ABUSED DRUGS

RA 9165 Government forensic lab or lab accredited and monitored by DOH Screening and Confirmatory (Service capability) Mandatory or Random (Clientele) Valid for ONE year from date of issue POSITIVE screening lab test must be confirmed for it to be valid.

Drivers license Firearms license Permit to carry firearms outside of residence Officers and members of the military, police and other law enforcement agencies All persons who by nature of their profession carry firearms

Persons charged of imprisonment of not less than 6 years and 1 day Any person arrested for violating RA 9165
Screened test within 24 hours Confirmed within 15 days

Candidates for public office

High School and College students Officers and employees of public and private offices

Examples: Amphetamine sulfate, dextroamphetamine (Dexedrine), methamphetamine (Desoxyn, Methedrine). Metamphetamine: also known as Speed, Ice, Chalk, Meth, Crystal, Crank, Fire, Shabu, Poor Mans Cocaine Medical uses: Attention deficit disorder (hyperactivity) of childhood, narcolepsy, obesity (occasionally and for limited period) Effects attractive to abuser: Euphoria, increased ability to concentrate, increased alertness, heightened ability to perform intellectual and physical tasks, appetite suppression (for weight loss).

Ecstasy (methylenedioxymethapetamineMDMA): also known as E, X, XTC, Adam, Clarity, Lovers Speed. The drug comes in different tablet forms and styles to avoid recognition by authorities.

Adverse effects: Insomnia, restlessness, irritability, palpitations, rapid heartbeat, sweating, dilation of pupils, confusion, psychosis, convulsions, death. How abused: Pills taken orally; solution injected intravenously; occasionally snorted into the nose in granular form. Typical urine detection cutoff level: 300 ng/mL Period detectable after last dose: Up to 30 hours on low dose, 120 hours on high dose.

 Rush

( 20 40 minutes) High ( 3 days ) Binge Crash

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Discuss the implications of this experiment:

Low dose ecstasy was given to an isolated rat. There was no visible effect on the rat but the animals brain biopsy revealed minimal damage. But when the same dose was given to 20 rats confined together in a cage, all rats died and brain biopsy revealed severe damage.

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Before

After

The following poem was written by a young girl who was in jail for drug charges, and was addicted to crystal meth (TIC). She wrote this while in jail. As you will soon read, she fully grasped the horrors of the drug, as she tells in this simple, yet profound poem. She was released from jail, but true to her story, the drug owned her.

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(on initial drug screen only): decongestants (ephedrine [Vatronol, Efedron], phenylpropanolamine [Propagest, Sucrets Decongestant Formula, Rhindecon]); "diet pills" (phenmetrazine [Preludin], phentermine [Phentrol, Tora, Fastin, Obe-Nix, Obephen, Obermine, Obestin, Parmine, Phentamine, Phentrol 2, Unifast, Wilpowr, Adipex-P, Dapex-37.5, Ionamin, Phentrol], phenylpropanolamine [Diadax, Prolamine, Control, Dex-A-Diet, Dexatrim-15, Unitrol, Maximum Strength Acutrim, Appedrine]; blood vessel dilators (isoxuprine [Vasodilan], nylidrin [Adrin, Arlidin]). Only confirmatory testing of the urine will determine if these interfering drugs are present. It should be noted that some of these drugs, such as phenmetrazine and phentermine, while not technically amphetamines, have similar abuse potential and similar adverse effects.
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Phenylethylamine (a product of decomposing, unpreserved urine) may produce falsepositive screens in unrefrigerated, old specimens which have not been treated with fluoride preservative.

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Examples:Long acting phenobarbital; intermediate-acting- amobarbital (Amytal), butabarbital, talbutal; short-actingsecobarbital (Seconal), pentobarbital (Nembutal). Medical uses: Treatment of insomnia (short term only, and avoided altogether by most physicians), long-term treatment of epilepsy (phenobarbital), surgical anesthesia. Effects attractive to abuser: Sedation, loss of inhibitions, induction of sleep. Generally, the short-acting barbiturates have more abuse potential than long-acting types.
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Adverse effects: Agitation, confusion, nightmares, hallucinations, lethargy, hangover, suppression of breathing reflexes, coma, death. Physical dependence is well known, and withdrawal effects can be severe and dangerous, even fatal. How abused: Pills taken orally; solution injected intravenously. Typical urine detection cutoff level: 300 ng/mL

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Period detectable after last dose: long-acting 7 days, intermediate-acting 2-3 days; shortacting 1-2 days. Substances causing false positive results: None reported.

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Examples: Roxane, Dolophine Medical uses: Treatment of opiate addicts in approved program Effects attractive to abuser: Same as opiates (below) Adverse effects: Same as opiates (below) but with lesser degree of physical dependency (addiction) How abused: Pills taken orally; solution injected intravenously.

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Period detectable after last dose: 7.5-56 hours Substances causing false positive results: doxylamine [Unisom Nighttime Sleep Aid]. Presence of this substance would be ruled out by confirmatory testing.

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Examples: Morphine, heroin, codeine (as found in many prescription cough medicines, such as Robitussin-AC, and pain medications, such as Tylenol #3, Phenaphen #3 & #4, Empirin #3 & #4), oxycodone (Percodan), hydromorphone (Dilaudid), hydrocodone (as in many prescription cough medicines). Medical uses: Relief of moderate to severe pain, treatment of persistent cough (codeine), treatment of diarrhea.

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Effects attractive to abuser: Euphoria, sedation.

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Adverse effects: Drowsiness, apathy, confusion, nausea, vomiting, suppression of breathing reflexes, constricted pupils, physical addiction, coma, death. How abused: Pills taken orally; solution injected intravenously or subcutaneously; occasionally snorted into the nose in granular form. Typical urine detection cutoff level: 300 ng/mL Period detectable after last dose: heroin, 1-4 days; meperidine, 4-24 hours; morphine, 84 hour minimum

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Notes: This family of drugs undergoes extensive chemical changes due to the normal detoxification processes of the body. Therefore, the drug detected in the urine screen may not be the same as that originally taken by the subject. For instance, both heroin and codeine are converted to morphine before excretion in the urine.

Substances causing false positive results: none reported; however, foods containing poppy seeds (the natural source of traditional opiate drugs) will produce true positive results when screening the urine of an otherwise innocent subject.

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Examples: Diazepam (Valium), chlordiazepoxide (Librium), flurazepam (Dalmane), oxazepam (Serax), lorazepam (Ativan), clonazepam (Clonopin). Medical uses: Treatment of anxiety disorders, convulsions, and muscle spasms. Effects attractive to abuser: Euphoria, sedation, relief of anxiety, induction of sleep.
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Adverse effects: Drowsiness, apathy, fatigue, decreased activity level, dizziness, fainting, impaired ability to concentrate on tasks, disturbance of vision and hearing, physical addiction. How abused: Pills taken orally. Typical urine detection cutoff level: 300 ng/mL

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Period detectable after last dose: around 2-4 days, but depending greatly on dose. For instance, a single 10 mg PO dose of diazepam may not ever be detected, but a 5 times daily dose of 10 mg will be detectable for 3-7 days. Substances causing false positive results: none reported.

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Examples: Marijuana, hashish, hash oil Medical uses: Treatment of nausea and vomiting due to cancer chemotherapy. Effects attractive to abuser: Euphoria, intensified sensual and aesthetic perceptions. Adverse effects: Paranoia, panic, impairment of memory and ability to perform tasks, distorted perception of time, physical and psychological dependence.
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MARIJUANA also known as Weed, Pot, Grass, Reefer, Ganja, Mary Jane, Blunt, Joint, Roach, Nail Forms of Marijuana: Dried green leaves of cannabis plant usually rolled in cigarette paper and smoked in joint pipe or bong (larger pipe designed to send more smoke to lungs). Roach clip is used to hold tiny butt of joints. Marijuana is sometimes baked in brownies or cookies to avoid lung irritation.
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Marijuana affects your health. Marijuana limits your bodys ability to resist infection. Long term use increases the risk of developing mental illness. Marijuana smoke irritates the throat and lungs and has more tar than cigarette smoke. Frequent use is linked to increase risk of lung cancer, bronchitis, and emphysema. It speeds up heartbeat and blood pressure.
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Hash (more potent form of tetrahydrocannabinol or THC), brown substance made of pressed resin from cannabis, Hash Oil, the most potent condensed THC, is distilled liquid resin, often added to a joint. Marijuana can laced with other dangerous drugs without your knowledge.

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How abused: Smoked in cigarettes or pipe; occasionally eaten as ingredient baked into confections. Typical urine detection cutoff level: 100 ng/mL or 20 ng/mL (optional) Period detectable after last dose: This is highly variable. A one joint per week user has detectable levels of cannabinoids form 7 to 34 days, while a heavy daily user may be detected from 6 to 81 days after last use.
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Substances causing false positive results: none reported.

A screen detection cutoff level of 20 ng/mL, requested by some laboratory clients, may produce false positives due to passive inhalation of marijuana smoke, but this is controversial. At the cutoff level of 100 ng/mL, persons exposed passively to the smoke of others by virtue of being in the same room with abusers should be negative on urine drug screen, although more sensitive chemical techniques (such as gas chromatography/mass spectrometry, which has a sensitivity of 10 ng/mL) may demonstrate the drug in such an individual's urine.

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Cocaine hydrochloride is the typical form used by abusers who ingest the drug by snorting the granular form into the nose; It can also be dissolved in water and injected intravenously. Cocaine base is available in a waxy cake form ("rock" or "crack") which is vaporized with a torch and the vapors inhaled through a tube. Medical uses: Used almost exclusively by ear, nose and throat doctors to produce local anesthesia and control blood loss during minor nasal surgery.
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Effects attractive to abuser: Euphoria, increased ability to concentrate, increased alertness, heightened ability to perform intellectual and physical tasks, sexual stimulation, heightened sociability, enhanced self-confidence. Adverse effects: Restlessness, nervousness, tremor, convulsions, disturbances in heart rhythm, psychological dependence, myocardial infarction, sudden death. How abused: Snorted, injected, or smoked (see above).

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Typical urine detection cutoff level: 300 ng/mL Period detectable after last dose: 8-48 hours

Note: The laboratory detection of cocaine is performed by analyzing the urine for the presence of benzoylecgonine, a substance produced by the body's chemical detoxification of cocaine. Continuous conversion of cocaine to the metabolite occurs in voided, standing urine specimens (even with fluoridation and refrigeration) unless the specimen is kept at acid pH (<5). This may give the appearance of a negative specimen "turning positive" during storage, if the initial level of the metabolite was too low to trigger the screen in the fresh specimen. In truth, the specimen was positive all along, of course.

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Substances causing false positive results: none reported However, some legal South American herbal teas may contain small amounts of coca leaf extract, which may trigger a positive test in an "innocent" subject. Please note that cocoa, cacao, and Coca Cola are all completely unrelated to coca, which is the source of cocaine.

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Examples: Quaalude, Sopor Medical uses: Once used as a sleeping pill/sedative, now methaqualone is virtually never used for medical purposes. Effects attractive to abuser: Same as that for barbiturates (see above) Adverse effects: Same as that for barbiturates (see above) How abused: Pills taken orally.
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Typical urine detection cutoff level: 300 ng/mL Period detectable after last dose: up to 90 hours, depending on dose Substances causing false positive results: none reported.

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Examples: PCP, "angel dust" Medical uses: Veterinary tranquilizer; not used in human medicine. Effects attractive to abuser: Hallucinogenic effects Adverse effects: Lethargy, loss of coordination; unpredictable psychosis, sometimes with criminally violent behavior; death. How abused: Taken orally, smoked in cigarette (often mixed with marijuana), injected intravenously as a solution, snorted into the nose in granular form.
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Typical urine detection cutoff level: 75 ng/mL Period detectable after last dose: 5-10 days Substances causing false positive results: Thioridazine (Mellaril), an antipsychotic drug, has been reported to cause false positive results, as has the insecticide parathion.

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Examples: Beer, wine, distilled spirits Medical uses: Rarely, if ever, used for medical purposes. Effects attractive to abuser: Release of social inhibitions, euphoria, sedation Adverse effects: Same as that for barbiturates (see above).

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% Ethanol (grams/ 100 ml

Dose (ml)

Ethanol (grams)

Number of drinks per day Toxic Threshold

WINE

12%

120 ml

11.5 g

Men- 4 Women- 1 to 2 Men- 4 Women- 1 to 2

BEER

4%

360 ml

11.5 g

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ETHANOL IN ALCOHOL IS DANGEROUS! ANYONE TAKING MORE THAN SIX DRINKS A DAY IS RISKING PERMANENT LIVER DAMAGE

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Ethanol is absorbed in the stomach into the bloodstream and is delivered to the liver where it is broken down If the liver is regularly overloaded with alcohol, liver cells are damaged Damage to the liver cells results to CIRRHOSIS, a permanent liver damage leading to total failure and death.

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How abused: Drunk in beverage Period detectable after last dose: 8-10 hours

Note: Alcohol is the only drug of abuse (other than tobacco) that is legal for all adults to use.

Illegal use (as in driving while intoxicated) is defined by the presence of a blood alcohol level of greater than 100 mg/dL (0.10% by volume) in Texas (lower in some other states). It is impossible to determine if a subject is legally intoxicated by measurement of the urine alcohol level. A blood specimen must be collected for this determination to be made by a clinical laboratory.
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Clinical pathologist Physician trained in laboratory management and quality assurance program Licensed physician, chemist, medical technologist, pharmacist, or chemical engineer drug testing lab is a division, section, unit of a clinical lab Administrative and technical functions

Chemist Medical Technologist Pharmacist Chemical Engineer

Verifies completeness of CCF Prepares specimen for analyses Examines, processes and analyzes specimen Interprets, records, releases and signs out lab reports

A trained individual who instructs, assists a donor at collection sit, receives and makes an initial inspection of specimen for drug testing and initiates and completes the CCF At least high school graduate Must have undergone training in specimen collection
Ensures specimen integrity at collection site Performs correct specimen collection Ensures security of procedure Accomplishes CCF correctly Performs initial specimen validity

Employer of client/ donor/ subject Investigator at crime scene Complainant Owner/ administrator of establishment

Within the laboratory Hand washing facility outside of toilet Toilet coloring agent All mandatory tests except for crime scene and post accident

Workplace, school, jail, rehab, site of crime Critically ill/ disabled PERMIT from BHFS 10 days prior Minimum of 20 tests No testing should be done at the site

30 or 60 ml, polyethylene bottle, wide mouth with screw cap

Photo ID drivers license, employee ID, passport Identification by authorized agency representative And other ID allowed by agencys workplace drug testing plan

Id by a co-worker Id by another donor Use of a single, non photo ID credit card, voters registration card

Check ID of donor Explains collection procedure Fill up step 1 of CCF asks donor to remove outer garments Examines pockets etc Asks donor to wash hands Asks donor to select specimen bottle and label

Reasons for conducting validity test:

Unobserved urine collection Suspicion that the urine specimen has been tampered

Reasons for conducting validity test:

Unobserved urine collection Suspicion that the urine specimen has been tampered

Adulterated, substituted or diluted Improperly collected, handled and stored Improperly documented

Adulterated
pH less than 3 or greater than 11 Nitrite greater than 500

Diluted
Specific gravity of less than 1.003 Creatinine less than 1768 umol/L

Substituted
pH less than 2 or greater than 9 Specific gravity less than 1.033 or greater than 1.020 Creatinine less than 442 umol/L

Results should be issued within 15 days Positive screening results should be subjected to confirmatory testing Screening laboratory is the ONLY one authorized to release the FINAL report Results cannot be relayed through the telephone

CCF for the confirmatory lab (form DT-oo2D) Request for confirmatory Drug Testing Uploaded result of DTOMIS Sample properly labelled and sealed

THANK YOU!

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