drug testing 101 - arizona state university · 2019-12-19 · drug testing 101 & mythbusters donor...
TRANSCRIPT
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DRUG TESTING 101
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TOPICS OF DISCUSSION
Collection/Chain of Custody
Sample Media Comparison / Detection
Dilution/Adulteration/Substitution
Ethyl Glucuronide
Opiates
Benzodiazepine
THC New Usage
New Drug Trends
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COLLECTIONSChain of Custody
Drug Testing 101 & Mythbusters 2015
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CHAIN OF CUSTODY
Drug Testing 101 & Mythbusters
Donor verification: Picture ID Signature on CCF Signature on bottle label
TASC CST documentation: Time of Collection Collection Observed and Temperature
Checked
Signed by lab staff upon receipt into laboratory
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URINE COLLECTION
Drug Testing 101 & Mythbusters
Client‘s photo ID verified and signs log book. CCF is initiated.
ID verified by CST at restroom
Restroom for visual observation
CST verifies CCF with client after sample collected
Security seal applied in client’s presence
Client signs security seal on container & CCF
Sample placed in secure storage
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HAIR FOLLICLE
Drug Testing 101 & Mythbusters
Client ‘s photo ID verified and signs log book.
Client’s paperwork is filled out by donor
CST lays out all supplies & explains the procedures
CST sanitizes supplies in front of client
CST collects 90-120 strands of hair (samples from 3 different spots on the crown)
CST places samples on the foil in front of the client
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HAIR FOLLICLE
Drug Testing 101 & Mythbusters
CST wraps hair sample in the foil
CST shows the client the envelope to confirm it is empty and places the hair in the envelope.
CST closes the envelope and has the client initial and date it verifying it is their sample.
CST places the chain of custody and sample into the bag and seals it in front of the client.
CST gives the client a copy of the chain of custody that was put with the sample.
Sample placed in secure storage
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ORAL FLUID
Drug Testing 101 & Mythbusters
Donor ‘s photo ID verified and signs log book. CCF is initiated.
CST collects all supplies & explains testing procedures.
CST will fill out donors information on the test tube
CST opens a sealed pouch containing the oral swab, opens the red cap, hands the non absorbent end of the swab to the client to put in their mouth. CST will wait until blue line fully appears on the indicator.
CST will take the sample and place it back in the test tube and put the red cap on it.
CST will put paperwork and sample into the sample bag and seal it in front of the client.
CCF sticker is placed over top of the container and signed by client then sealed in bag. Sample placed in secure storage
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SAMPLE MEDIA / DETECTION
Drug Testing 101 & Mythbusters 2015
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SAMPLE MEDIA
Drug Testing 101 & Mythbusters
Various sample media types available to implement a drug abuse monitoring program
Hair, Oral Fluid, and Urine- most common
Blood and Sweat - uncommon
Each media type has it’s advantages/disadvantages
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HAIR FOLLICLE
Drug Testing 101 & Mythbusters
Pros Effective baseline test – Unknown drug use
history
Adulteration difficult
ConsNot useful for routine monitoring since the
drug use cannot be pin-pointed
Limited test menu
Head hair may not be available/ Potential issue with treated hair
May not pick up a single drug use
Detection times are: Head hair: 14-90 days priorBody hair: 30-365 days prior
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ORAL FLUID
Drug Testing 101 & Mythbusters
Pros Samples may be collected in the field and does
not require same gender collection.
If its collected correctly it is difficult to adulterate
Is recommended for clients that may be on certain medications or for medical reasons (Dialysis/catheter)
Cons Short detection period
Ineffective for THC and EtG Detection
Moderate cost
Detection time is 12-36 hours/ 6-8 hours for THC
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URINE
Drug Testing 101 & Mythbusters
ProsAbility to split the sample for additional testing
Industry standard
Long history of legal acceptance
Broad, cost effective menu
ConsRequires visually observed collection to avoid
adulteration/substitution
Potential for specimen dilution/adulteration in vivo and in vitro
Detection time is 24-72 hours
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DETECTION TYPES FOR EACH MEDIA
Drug Testing 101 & Mythbusters
Media Approximate Detection Period
Urine 24-72 hours
Oral Fluid 12-36 hours / 6-8 hours THC
Hair Head hair: 14-90 days priorBody hair: 30-365 days prior
Blood 8-36 hours
Sweat 1-4 weeks (period patch is worn)
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URINE DETECTION TIMES
Drug Testing 101 & Mythbusters
Stimulants:Amphetamines, Cocaine, Ecstasy, 24-72 hrsBath Salts
Narcotics / Narcotic Analgesics:Methadone, Opiates, Propoxyphene 24-72 hrs
Sedative HypnoticsBarbiturates, Benzodiazepines 24-72 hrs / 2-6 wks*
Hallucinogens:Marijuana 24-72 hrs / 2-6 wks*PCP, LSD 2-5 days
Depressants:Alcohol 1-12 hoursEthyl Glucuronide (EtG) 8-72 hours
*It is always recommended to order a GCMS or a LC-MS/MS confirmation if a client is contesting the result.
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MEDIA STRATAGIES
Hair Use to establish a “baseline” at beginning of program Use if client misses over 30 continuous days of testing
Urine Random Schedule: Variable from 1x/month to 2x/week Fixed Schedule (2x/week): Every Mon/Thu or Tue/Fri Intensive: Every Mon/Wed/Fri
Oral Fluid Medical reasons (Dialysis / Catheter) Testing 2x/week recommended
Drug Testing 101 & Mythbusters 2015
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DILUTION/ADULTERATION/SUBSTITUTION
Drug Testing 101 & Mythbusters 2015
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DILUTED
In vivo dilution is the most common method employed to circumvent a drug test.
Principle:The ingestion of copious amounts of fluids prior to providing a urine sample in order to induce polyuria and ultimately lower the concentration of drugs in the bladder below the detectable limit.
Drug Testing 101 & Mythbusters 2015
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EFFECTS OF WATER LOADING
Drug Testing 101 & Mythbusters 2015
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DIURETICS
Drug Testing 101 & Mythbusters 2015
Natural diuretics are natural foods and herbs that induce the removal of excess fluids in the body by increasing urination.
Caffeine, fruits and vegetables, fruit juices, some herbs like green tea.
Diuretic drugs treat edema caused by disorders of the heart, kidneys, liver or lungs. They are used commonly in treatment of hypertension.
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DILUTION INTERPRETATION
Drug Testing 101 & Mythbusters 2015
Is there a history of diluted samples?
Are there occurrences of missed scheduled or random testing dates?
Results of recent prior and subsequent samples “Positive” for drug(s)?
Is the donor under medical supervision that dictates use of diuretics and/or high fluid intake?
Intentional or Incidental Dilution?
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ACTING ON DILUTED SAMPLES
Drug Testing 101 & Mythbusters 2015
Establish a procedure for handling diluted samplesDefine non-complianceDetermine ramifications
Document donors understanding of compliance
Consider Negative Dilute samples to be Non-Compliant
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ADULTERATION
Drug Testing 101 & Mythbusters
Nationwide product distribution InternetSmoke shops or “head shops”Mail order / magazine advertisements
Offer next-day delivery with money-back guarantees
Disseminate misinformation to perpetuate myths about drug testing
Make exaggerated and unsubstantiated claims as to the efficacy of their products
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COMMON METHODS
Drug Testing 101 & Mythbusters
Physical Tampering - Additives
Specimen Substitution
Devices
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THE ADULTERANT INDUSTRY
Nationwide product distribution Internet, smoke shops or “head shops” and mail order / magazine advertisements
Offer next-day delivery with money-back guarantees
Will go off of myths to get people to buy their product.
Drug Testing 101 & Mythbusters 2015
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SPECIMEN SUBSTITUTION
Drug Testing 101 & Mythbusters
Dehydrated urine
Non-urine liquids
Also used in devices
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DEVICES
Concealed beneath clothing
Utilizes drug-free urine
Maintains proper urine temperature with heating pads or digital heating packs
Typically sold to males; may include prosthetic penis
Typically very expensive / single use only
TASC has a very specific monitoring system and clients are instructed to use very detailed testing procedures
Drug Testing 101 & Mythbusters 2015
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CONFISCATED DEVICES
Drug Testing 101 & Mythbusters 2015
The Whizzinator
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CONFISCATED DEVICES
Drug Testing 101 & Mythbusters 2015
DIY Devices
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CONFISCATED DEVICES
Drug Testing 101 & Mythbusters 2015
Female Devices
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VISUAL MONITORING COLLECTION
Drug Testing 101 & Mythbusters
Female Restroom Male Restroom
One way mirror to view collection
Bluing agent in toilets
No hot water
No chemicals in area
Remove excessive clothing
No items allowed in restroom
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ALCOHOL TESTING
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URINE ALCOHOL
Alcohol can be detected in the urine for approximately 12 hours.
Potential for a false positive due to sugars in urine.Diabetic individuals who are not being treated.Bacteria in urine ferments sugars into alcohol. Glucose test should be performed on a positive sample.
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ETHYL GLUCURONIDE (ETG)Ethyl Glucuronide (EtG) is a unique biological metabolite that isformed in the body after the consumption of ethanol, typicallyfrom drinking alcoholic beverages.
Reported to be detectable in urine typically from 8-80 hours after ingestion, and 2-36 hours in blood
EtG is detectable over a period roughly 5-6 times longer than traditional urine ethanol testing
Detectable in oral fluid only a few hours longer than ethanol*
EtG has also been isolated in hair follicles*G.Heiseth, B. Yttredal, et.al. ; JATox: July 2010
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URINE ETG
EtG is realistically detectable for approximately 6-72 hours at the industry norm 500 ng/mL cutoff limit
Peak urine detection time is approximately 8 hours after ingestion event
Normal urinary EtG levels in abstainers are
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HOW MUCH ALCOHOL DID MY CLIENT DRINK?
• It is not possible to determine the amount of EtG that will be produced from a measure of Ethanol (or vice versa) -Retrograde extrapolation cannot be performed
• Metabolism of Ethanol and EtG and EtS is genetically determined - Variability between individuals could be a 200-fold difference!
• Age, gender, race, physical health, diet, metabolism, and time of sample collection are but a few significant variables that can affect EtG detected.
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WHY TEST ETS?
EtG can possibly disappear (or be degraded) in urine due to certain bacterial contamination of the sample
EtS is not degraded by common bacterial contaminants
EtG can be synthesized by bacteria (such as E. coli ) in-vitro in the presence of alcohol (!)*
Presence of both EtG and EtS is a strong indicator of alcohol consumption
Presence of EtS alone may indicate alcohol consumption in conditions where the sample is contaminated (UTI infection)*A. Helander, et.al. ; ClinChem: August 2007
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EXAMPLE ETG OBSERVATIONS
Two non-alcoholic beers EtG concentration after 12 hours: 93 ng/mL –
Negative
A teaspoon of communion wine EtG concentration after 12 hours: 77 ng/mL
Negative
Three 1 oz doses of Nyquil over 24 hoursEtG concentration after 12 hours : 246 ng/mL
Negative-
Compiled from various sources
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EXAMPLE ETG OBSERVATIONS
• Single Beer (4.5% Alcohol) Positive EtG above the 500 ng/mL cutoff level for 16 hours Concentration peaking at 4,000 ng/mL after 4 hours
• Three glasses of wine (12% Alcohol) consumed over 3 hours Positive EtG above the 500 ng/mL cutoff level for 32 hours Concentration peaking at 68,000 ng/mL after 14 hours
• Six shots of vodka over 3 hours ETG in the range of 10,000 ng/mL –100,000 ng/mL Peaked at 16 hours and detectable for 54 hours
Compiled from various sources
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HYGIENE PRODUCTS
Hand sanitizer applied every 15 minutes for 8 hours Maximum EtG of approx 50 ng/mL – Negative
Gargling mouthwash 3 times a day for 5 days Maximum EtG concentration of 117 ng/mL – Negative
Gargling mouthwash 4 times a day for 78 hours Maximum EtG level: 173 ng/mL - Negative
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SUMMARY
If usage is denied, confirmation is Highly Recommended LC-MS/MS Quantification of EtG and EtS
Avoid significant sanctions when: EtG is confirmed below 500 ng/mL
Consider Medical Conditions Diabetics Clients with Urinary Tract Infections
Implement a Client Agreement to avoid incidental exposure
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OPIATES
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OPIATESPrescription/Drug Opiate Parent Drug/Metabolite
Heroin Diacetylmorphine 6-MAM, Morphine, Codeine
Tylenol #3, #4 Codeine Codeine, Morphine
MS Contin, Roxanol
Morphine Morphine, Hydromorphone
Vicodin, Vicoprofen, Tussionex, H-C Tussive
Hydrocodone Hydrocodone, Hydromorphone
Dilaudid Hydromorphone Hydromorphone
Oxycontin, Percodan, Percoset, Roxicet
Oxycodone Oxycodone, Oxymorphone
Opana Oxymorphone Oxymorphone
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BENZODIAZEPINES
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BENZODIAZEPINES
Prescription Benzodiazepine Parent Drug/Metabolite
Versed Midazolam Midazolam, Hydroxymidazolam
Prosom Estazolam Estazolam, Hydroxyestazolam
Restoril Temazepam Temazepam, Oxazepam
Rohypnol Flunitrazepam Flunitrazepam, Desalkylflunitrazepam, 7-Aminoflunitrazepam
Serax Oxazepam Oxazepam
Valium Diazepam Diazepam, Nordiazepam, Temazepam, Oxazepam
Xanax Alprazolam Alprazolam, Hydroxyalprazolam
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BENZODIAZEPINES
Prescription Benzodiazepine Parent Drug/Metabolite
Ativan Lorazepam Lorazepam
Centrax Prazepam Prazepam
Dalmane Flurazepam Flurazepam, Hydroxyethylflurazepam
Halcion Triazolam Triazolam
Klonopin Clonazepam Clonazepam, 7-Aminoclonazepam
Librium Chlordiazepoxide Chlordiazepoxide, , Nordiazepam, Oxazepam
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THC
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THC DETECTION PERIOD
THC metabolites are fat-soluble, and may be retained in fatty tissue depending upon dosage and recent usage history
• May take time to produce consistent negative urine samples
Casual users: 2-5 days Chronic users: 3-6 weeks
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DETERMINING NEW USE
THC:Creatinine (THC:CRE) ratios are commonly used to normalize sample dilution effects.
The ratios can be used directly to monitor THC abstention and elimination, or to determine the probability of a new usage event.
Most effective when interpreting GCMS analyses
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THC:CREATININE RATIO
Ratio is calculated as:THC (ng/mL) X 100 = THC:Cre (mg/mg)
Creatinine (mg/dL)
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THC ELIMINATION
THC Half-Life
Urinary THC excretion half-life is 1-10 days depending on usage history (mean half-life is 3.0 ± 2.3 days)‡
1 day for infrequent/casual users10 days for heavy/chronic users
‡Johansson et al, J. Anal Toxicol 13: 218-223 (1989)
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0
50
100
150
200
250
0 4 8 12 16 20 24 28 32 36 40
THC
Con
cent
ratio
n (n
g/m
L)
Days Since Abstention
THC Elimination - Usage Comparison
Chronic
Casual
EIA Cutoff
GCMS Cutoff
Chronic User
Casual User
Chart4
000250
222225
444195
666166
888145
101010125
121212108
14141493
16161680
18181871
20202062.5
22222255
24242448
26262643
28282836.5
30303031.25
32323227
34343423
36363620
38383817
40404015.625
Casual
EIA Cutoff
GCMS Cutoff
Chronic
Days Since Abstention
THC Concentration (ng/mL)
THC Elimination - Usage Comparison
250
50
15
125
50
15
62.5
50
15
31.25
50
15
15.625
50
15
7.8125
50
15
3.90625
50
15
1.953125
50
15
0.9765625
50
15
0.48828125
50
15
0.244140625
50
15
0.1220703125
50
15
0.0610351563
50
15
0.0305175781
50
15
0.0152587891
50
15
0.0076293945
50
15
0.0038146973
50
15
0.0019073486
50
15
0.0009536743
50
15
0.0004768372
50
15
0.0002384186
50
15
Sheet1
DaysCasualChronicEIA CutoffGCMS Cutoff
02502505015
21252255015
462.51955015
631.251665015
815.6251455015
107.81251255015
123.906251085015
141.953125935015
160.9765625805015
180.48828125715015
200.24414062562.55015
220.1220703125555015
240.0610351563485015
260.0305175781435015
280.015258789136.55015
300.007629394531.255015
320.0038146973275015
340.0019073486235015
360.0009536743205015
380.0004768372175015
400.000238418615.6255015
420.00011920935015
440.00005960465015
460.00002980235015
480.00001490125015
0250
10125
2062.5
3031.25
4015.625
507.8125
603.90625
Sheet1
Casual
EIA Cutoff
GCMS Cutoff
Days Since Abstention
THC Concentration (ng/mL)
THC Elimination - Usage Comparison
Sheet2
Chronic
Sheet3
Casual
EIA Cutoff
GCMS Cutoff
Chronic
Days Since Abstention
THC Concentration (ng/mL)
THC Elimination - Usage Comparison
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THC ClearanceTHC Clearance Data
0
50
100
150
200
250
300
350
400
450
0 8 16 24 32 40 48 56 64 72
Days until Clean
Num
ber o
f Clie
nts
99% of Population Negative by 6 weeks
- - -Median: 18 days
D. Kramer; TASC (2009)
Chart1
0
8
16
24
32
40
48
56
64
72
Dataset
Days until Clean
Number of Clients
THC Clearance Data
277
392
354
386
350
219
113
24
4
1
Sheet1
081624324048566472
20027.4010013.705006.852503.431251.71625.86312.93156.4678.2339.12
6177.423088.711544.36772.18386.09193.0496.5248.2624.13Half-Life of 8 Days
5345.102672.551336.28668.14334.07167.0383.5241.7620.88
4337.852168.931084.46542.23271.12135.5667.7833.8916.94DaysClients% Pop
3905.531952.77976.38488.19244.10122.0561.0230.5115.26027713.1%13.1%
3379.471689.74844.87422.43211.22105.6152.8026.40839218.5%31.6%
3286.261643.13821.57410.78205.39102.7051.3525.671635416.7%48.3%
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DETERMINING A USAGE EVENT
Medical-Legal MethodManno, et. al. (1984)‡
If THC:Creatinine ratio between samples increases ≥ 50%,new usage on or between these dates is suspected
False Positive/Interpretation Rate: 0.1% False Negative/Interpretation Rate: 24%
‡Manno et al; The Cannabinoids: Chemical, Pharmacologic, Therapeutic Aspects; Academic Press (1984)
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0 3 7 10 15 22THC (EIA) 170 128 88 75 40 30Creatinine 105 128 112 120 120 99THC:Cre 162 100 79 63 33 30
0
50
100
150
200
250
THC Concentration vs. THC:Creatinine Ratio
THC (EIA)CreatinineTHC:Cre
Normal Hydration
Chart11
00161.9047619048
33100
7778.5714285714
101062.5
151533.3333333333
222230.303030303
THC (EIA)
Creatinine
THC:Cre
THC Concentration vs. THC:Creatinine Ratio
170
105
128
128
88
112
75
120
40
120
30
99
Sheet1
DaysCasualChronicEIA CutoffGCMS Cutoff
02502505015
21252255015
462.51955015
631.251665015
815.6251455015
107.81251255015
123.906251085015
141.953125935015
160.9765625805015
180.48828125715015
200.24414062562.55015
220.1220703125555015
240.0610351563485015
260.0305175781435015
280.015258789136.55015
300.007629394531.255015
320.0038146973275015
340.0019073486235015
360.0009536743205015
380.0004768372175015
400.000238418615.6255015
420.00011920935015
440.00005960465015
460.00002980235015
480.00001490125015
DaysTHC (EIA)CreatinineTHC:Cre
0170105162
3128128100
78811279
107512063
154012033
22309930
Sheet1
Casual
EIA Cutoff
GCMS Cutoff
Days Since Abstention
THC Concentration (ng/mL)
THC Elimination - Usage Comparison
Sheet2
Chronic
Sheet3
THC (EIA)
Creatinine
THC:Cre
THC Concentration vs. THC:Creatinine Ratio
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56
THC Concentration vs. THC:Creatinine Ratio
0
50
100
150
200
250
THC (EIA)CreatinineTHC:Cre
THC (EIA) 150 132 95 42 40 30
Creatinine 105 130 110 18 120 160
THC:Cre 143 102 86 233 33 19
0 3 7 10 15 22
New Usage
Diluted
Diluted Example
Chart9
00142.8571428571
33101.5384615385
7786.3636363636
1010233.3333333333
151533.3333333333
222218.75
THC (EIA)
Creatinine
THC:Cre
THC Concentration vs. THC:Creatinine Ratio
150
105
132
130
95
110
42
18
40
120
30
160
Sheet1
DaysCasualChronicEIA CutoffGCMS Cutoff
02502505015
21252255015
462.51955015
631.251665015
815.6251455015
107.81251255015
123.906251085015
141.953125935015
160.9765625805015
180.48828125715015
200.24414062562.55015
220.1220703125555015
240.0610351563485015
260.0305175781435015
280.015258789136.55015
300.007629394531.255015
320.0038146973275015
340.0019073486235015
360.0009536743205015
380.0004768372175015
400.000238418615.6255015
420.00011920935015
440.00005960465015
460.00002980235015
480.00001490125015
DaysTHC (EIA)CreatinineTHC:Cre
0150105143
3132130102
79511086
104218233
154012033
223016019
Sheet1
Casual
EIA Cutoff
GCMS Cutoff
Days Since Abstention
THC Concentration (ng/mL)
THC Elimination - Usage Comparison
Sheet2
Chronic
Sheet3
THC (EIA)
Creatinine
THC:Cre
THC Concentration vs. THC:Creatinine Ratio
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57
THC Concentration vs. THC:Creatinine Ratio
0
50
100
150
200
250
THC (EIA)CreatinineTHC:Cre
THC (EIA) 150 128 170 75 40 30
Creatinine 105 130 190 120 120 99
THC:Cre 143 98 89 63 33 30
0 3 7 10 15 22
Dehydrated Example
Dehydration
Chart10
00142.8571428571
3398.4615384615
7789.4736842105
101062.5
151533.3333333333
222230.303030303
THC (EIA)
Creatinine
THC:Cre
THC Concentration vs. THC:Creatinine Ratio
150
105
128
130
170
190
75
120
40
120
30
99
Sheet1
DaysCasualChronicEIA CutoffGCMS Cutoff
02502505015
21252255015
462.51955015
631.251665015
815.6251455015
107.81251255015
123.906251085015
141.953125935015
160.9765625805015
180.48828125715015
200.24414062562.55015
220.1220703125555015
240.0610351563485015
260.0305175781435015
280.015258789136.55015
300.007629394531.255015
320.0038146973275015
340.0019073486235015
360.0009536743205015
380.0004768372175015
400.000238418615.6255015
420.00011920935015
440.00005960465015
460.00002980235015
480.00001490125015
DaysTHC (EIA)CreatinineTHC:Cre
0150105143
312813098
717019089
107512063
154012033
22309930
Sheet1
Casual
EIA Cutoff
GCMS Cutoff
Days Since Abstention
THC Concentration (ng/mL)
THC Elimination - Usage Comparison
Sheet2
Chronic
Sheet3
THC (EIA)
Creatinine
THC:Cre
THC Concentration vs. THC:Creatinine Ratio
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SUMMARY
Most clients are testing negative by 1-3 weeks
99% of clients will test negative by 6 weeks
THC:CRE ratios should decrease at least 50% every 10 days
An increase in THC:CRE ratio of 50% suggests new usage
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THC CONCENTRATES
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PREPARATION
Made by packing a long tube with marijuana leaves
Add butane (lighter fluid)to the tube and collect the extract
Evaporate butane
Remaining oil is a concentrated THC product
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OIL Wax
Shatter
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DABBING
Place a ‘dab’ of concentrate on a heated surface Inhale vapors Delivers a THC hit of 50-90% ConcernsExplosions during production“Dirty Oil” containing harmful contaminantsThe possibility of overdosing
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SYNTHETIC CANNABINOIDSSpice/K2
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CANNABINOID RECEPTORS
Synthetic cannabinoids are substances that bind to one of the known cannabinoid receptors, i.e. CB1 or CB2, present in human cells
The CB1 receptor is located mainly in the brain and spinal cord and is responsible for the typical physiological and particularly the psychotropic effects of cannabis
The CB2 receptor is located mainly in the spleen and cells of the immune system
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SPICE Assassin Revolution, Bizarro Blueberry, Black Magic Smoke, Cloud 10, Colorado, Darkness, Kite, Purple Diesel, Sunshine Daydream, Sunshine Nightmare, Hammerhead, Diablo
Sold in smoke shops and online
Labeled and sold as incense:“Not for Human Consumption”
Herbs and botanicals treated with synthetic cannabinoids
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SYNTHETIC CANNABINOIDS First Generation Spice: 2009
JWH-018, JWH-073, JWH-250
Federal Ban: March 2011JWH-018, JWH-073, JWH-200, CP-47,497, CP-47,497-C8 homologue
Second Generation Spice:AM-2201, AM-2233, JWH-019, JWH-122, JWH-203, JWH-210,MPPP, RCS-8 (JWH-018, JWH-073, JWH-250 found in some products)
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1ST & 2ND GENERATION SPICEΔ9-THC
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THIRD GENERATION SPICE
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PB-22 5F-PB-22 AB-FUBINACA
AB-CHMINACA
FOURTH GENERATION SPICE
http://en.wikipedia.org/wiki/File:AB-FUBINACA_structure.pnghttp://en.wikipedia.org/wiki/File:AB-FUBINACA_structure.pnghttp://en.wikipedia.org/wiki/File:AB-CHMINACA.svghttp://en.wikipedia.org/wiki/File:AB-CHMINACA.svg
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DETECTION Most compounds are not detected by standard drug screening tests
(Negative on standard THC screen)
Detection period estimated to be 24-72 hours in urine Primarily detect metabolites in urine
Shorter detection period in blood and oral fluid Parent drug detected
Testing methodology utilized ELISA Liquid Chromatography/Tandem Mass Spectrometry (LC-MS/MS) Expensive
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TESTING CHALLENGES
Hundreds of potential compounds can be used in the manufacturing process of Spice products
Moving target – Spice industry responds to legislation, laboratories must respond to latest trend
Lack of complete understanding of metabolism for all known synthetic cannabinoids
Development of affordable screening tests that react with a wider range of synthetic cannabinoids
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SYNTHETIC STIMULANTSBath Salts
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Stimulant like Amphetamines
Substituted cathinones -- Methylenedioxypyrovalerone(MDPV) mephedrone, and methylone are the chemicals most often found in “bath salts”
Cathinone is a chemical derived from the Khat plant
Consumed orally or nasal administration
BATH SALTS
http://www.google.com/imgres?imgurl=http://www.shamanica.com/Botanicals/Catha%20edulis/Catha%20edulis%20small%20trees.jpg&imgrefurl=http://www.shamanica.com/Catha%20edulis.asp&h=331&w=300&sz=36&tbnid=t8mPNfNGLXDnyM:&tbnh=236&tbnw=214&prev=/search?q=picture+of+a+khat+plant&tbm=isch&tbo=u&zoom=1&q=picture+of+a+khat+plant&hl=en&usg=__9BUZm_Yb4OTJQ3FltS8OjzWy9B8=&sa=X&ei=fQVhT_fcMqXy2QWinJD8Bw&ved=0CBAQ9QEwAAhttp://www.google.com/imgres?imgurl=http://www.shamanica.com/Botanicals/Catha%20edulis/Catha%20edulis%20small%20trees.jpg&imgrefurl=http://www.shamanica.com/Catha%20edulis.asp&h=331&w=300&sz=36&tbnid=t8mPNfNGLXDnyM:&tbnh=236&tbnw=214&prev=/search?q=picture+of+a+khat+plant&tbm=isch&tbo=u&zoom=1&q=picture+of+a+khat+plant&hl=en&usg=__9BUZm_Yb4OTJQ3FltS8OjzWy9B8=&sa=X&ei=fQVhT_fcMqXy2QWinJD8Bw&ved=0CBAQ9QEwAA
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WHERE/HOW IS IT SOLD?
Sold in head shops, convenient stores and online PackagingBath SaltsPlant Food – White SnowInsect Repellent – White LightningStain Remover – Thunda Cat “NOT FOR HUMAN CONSUMPTION”
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EFFECTS Severe side effects Suicidal thoughts Agitation Combative/Violent behavior Confusion Hallucinations/psychosis Increased heart rate Hypertension Chest Pain Death or serious injury
The speed of onset is 15 minutes, while the length of the high from these drugs is four to six hours.
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INCREASING PROBLEM
TODAY | January 04, 2013 Navy’s anti-drug ad aims to scare sailorsNavy officials say a new ad aimed at a designer drug called bath salts was produced after an alarming spike in its use by sailors in 2012, but some are calling the video over the top. NBC’s Jim Miklaszewski reports.
http://www.today.com/video/today/50362252
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OVER-THE-COUNTER CONCERNSDXM
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DEXTROMETHORPHAN
OTC Cough Suppressant Found in more than 120 OTC cold medications Referred to as “Robo-tripping” or “Skittling” Medications can also contain pseudoephedrine,
acetaminophen and chlorpheniramine Abuse occurs in all age groups but is more prevalent in
youth
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DXM EFFECTS Heightened sense of perceptual awareness Altered time perception Visual hallucinations
Hyperexcitability Lethargy Ataxia Slurred Speech Sweating Hypertension Nystagmus
Reported by abusers
Clinical Presentation
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DXM EFFECTS
At high doses the pharmacology of DXM is similar to PCP and Ketamine
Impaired motor function
Numbness
Nausea/Vomiting
Increased heart rate and blood pressure
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THANK YOU FOR YOUR TIME.
Drug Testing 101Topics of DiscussionCollectionsChain of custodyUrine CollectionHair FollicleHair FollicleOral FluidSample Media / DetectionSample MediaHair FollicleOral FluidUrineDetection types for each mediaUrine detection timesMedia stratagiesdILUTion/Adulteration/�substitutionDILUTEDEffects of water loadingdiureticsDilution interpretationActing on diluted samplesadulterationCommon methodsThe Adulterant IndustrySpecimen SubstitutionDevices�Confiscated devicesConfiscated devicesConfiscated devicesVisual Monitoring Collection�Alcohol testingUrine AlcoholEthyl Glucuronide (EtG)Urine EtGHow much alcohol did my client drink?Why Test EtS?Example EtG ObservationsExample EtG ObservationsHygiene Products SummaryopiatesOpiatesbenzodiazepinesBenzodiazepinesBenzodiazepinesthcTHC Detection PeriodDetermining New UseTHC:Creatinine RatioTHC EliminationSlide Number 52THC ClearanceDetermining a Usage EventSlide Number 55Slide Number 56Slide Number 57SummaryTHC ConcentratesPreparationSlide Number 61OilDabbingSynthetic CannabinoidsCannabinoid ReceptorsSpiceSynthetic Cannabinoids1st & 2nd Generation SpiceThird Generation SpiceFourth Generation SpiceDetectionTesting ChallengesSynthetic StimulantsBath saltsWhere/how is it sold?EffectsIncreasing ProblemOver-the-Counter ConcernsDextromethorphanDXM EffectsDXM EffectsThank you for your time.