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ABUSED DRUGS
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RA 9165
Government forensic lab or lab accredited andmonitored by DOH
Screening and Confirmatory (Servicecapability)
Mandatory or Random (Clientele)
Valid for ONE year from date of issue
POSITIVE screening lab test must beconfirmed for it to be valid.
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Drivers license
Firearms license
Permit to carry firearms outside of
residence Officers and members of the military,
police and other law enforcementagencies
All persons who by nature of theirprofession carry firearms
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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
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High School and College students
Officers and employees of public andprivate offices
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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, increasedalertness, heightened ability to perform intellectual andphysical tasks, appetite suppression (for weight loss).
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Ecstasy (methylenedioxymethapetamine-MDMA): also known as E, X, XTC, Adam,Clarity, Lovers Speed.The drug comes in different tablet forms andstyles to avoid recognition by authorities.
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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 highdose.
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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 theanimals brain biopsy revealed minimaldamage. But when the same dose was givento 20 rats confined together in a cage, all ratsdied and brain biopsy revealed severedamage.
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Before After
The following poem was written by a young girl who was in jail for drugcharges, and was addicted to crystal meth (TIC). She wrote this
while in jail. As you will soon read, she fully grasped the horrors ofthe 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 DecongestantFormula, 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 someof these drugs, such as phenmetrazine and phentermine,while not technically amphetamines, have similar abusepotential and similar adverse effects.
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Phenylethylamine (a product of decomposing,unpreserved urine) may produce false-positive screens in unrefrigerated, oldspecimens which have not been treated withfluoride preservative.
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Examples:Long actingphenobarbital;intermediate-acting- amobarbital (Amytal),butabarbital, talbutal; short-acting-
secobarbital (Seconal), pentobarbital(Nembutal). Medical uses: Treatment of insomnia (short
term only, and avoided altogether by mostphysicians), long-term treatment of epilepsy
(phenobarbital), surgical anesthesia. Effects attractive to abuser: Sedation, loss of
inhibitions, induction of sleep. Generally, theshort-acting barbiturates have more abusepotential 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, andwithdrawal effects can be severe and dangerous,even fatal.
How abused: Pills taken orally; solution injectedintravenously.
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; short-acting 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 withlesser degree of physical dependency (addiction)
How abused: Pills taken orally; solution injected
intravenously.
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Period detectable after last dose: 7.5-56hours
Substances causing false positive results:doxylamine [Unisom Nighttime Sleep Aid].Presence of this substance would be ruled outby confirmatory testing.
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Examples: Morphine,heroin, codeine(as found in manyprescription coughmedicines, such as
Robitussin-AC, and pain medications, suchas Tylenol #3, Phenaphen #3 & #4, Empirin#3 & #4), oxycodone (Percodan),hydromorphone (Dilaudid), hydrocodone (asin many prescription cough medicines).
Medical uses: Relief of moderate to severepain, 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 ofbreathing reflexes, constricted pupils,
physical addiction, coma, death. How abused: Pills taken orally; solution
injected intravenously or subcutaneously;occasionally snorted into the nose in granularform.
Typical urine detection cutoff level: 300ng/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 undergoesextensive chemical changes due to thenormal detoxification processes of the body.Therefore, the drug detected in the urinescreen may not be the same as that originallytaken by the subject. For instance, bothheroin and codeine are converted tomorphine before excretion in the urine.
Substances causing false positive results:none reported; however, foods containingpoppy seeds (the natural source of traditional
opiate drugs) will produce true positiveresults when screening the urine of anotherwise 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, physicaladdiction.
How abused: Pills taken orally. Typical urine detection cutoff level: 300
ng/mL
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Period detectable after last dose: around 2-4days, but depending greatly on dose. Forinstance, a single 10 mg PO dose ofdiazepam may not ever be detected, but a 5times 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 cancerchemotherapy.
Effects attractive to abuser:Euphoria, intensified sensualand aesthetic perceptions.
Adverse effects: Paranoia,panic, impairment of memory
and ability to perform tasks,distorted perception of time, physical andpsychological 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 injoint pipe or bong (larger pipe designed tosend more smoke to lungs). Roach clip is
used to hold tiny butt of joints. Marijuana issometimes baked in brownies or cookies toavoid lung irritation.
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Marijuana affects your health. Marijuanalimits your bodys ability to resist infection.
Long term use increases the risk ofdeveloping mental illness.
Marijuana smoke irritates the throat andlungs 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 oftetrahydrocannabinol or THC), brownsubstance made of pressed resin from
cannabis, Hash Oil, the mostpotent condensedTHC, is distilled liquid
resin, often added toa joint. Marijuana canlaced with other
dangerous drugswithout yourknowledge.
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How abused: Smoked in cigarettes or pipe;
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How abused: Smoked in cigarettes or pipe;occasionally eaten asingredient baked into
confections.
Typical urine detection cutoff level: 100
ng/mL or 20 ng/mL (optional)
Period detectable after last dose: This ishighly variable. A one joint per week userhas detectable levels of cannabinoids form 7to 34 days, while a heavy daily user may bedetected from 6 to 81 days after last use.
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Substances causing false positive results: nonereported.
A screen detection cutoff level of 20 ng/mL,requested by some laboratory clients, mayproduce false positives due to passive inhalationof marijuana smoke, but this is controversial.
At the cutoff level of 100 ng/mL, persons exposedpassively to the smoke of others by virtue ofbeing in the same room with abusers should benegative on urine drug screen, although moresensitive chemical techniques (such as gas
chromatography/mass spectrometry, which has asensitivity of 10 ng/mL) may demonstrate thedrug in such an individual's urine.
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Cocaine hydrochloride is the typical formused by abusers who ingest the drug bysnorting the granular form into the nose;
It can also be dissolved in water andinjected intravenously.
Cocaine base is available in a waxy cakeform ("rock" or "crack") which is vaporizedwith a torch and the vapors inhaled througha tube.
Medical uses: Used almost exclusively byear, nose and throat doctors to producelocal anesthesia and control blood lossduring minor nasal surgery.
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Effects attractive to abuser: Euphoria,increased ability to concentrate,
increased alertness, heightened ability toperform intellectual and physical tasks,sexual stimulation, heightenedsociability, enhanced self-confidence.
Adverse effects: Restlessness,nervousness, tremor, convulsions,disturbances in heart rhythm,psychological dependence, myocardialinfarction, sudden death.
How abused: Snorted, injected, orsmoked (see above).
Typical urine detection cutoff level: 300 ng/mL
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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 performedby analyzing the urine for the presence ofbenzoylecgonine, a substance produced by thebody's chemical detoxification of cocaine.Continuous conversion of cocaine to the metaboliteoccurs in voided, standing urine specimens (even
with fluoridation and refrigeration) unless thespecimen is kept at acid pH (
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Substances causing false positive results: nonereported
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 CocaCola 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 sleepingpill/sedative, now methaqualone is virtually neverused 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: nonereported.
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Examples: PCP, "angel dust" Medical uses: Veterinary tranquilizer; not
used in human medicine.
Effects attractive to abuser: Hallucinogeniceffects 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, snortedinto 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, hasbeen reported to cause false positive results, ashas the insecticide parathion.
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Examples: Beer, wine, distilledspirits
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- 4Women- 1 to 2
BEER 4% 360 ml 11.5 g Men- 4
Women- 1 to 2
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ETHANOL IN ALCOHOL IS DANGEROUS!ANYONE TAKING MORE THAN SIX DRINKS ADAY IS RISKING PERMANENT LIVER DAMAGE
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Ethanol is absorbed in the stomach into the
bloodstream and is delivered to the liverwhere it is broken down
If the liver is regularly overloaded withalcohol, liver cells are damaged
Damage to the liver cells results toCIRRHOSIS, a permanent liver damageleading to total failure and death.
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H b d D k i b P i d
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How abused: Drunk in beverage Perioddetectable after last dose: 8-10 hours
Note: Alcohol is the only drug of abuse (otherthan tobacco) that is legal for all adults to use.
Illegal use (as in driving while intoxicated) isdefined by the presence of a blood alcohollevel of greater than 100 mg/dL (0.10% byvolume) in Texas (lower in some other states).
It is impossible to determine if a subject islegally intoxicated by measurement of theurine alcohol level. A blood specimen must becollected for this determination to be made bya clinical laboratory.
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Clinical pathologist Physician trained in laboratory management
and quality assurance program
Licensed physician, chemist, medical
technologist, pharmacist, or chemicalengineer drug testing lab is a division,section, unit of a clinical lab
Administrative and technical functions
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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
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A trained individual who instructs, assists a
donor at collection sit, receives and makesan initial inspection of specimen for drugtesting and initiates and completes the CCF
At least high school graduate
Must have undergone training in specimencollection
Ensures specimen integrity at collection site
Performs correct specimen collection
Ensures security of procedure
Accomplishes CCF correctly
Performs initial specimen validity
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Employer of client/ donor/ subject
Investigator at crime scene
Complainant
Owner/ administrator of establishment
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Within the laboratory Hand washing facility outside of toilet
Toilet coloring agent
All mandatory tests except for crime sceneand post accident
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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 withscrew cap
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Photo ID drivers license, employee ID,passport
Identification by authorized agencyrepresentative
And other ID allowed by agencys workplacedrug testing plan
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Id by a co-worker Id by another donor
Use of a single, non photo ID credit card,voters registration card
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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
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Reasons for conducting validity test:
Unobserved urine collection Suspicion that the urine specimen has been
tampered
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Reasons for conducting validity test:
Unobserved urine collection Suspicion that the urine specimen has been
tampered
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Adulterated, substituted or diluted Improperly collected, handled and stored
Improperly documented
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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
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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
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CCF for the confirmatory lab (form DT-oo2D)
Request for confirmatory Drug Testing
Uploaded result of DTOMIS
Sample properly labelled and sealed
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THANK YOU!