Notes	52	(3)
On-Site Testing Devices in the Criminal Justice System	55	(12)
Leo J. Kadehjian
James Baer
Drug Testing in the Criminal Justice Arena	55	(5)
Introduction	55	(1)
On-Site Testing	56	(1)
Use of Noninstrument Drug Testing Devices	57	(3)
Legal Admissibility, Evidentiary Weight, and Due Process	60	(4)
Standards for Admissibility of Scientific Evidence	61	(1)
Cases Addressing the Use of Noninstument Drug Testing Devices	62	(1)
Requirements for Repeat and/or Confirmation Testing	62	(2)
Conclusions	64	(3)
References	64	(3)
On-Site Testing Devices and Driving-Under-the-Influence Cases	67	(10)
J. Michael Walsh
Introduction	67	(1)
On-Site Testing in DUI Cases	68	(7)
Summary	75	(2)
References	75	(2)
Analysis of Ethanol in Saliva	77	(18)
Kurt M. Dubowski
Introduction	77	(2)
Saliva as a Specimen; Saliva Collection; Relationship of Saliva and Blood-Alcohol	79	(3)
Saliva Collection	80	(1)
Relation of Saliva-Alcohol to Alcohol in Other Body Fluids	80	(2)
Saliva-Alcohol Testing Principles and Procedures	82	(2)
Commercial Saliva-Alcohol Screening Test Devices	84	(3)
Quality Assurance	87	(4)
Testing Personnel	90	(1)
Interpretation and Use of Results	91	(4)
References	91	(4)
Analysis of Drugs in Saliva	95	(16)
Vina Spiehler
Dene Baldwin
Christopher Hand
Roadside or On-Site Saliva Drug Testing	95	(5)
Introduction	95	(1)
Saliva Collection	95	(1)
Cutoff Concentrations in Saliva	96	(1)
Amphetamines	97	(1)
Benzodiazepines	98	(1)
Cannabinoids	98	(1)
Cocaine	99	(1)
Opiates	99	(1)
Conclusion	99	(1)
Cozart RapiScan Saliva Drug Test System	100	(8)
Introduction	100	(1)
Testing Principle	100	(3)
Quality Control	103	(1)
Interpretation	103	(1)
Performance	104	(3)
Adulteration	107	(1)
Unique Features	108	(1)
References	108	(3)
AccuSign Drugs of Abuse Test	111	(12)
Johannes J. W. Ros
Marinus G. Pelders
Introduction	111	(1)
The AccuSign Test Slide	111	(4)
Summary of Studies	115	(5)
Nonpublished Pilot-Study	115	(1)
Duo Research Report	116	(1)
Performance of AccuSign Slide Test Near the Cutoff	117	(3)
Discussion	120	(1)
Conclusions	120	(1)
Product Contact Information	121	(2)
References	121	(2)
The EZ-SCREEN and RapidTest Devices for Drugs of Abuse	123	(20)
Santo Davide Ferrara
Luciano Tedeschi
Franca Castagna
Introduction	123	(1)
EZ-SCREEN	123	(7)
Principle	123	(2)
Materials and Reagents	125	(1)
Procedure and Interpretation	125	(1)
Performance Characteristics	125	(5)
RapidTest	130	(10)
Principle	130	(2)
Materials and Reagents	132	(1)
Procedure and Interpretation	133	(1)
Performance Characteristics	133	(7)
References	140	(3)
Frontline Testing for Drugs of Abuse	143	(10)
Serge Schneider
Robert Wennig
Introduction	143	(1)
Test Principle and Test Instructions	143	(2)
Test Principle	143	(2)
Test Instructions	145	(1)
Evaluation of the Frontline Tests	145	(5)
Crossreactivity and Cutoff Concentrations	147	(2)
Influence of Temperature	149	(1)
Evaluation of Frontline Tests	149	(1)
Conclusions	150	(3)
References	150	(3)
Abuscreen ONTRAK Tests for Drugs of Abuse	153	(10)
Laurel J. Farrell
Introduction	153	(1)
Principle of Abuscreen ONTRAK	153	(7)
Procedure	154	(5)
Quality Control	159	(1)
Performance	159	(1)
References	160	(3)
The OnTrak TesTcup® System	163	(22)
Dennis J. Crouch
Introduction	163	(2)
Product Design and Theory of Drug Detection	165	(1)
Analysis Method and Analysis Precautions	166	(2)
Method	166	(1)
Precautions	167	(1)
Interpretation of Results	168	(2)
Review and Discussion of the Literature	170	(11)
Study #1	170	(1)
Methods	170	(1)
Results	170	(2)
Discussion	172	(1)
Study #2	172	(1)
Methods	172	(1)
Results	173	(1)
Discussion	173	(1)
Study #3	173	(1)
Methods	173	(1)
Results	174	(1)
Discussion	174	(1)
Study #4	175	(1)
Methods	175	(1)
Results	175	(1)
Discussion	176	(1)
Study #5	176	(1)
Methods	176	(2)
Results	178	(1)
Discussion	178	(1)
Study #6	179	(1)
Methods	179	(1)
Results	179	(1)
Discussion	179	(1)
Study #7	180	(1)
Methods	180	(1)
Results	180	(1)
Discussion	180	(1)
Conclusions	181	(1)
Acknowledgment	182	(3)
References	182	(3)
OnTrak TesTstik Device	185	(14)
Salvatore J. Salamone
Jane S-C. Tsai
Introduction	185	(1)
Materials and Methods	186	(2)
Instrumentation and Reagents	186	(1)
Precision Study Methods	186	(1)
Clinical Evaluation and Comparative Study	187	(1)
Specificity	187	(1)
The TesTstik Device	188	(1)
Principle of Procedure	189	(3)
Procedure	192	(1)
Performance	192	(5)
Availability	197	(1)
Acknowledgments	197	(2)
References	197	(2)
Triage® Device for Drug Analysis	199	(14)
Rafael de la Torre
Introduction	199	(1)
Test Procedure	200	(6)
Solution-Phase Reaction	202	(1)
Solid-Phase Reaction	202	(1)
Cutoff Definition	203	(3)
Internal Quality Control	206	(1)
Clinical and Laboratory Evaluations	206	(7)
References	209	(4)
Visualine II™ Drugs-of-Abuse Test Kits	213	(6)
Scott A. Kuzdzal
James H. Nichols
Introduction	213	(1)
Principle	213	(1)
Description of Test Kits	214	(1)
Performance Evaluation	215	(2)
Management and Clinical Utility	217	(1)
Conclusions	218	(1)
Drugs-of-Abuse Test Devices: A Review	219	(34)
Robert E. Willette
Leo J. Kadehjian
Introduction	219	(2)
Background	219	(1)
Study Design	219	(1)
Study Devices	220	(1)
Results	221	(6)
Introduction	221	(1)
Analysis of Results	221	(1)
Interpretation of the Results	222	(3)
Operator Variability	225	(1)
Operational Characteristics	226	(1)
Summary	227	(26)
Table 1 Drug Cutoffs	228	(1)
Table 2 Amphetamine Test Results vs GC/MS-AOC Study, HHS Cutoffs	228	(1)
Table 3 Amphetamine Test Results vs GC/MS-AOC Study, AOC Cutoffs	229	(1)
Table 4 Cocaine Test Results vs GC/MS-AOC Study, HHS/AOC Cutoffs	229	(1)
Table 5 Opiates Test Results vs GC/MS-AOC Study, HHS Cutoffs	230	(1)
Table 6 Opiates Test Results vs GC/MS-AOC Study, AOC Cutoffs	230	(1)
Table 7 Cannabinoids Test Results vs GC/MS-AOC Study, HHA/AOC Cutoffs	231	(1)
Table 8 Phencyclidine Test Results vs GC/MS-AOC Study, HHS/AOC Cutoffs	231	(1)
Table 9 All Drugs Test Results vs GC/MS-AOC Study, HHS Cutoffs	232	(1)
Table 10 All Drugs Test Results vs GC/MS-AOC Study, AOC Cutoffs	232	(1)
Table 11 Amphetamines Test Results vs GC/MS-HHS Study, HHS Cutoffs	233	(1)
Table 12 Amphetamines Test Results vs GC/MS-HHS Study, AOC Cutoffs	233	(1)
Table 13 Cocaine Test Results vs GC/MS-HHS Study, HHS/AOC Cutoffs	234	(1)
Table 14 Opiates Test Results vs GC/MS-HHS Study, HHS Cutoffs	234	(1)
Table 15 Opiates Test Results vs GC/MS-HHS Study, AOC Cutoffs	235	(1)
Table 16 Cannabinoids Test Results vs GC/MS-HHS Study, HHS/AOC Cutoffs	235	(1)
Table 17 Phencyclidine Test Results vs GC/MS-HHS Study, HHS/AOC Cutoffs	236	(1)
Table 18 All Drugs Test Results vs GC/MS-HHS Study, HHS Cutoffs	236	(1)
Table 19 All Drugs Test Results vs GC/MS-HHS Study, AOC Cutoffs	237	(1)
Table 20 Variation in Test Results for Products Manufactured by the Same Company (from HHS Study, HHS Cutoffs)	237	(1)
Table 21 Product Descriptions, Operation, and Distributor Information, AOC and DWP Studies AOC Study	238	(6)
DWP Study	244	(9)
Sample Adulteration and On-Site Drug Tests	253	(12)
John T. Cody
Introduction	253	(2)
Dilution	255	(2)
Adulterants	257	(4)
Acid	257	(1)
Chromate	258	(1)
Glutaraldehyde	258	(1)
Nitrite	259	(1)
Other Adulterants	260	(1)
On-Site Adulteration Tests	261	(1)
Conclusions	262	(3)
References	262	(3)
Index	265