Substance Abuse Cases What Every Attorney Should Know About Drug And Alcohol Testing

Beth E. Maultsby
Goranson Bain, PLLC
8350 N. Central Expwy., Suite 1700
Dallas, Texas 75206
(214) 373-7676

Jim Turnage
Forensic DNA & Drug Testing, Inc.
701 Commerce Street
Dallas, Texas 75202
(214) 573-7600

Vickers L. Cunningham
Recovery Healthcare Corporation
2520 Electronic Lane, Suite 810
Dallas, Texas 75220
(214) 350-1711

The University of Texas School of Law
9^th Annual Family Law On The Front Lines
June 18-19, 2009
San Antonio

Introduction

In a family law case, it is common for one party to accuse the opposing party of substance abuse. As a result, drug/alcohol testing has become a commonplace tool used to determine (1) the accuracy of substance abuse allegations; and (2) issues related to custody and visitation. When used properly, drug/alcohol testing is a valuable tool. Armed with the proper information, drug/alcohol testing can then be used to provide evidence of drug use and non-compliance with court orders or abstinence and compliance with court orders. Unfortunately, Judges and attorneys are often uninformed regarding the technical nuances of the various testing methods, which results in drug/alcohol testing that is inappropriate to the specific circumstances of the case.

The purpose of this paper is to provide attorneys and Judges with information regarding the technical applications and limitations of the various drug/alcohol-testing methods. This paper will also provide practical tips for attorneys handling a case involving substance abuse. This paper is broken down in the following components:

Frequently Asked Questions
Attorney Tips
Court Cases Discussing Hair Testing
Drug Chart – Detection Period
Drugs of Abuse – Uses and Effects
Court Form – Forensic DNA & Drug Testing Services, Inc.

Frequently Asked Questions

Frequently Asked Questions – Understanding Drugs Most Frequently Abused

Question: What are the most commonly abused drugs?

Answer:

Alcohol: Alcohol, while a legal drug, is often abused and habitual use can lead to addiction and significant physical and psychological health problems. Alcohol is rapidly metabolized by the liver into its principle chemical components including carbon dioxide and sugars. Alcohol is within the family of depressant drugs with symptoms including slurred speech, loss of motor coordination and impaired judgment. Alcohol is consumed primarily for its psychotic effects which include a loss of inhibitions and euphoria.

Amphetamine: (AMP) Amphetamines are central nervous stimulants whose effects include alertness, wakefulness, increased energy, reduced hunger and an overall feeling of well being. Large doses and long term usage can result in higher tolerance levels and dependence. The most common source for amphetamine is prescription diet pills.

Barbiturates: (BAR) Classified generally as depressants, barbiturates produce a state of intoxication that is remarkably similar to alcohol intoxication. Symptoms include slurred speech, loss of motor coordination and impaired judgment. Depending on the dose, frequency, and duration of use, one can rapidly develop tolerance, physical dependence and psychological dependence on barbiturates. Barbiturate abusers prefer the short-acting and intermediate-acting barbiturates pentobarbital (Nembutal), secobarbital (Seconal) and amobarbital (Amytal). Other short and intermediate-acting barbiturates are butalbital (Fiorinal, Fioricet), butabarbital (Butisol), talbutal (Lotusate) and aprobarbital (Alurate). After oral administration, the onset of action is from 15 to 40 minutes and the effects last up to 6 hours.

Benzodiazepines: (BZO) Also classified as depressants, benzodiazepines are used therapeutically to produce sedation, induce sleep, relieve anxiety and muscle spasms and to prevent seizures. In general, benzodiazepines act as hypnotics in high doses, as anxiolytics in moderate doses and as sedatives in low doses. Like the barbiturates, benzodiazepines differ from one another in how fast they take effect and how long the effects last. Shorter acting benzodiazepines, used to manage insomnia, include estazolam (ProSom), flurazepam (Dalmane), quazepam (Doral), temazepam (Restoril) and triazolam (Halcion). Benzodiazepines with longer durations of action include alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), halazepam (Paxipam), lorazepam (Ativan), oxazepam (Serax) and prazepam (Centrax). Abuse of Benzodiazepines occurs primarily because of the “high” which replicates alcohol intoxication. Approximately 50 percent of people entering treatment for narcotic or cocaine addiction also report abusing benzodiazepines.

Cocaine: (COC) Cocaine is made from coca leaves. Its effects include alertness, wakefulness, increased energy and an overall feeling of euphoria. Cocaine may be smoked, inhaled (“snorted”) or injected. Cocaine can be a very addictive drug.

Ecstasy: Methylenedioxymethamphetamine (MDMA) is a designer drug first synthesized in 1913 by a German drug company for the treatment of obesity. Those who take the drug frequently report adverse effects, such as increased muscle tension and sweating. MDMA is not clearly a stimulant, although it has, in common with amphetamine drugs, a capacity to increase blood pressure and heart rate. MDMA does produce some perceptual changes in the form of increased sensitivity to light, difficulty in focusing, and blurred vision in some users. Its mechanism of action is thought to be via release of the neurotransmitter serotonin. MDMA may also release dopamine, although the general opinion is that this is a secondary effect of the drug. The most pervasive effect of MDMA, occurring in almost all people who have taken a reasonable dose of the drug, is to produce a clenching of the jaws. Symptomatic and biological responses to MDMA are similar to those produced by methamphetamine.

A new version of Ecstasy, called “Extreme Drug” and laced with methamphetamine, is entering the US through the northern states from illegal labs in Canada. Canadian ecstasy laboratories are producing more than 2 million tablets per week.

Methadone: (MTD) Although chemically unlike morphine or heroin, methadone produces many of the same effects. Methadone is primarily used today for the treatment of narcotic addiction. It is also used as a mild pain reliever. The effects of methadone are longer-lasting than those of morphine-based drugs. Methadone’s effects can last up to 24 hours, thereby permitting administration only once a day in heroin detoxification and maintenance programs. Ironically, methadone, used to control narcotic addiction, is a frequently abused narcotic, often encountered on the illicit market and methadone has been associated with a number of overdose deaths.

Methamphetamine: (MET or M-AMP) Methamphetamine is a stimulant drug. It is used in pill form or in powdered form by snorting or injecting. Crystallized methamphetamine is inhaled by smoking and is a considerably more powerful form of the drug. Some of the effects of methamphetamine use include: increased heart rate, wakefulness, physical activity and decreased appetite. Methamphetamine use can cause irreversible damage to the brain, producing strokes and convulsions, which can lead to death. Ecstasy, a new trendy and popular drug among teenagers is a refined and processed form of methamphetamine.

Opiates: (OPI) Opiates are any of the addictive narcotic drugs derived from the resin of the poppy plant. Opiates are analgesics (pain reducers) which work by depressing the central nervous system. They can also depress the respiratory system. Doctors often prescribe them for severe or chronic pain. Opiates are very addictive, both physically and psychologically. Use for only a short time normally results in addiction. Some commonly used opiates are: Codeine, Heroin, Methadone, Morphine, Opium, Percodan, Talwin, Dilaudid, Hydrocodone and Demerol. Opiates are commonly referred to as “downers”. Opiates can appear in many forms: white powder or crystals; small white, yellow or orange pills; large colorful capsules; clear liquid and dark brown, sticky bars or balls. Heroin accounts for the majority of the illicit opiate abuse. Some physical indications of opiate use include: extreme loss of appetite and weight, needle tracks or punctures, black and blue marks from “skin popping”, scars along veins, cramps, nausea, vomiting, excessive scratching and complaint of itching, excessive sweating, constipation, raw, red nostrils from snorting, runny nose, pin-point pupils and watery eyes, reduced vision, drowsiness, euphoria, trance-like states, excessive thirst, tremors, twitching, unkempt appearance, strong body odor, irritability, chills; slight hallucinations and lethargy. Opiates reduce attention span, sensory and motor abilities, produce irrational behavior, depression, paranoia, and other psychological abnormalities.

Oxycodone: (OXY) Pharmaceutical drugs Percodan, Percocet, Roxicodone, Oxycontin. While classified as an Opiate, the chemical structure and metabolite of Oxycodone requires a separate Opiate test with a substantially higher sensitivity detection level than that of the standard Opiate drug test. Consequently, a positive test result will not only confirm Oxycodone but other prescribed opiates as well that were listed under Opiates in the previous paragraph. Oxycodone is generally prescribed in oral pill form with the analgesic buffer Acetaminophen. Acetaminophen, 4′-hydroxyacetanilide, is a non-opiate, non-salicylate analgesic and antipyretic which occurs as a white, odorless, crystalline powder, possessing a slightly bitter taste.

Phencyclidine: Phencyclidine hydrochloride (PCP), also known as “angel dust,” is a hallucinogen. PCP is commonly taken orally, by inhalation, by snorting or injection. The effects of this drug are unpredictable and variable. Users may exhibit signs of euphoria, anxiety, relaxation, increased strength, time/space distortions, panic or hallucination. PCP use can lead to paranoia and extreme irrational behavior. Once popular, PCP use has declined dramatically in recent years and is no longer considered a major drug of abuse. However, it is still available on the streets and used by certain groups.

Propoxyphene: (PPX) is a narcotic analgesic compound bearing structural similarity to methadone. As an analgesic, propoxyphene can be from 50-75% as potent as oral codeine. Darvon and Darvocet are two of the most common brand names for the drug. Darvocet contains 50-100 mg of propoxyphene napsylate and 325-650 mg of acetaminophen. Peak plasma concentrations of propoxyphene are achieved from 1 to 2 hours post dose. In the case of overdose, propoxyphene blood concentrations can reach significantly higher levels.

Marijuana: Tetrahydrocannibinol (THC) is an active component in marijuana. Marijuana, a hallucinogen, is commonly ingested by smoking, but it may also be eaten. Marijuana may impair learning and coordination abilities. Marijuana is most commonly the drug of choice among teenagers and young adults. The hallucinogenic effect of Marijuana can lead to irrational behavior, disorientation, and paranoia. Marijuana is the most common recreational drug of abuse.

All forms of cannabis have negative physical and mental effects. Several regularly observed physical effects of cannabis are a substantial increase in the heart rate, bloodshot eyes, a dry mouth and throat, and increased appetite.

Use of cannabis may impair or reduce short-term memory and comprehension, alter sense of time, and reduce ability to perform tasks requiring concentration and coordination, such as driving a car. Motivation and cognition may be altered, making the acquisition of new information difficult. Marijuana can also produce paranoia and psychosis.

Because users often inhale the unfiltered smoke deeply and then hold it in their lungs as long as possible, marijuana is damaging to the lungs and pulmonary system. Marijuana smoke contains more cancer-causing agents than tobacco smoke. Long-term users of cannabis may develop psychological dependence and require more of the drug to get the same effect. The marijuana on the streets today is much stronger than it was in the 60s and 70s. It is getting strong and more potent every year.

Tricyclic antidepressants, (TCA) Tricyclic antidepressants have been prescribed since the 1950s for depression and compulsive disorders. Until recently TCAs were the primary choice of physicians for the vast majority of people with major depressive disorders. Ironically TCAs are often prescribed for symptomatic treatment of drug addiction and withdrawal and in particular, alcoholism. Tricyclic antidepressants work by raising the levels of serotonin and norepinephrine in the brain by slowing the rate of reuptake, or re-absorption, by nerve cells. Usually TCAs are taken over an extended period as effects from the drugs are gradual. Because of the possibility of causing serious cardiac complications, TCAs can be lethal if misused at high doses. Abuse of TCAs can be the result of fear of relapse rather than any psycho-pharmacological effect however the potential for TCA abuse is well established, since the drugs have clearly defined euphoric psychological and stimulatory physiological action in cases of chronic usage. Generic and brand names of the tricyclic antidepressants include Adapin, Amitriptyline, Amoxapine, Asendin, Desipramine, Doxepin, Elavil, Imipramine, Ludiomil, Maprotiline, Norpramin, Nortriptyline, Pamelor, Pertofrane, Protriptyline, Sinequan, Surmontil, Tofranil, and Vivactil. Any comprehensive drug screening program should include a TCA panel.

Question: What are the common street names for the frequently abused drugs?

Answer:

A comprehensive list can be found by searching the internet with terms such as “drug street slang.”

Amphetamine	Speed, amp, bennies, black beauties, chalk, uppers, hi, speed balls, beans, hiballs, beenie babies, eve
Methamphetamine	Crystal, meth, ice, glass, speed, icebergs, bergs, ecstasy, MDEA
Cocaine	Coke, crack, snow, flake, blow, rock, line, snuff, sugar, snort, stones, nose candy, freebase, toot
Marijuana	Pot, weed, herb, bud, MJ, doobie, reefer, joint, blunts, grass, rope, hemp, roach
Phencyclidine (PCP)	Angel dust, sherms, star dust, magic dust, dust, silver/gold glitters, wack
Opiates (heroin)	Horse, smack, hairy hombre, H, scag, jones, fix
Barbiturates Benzodiazepines	Downers, uppers, highway, lows, reds, barbs, trangs
MDMA	Ecstasy, adam, XTC, X, hug drug, beans, love drug, lover’s speed

Frequently Asked Questions — Drug Testing In General

Question: What are the most common methods of drug testing in family law cases?

Answer: There are three major types of drug testing:

Urine – Urine testing is the most common and has a broader window of detection than saliva testing. Saliva detection is usually less than 24 hours. Urine testing can test for the greatest range of detectable drugs. The detection window is a few days to a week. Marijuana is the exception with a detection window up to 40 days for chronic users. It is best used if the person has recently ingested drugs and for random testing.

Hair – Hair testing is non-invasive and used to indicate long term use. It is not a “follicle test” since the follicle is not attached to the hair or the part of the hair that is tested. “Hair test” accurately describes the test being performed. It takes approximately 150 strands of hair to have sufficient quantity to perform the test not 1 or 2 strands.

Drugs are captured in the core of the hair as blood passes through the hair follicle. The standard test from head hair covers a 90-day window of drug use. The most recent two weeks of hair growth is eliminated because during this period the length of the hair growth is from follicle to above the scalp plus the thickness of the scissors. This represents the first 1 inches of hair cut as close as possible to the scalp. Degradation starts to occur beyond 1 inches preventing an accurate test, or picture, of what actually occurred regarding drug use. Body hair may be used when head hair is too short or non-existing. The window of detection for body hair can be as long as 12 months but may be much shorter. Body hair grows for 7 to 12 months and then becomes dormant.

Hair testing is accurate but caveats exist. Marijuana is harder to detect than other drugs. Admitted marijuana users occasionally have negative test results. Another explanation for a negative test for marijuana, or any drug, can result from shampoos designed specifically to remove the drug from the core of the hair. Some of these products help reduce the levels, some do not. Even bleaching or coloring the hair has a minor effect of reducing the levels of the drug in the hair.

Nails – Fingernail and toenail testing is relatively new in drug testing. It is being used when the donor shaves his or her head to avoid a hair test or use of shampoos are suspected. The accuracy is the same as hair since both are made of keratin. The window of detection is 3 to 8 months.

Question: Does the lab test for more than one drug per sample?

Answer: Yes. Most labs use multiple drug test panels or screens in the initial test. The multi drug screen allows you to run several drugs using one device and one sample. It is important to know before the test is performed what test panel is being administered and what drugs are included in the panel. Drugs tested in one panel may vary greatly based on the testing company, the lab, the expense and the expectations. The following drugs are included in the most common test panels but others may be added if specifically requested: Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Cannabis (THC), Methadone, Methamphetamines, Opiates, PCP and MDMA (Ecstasy), and Propoxyphene.

Question: What are the methodologies used to test for drugs?

Answer: There are two primary methods used to screen for drugs. The initial screen is Immunoassay and confirmations performed by Gas Chromatography/Mass Spectrometry (GC/MS), Gas Chromatography/Mass Spectrometry/Mass Spectrometry (GC/MS/MS), or Liquid Chromatography/Mass Spectrometry/Mass Spectrometry (LC/MS/MS)

Immunoassay is the most commonly used method to initially screen samples. It is a rapid process that can test many samples per run. It works on the principle of antigen-antibody interaction. Antibodies are chosen which will bind selectively to drugs or their metabolites. The binding is then detected using either enzymes, radioisotopes or fluorescent compounds. Any positive found in the screening process is confirmed by a second method.

Confirmation test by GC/MS, GC/MS/MS or LC/MS/MS is used in the event that drugs or their metabolites are detected in the initial screening test. The sample is tested again using an one of the more sensitive methodologies for the confirmation test. This is the most precise tests for identifying and quantifying drugs or their metabolites. It involves a two step process, whereby Gas Chromatography separates the sample into its constituent parts and Mass Spectrometry identifies the exact molecular structure of the compounds. The combination of Gas Chromatography/Mass Spectrometry or one of the other confirmation methods is considered to be the definitive method of establishing the presence of drugs or their metabolites.

Question: Are there standards used to determine if a drug test is truly positive?

Answer: Yes.The Substance Abuse and Mental Health Services Association (SAMHSA) provides guidelines for what qualifies as a positive drug test. If a test does not give results higher than the guidelines or cut-off level, it does not qualify as a “positive” test. If an immunoassay test gives positive results, a second confirmation test must also give positive results before the results are released as positive.

Question: Are there differences between urine cut-off levels and hair cut-off levels?

Answer: Yes. In general, cut-off levels for urinalysis have been established to reduce the possibility of external or incidental exposure such as passive inhalation. A true comparison of hair/urine cut-off levels is impossible, since the time frame differs (90 days vs. 5 days). SAMHSA’s recommended cut-off levels for forensic urinalysis tests are expressed in nanograms per milliliter (ng/ml) of urine. Hair cut-off levels are expressed in picograms per milligram (pg/mg) of hair.

Question: What is a metabolite?

Answer: A metabolite is any substance produced or used during metabolism (digestion). In drug use, the term usually refers to the end product that remains after metabolism. In other words, the body changes the parent drug to a metabolite.

Question: Why is it important to understand about metabolites in drug testing?

Answer: When a sample is given for drug testing, it will be tested for the drug itself (parent) and the substances (metabolites) produced by the body when it processes (metabolizes) the drug. The existence of a drug’s metabolite confirms that a person ingested the drug. For example, if a drug test showed a positive for benzoylecgonine or norcocaine then the person being tested had ingested cocaine. The presence of the metabolite cocaethylene indicates and proves that the person consumed alcohol at the same time as the cocaine.

Below is a chart of the drug and its metabolite:

Parent Drug	Metabolizes To
Amphetamine	Amphetamine
Methamphetamine	Amphetamine
Cocaine	Benzoylecgonine, Norcocaine
Marijuana	Carboxy – THC
Hydrocodone	Hydromorphone
Oxycodone	Oxymorphone
Heroin	6-acetylmorphine

Question: Will commonly ingested substances such as vitamins, penicillin, aspirin, caffeine and acetaminophen (Tylenol), affect the results of a drug test?

Answer: No. The tests are drug and drug metabolite specific. Because these commonly ingested substances are chemically and structurally different after being metabolized, they will under most circumstances not interfere with or compromise test results.

Question: Are there some prescription and non-prescription medication that will affect a drug test?

Answer: Yes, there are some prescriptions that contain the same drugs that are commonly found in street drugs. There is no easy way to distinguish between the two forms of the drug. However, the problem is not as big as it would seem.

There are no prescriptions for PCP. It is extremely rare to find cocaine used in a medical setting, although it happens occasionally, usually to control bleeding from the eye or nose. If used, it will be well documented in the person’s medical file. Such use would cause the urine to test positive for cocaine metabolite for approximately 6 hours. It would not be sufficient quantity to cause a positive hair test.

Poppy seeds do not interfere in this type of testing. Other prescribed opiates may occasionally cause a positive screen but are sorted out in a confirmation test.

There are some prescription diet pills that contain either amphetamine or methamphetamine, as well as a drug for Parkinson’s disease that is a form of methamphetamine. Some doctors prescribe amphetamines for ADHD. Ecstasy is included in the amphetamine class of drugs, and is specifically identified by the GC/MS confirmation.

When a person submits for a drug test, he or she should provide the collection agency with a list of all prescribed medications unless it is a pre-employment test. There are literally hundreds of brand name and generic drugs being prescribed today.

If you have a question on a specific prescribed medication, you will need to know the general classification of that medication to determine if it will test positive on any of the specific drug test panels, i.e.: opiates, amphetamine, methamphetamine, benzodiazepines, barbiturates etc. For general classifications on prescription drugs you can either ask your pharmacist or go online to http://www.rxlist.com and enter the name of the prescription drug to determine its general classification and pharmacology.

Question: What is the difference between heroin, morphine and codeine?

Answer: Chemically, nothing. All three of these drugs are derived from opium or the opium chemical structure and are in the Opiate class of drugs. The difference is primarily in the manner in which opium is refined or synthetically manufactured and the form and method of delivery. Heroin quickly metabolized to morphine in approximately 8 hours. The probable cause of a morphine positive test is (1) prescribed morphine or (2) heroin use.

Question: What is the difference between methamphetamine and amphetamine?

Answer: Both amphetamine and methamphetamine are potent symphathominetic agents. Methamphetamine metabolizes (or changes) into amphetamine in the body at a 10 to 1 ratio. A higher level of amphetamine exceeding the 10 to 1 ratio probably indicates the donor is also taking a prescribed amphetamine at the same time as using methamphetamine. There will not be methamphetamine levels on a drug test if the person is taking only a prescribed amphetamine. Amphetamines, such as Adderall, does not metabolize to methamphetamine.

Frequently Asked Questions — Urine Testing

Question: Are there standards used in urine testing to screen out a false positive test result?

Answer: Under the DOT or Federal testing guidelines, drug testing has two cutoff levels for positive detection. That is, labs that follow the guidelines consider drug testing to be negative if detection is below either cutoff level. In the case of urine analysis, drug testing cutoff levels are measured in nanograms per milliliter (ng/ml). For example, an initial screening for marijuana must show at least 50 ng/ml, and then confirmatory tests must prove at least 15 ng/ml. If the initial screening doesn’t show at least 50 ng/ml, then it’s considered to be negative and the confirmatory tests aren’t performed.

All other testing, such as court ordered testing, is considered Non-Federal or Non-DOT. The screening level for marijuana can be as low as 20 ng/ml to extend the window of detection in a urine test. The lab can also perform a Limit of Detection (LOD) test using the lowest possible cutoff levels. The LOD should be used only in certain case scenarios to determine it a specific drug has been used.

Question: Why are screening and confirmation cut-off levels different?

Answer: Simply stated, screening and confirmation testing are performed using different testing methodologies that precipitate different cut-off levels. The immunoassay tests used to perform initial drug screening are designed to detect a wide range of chemically similar compounds that react with the antibodies which are at the core of the chemistry making up the tests. In contrast, GC/MS confirmatory testing detects specific metabolites that provide identification and quantification of a specific drug.

For example, marijuana has approximately 5 metabolites that the immunoassay will identify. The total nanogram level is the sum of all 5 metabolites. The GC/MS confirmation identifies only one of the 5 metabolites and reports the sum of only that metabolite.

Question: What is creatinine?

Answer: Creatinine is the normal metabolic waste in urine. It is the primary means to determine if a urine sample is diluted resulting in an invalid test.

Question: Is the creatinine level important in urine drug testing?

Answer: Yes. Because the creatinine is excreted from the body at a constant rate, there are expected values for creatinine in normal human urine. The creatinine cutoff levels are as follows:

Normal human urine — The creatinine value is greater than 20mg/dL. Normal levels average between 100 and 200 mg/dL.

Diluted urine — the creatinine value is between 6 and 20mg/dL.

Substituted urine sample — The creatinine value is 5mg/dL or less meaning the sample is not consistent with human urine. The donor has poured something into the urine such as water. To eliminate this problem, order the donor to provide a witnessed collection. This means the collector of the same gender actually observes the sample going into the collection cup.

Question: What are the effects of sample dilution or adulteration and how are these tested for?

Answer: The most common method of sample manipulation to avoid a positive drug screen is dilution. Other forms of sample adulteration are the in vitro addition of adulterants or additives into the specimen sample to destroy the chemical reaction properties of lateral flow. The chart below shows the effect that dilution, adulteration or substitution has on standard urine drug screens.

Specimen Validity/Adulteration Testing
Validity Marker	Commercial Product	Method of Introduction to Urine	Mode of Action
Creatinine	HO	In vivo or in vitro. Creatinine is always present in normal human urine however abnormally low or absent levels would indicate diluted or substituted non human samples.	When abnormally large quantities of fluids (HO) are consumed in vivo the urine is diluted and creatinine levels are substantially reduced as are other detectable chemical markers including drugs and their metabolites. Alternatively a sample donor may attempt to compromise a test result by adding water to the urine sample (in vitro) to dilute drug concentrations. Creatinine levels are usually checked in conjunction with Specific Gravity to screen for diluted or substituted specimens.
Nitrites Oxidants	Klear, Whizzies UrineLuck	In vitro. Donor adds potassium nitrate to the urine specimen	Nitrates are oxidizing agents that attack the drug or drug metabolite molecules when present. The primary effect of nitrates is to interfere with antibody binding in lateral flow tests and GC/MS confirmation testing of cannabinoid positives. Specimens with abnormally high nitrate levels should be considered as suspect.
pH	N/A	In vivo by ingestion of substances that would change the urine pH values to outside the normal range (virtually impossible) or in vitro when the donor adds a acidic or caustic agent (bleach) to the sample to grossly modify the pH.	The pH of the sample may influence or compromise the enzymatic and antibody reactions in lateral flow drug tests. An extremely high (>9.5) or low (<3.0) pH may depress the enzymatic rate. Also the chemical stability of the drug or drug metabolite may be compromised resulting in a false negative or negative test reaction requiring a retest with a fresh specimen.
Specific Gravity	HO	In vivo. Donor consumes large quantities of liquids (HO) or in vitro, the donor adds fluid (HO) to the urine specimen.	Abnormally low readings of Specific Gravity generally indicate a diluted sample especially when creatinine levels are also low.
Glutaraldehyde	UrinAid ClearChoice	In vitro. Donor adds cleansing agents containing Glutaraldehyde.	Glutaraldehyde interferes with the enzymes used in some lateral flow drug tests resulting in a false negative or invalid test result.

Question: Is the temperature of the urine important?

Answer: Yes. The urine specimen may not be valid if the temperature is not within a certain range. The average temperature of a non-witnessed urine sample returned to the collector is 95 to 97 degrees. The temperature of the collection container will drop the temperature of the urine slightly plus the time it takes to return the sample to the collector must also be considered. Any temperature less or greater than this may not be consistent with normal human urine or a substituted sample. A perceptive and properly trained collector will make a decision to reject or accept the sample if the temperature is out of range. A witnessed collection will eliminate the problem with donors attempting to substitute or alter a urine specimen. A second sample is normally requested when the first is rejected for improper temperature or suspicious activity.

The above guidelines are not for DOT/Federal drug testing and can be found in 49 CFR Part 40.

Question: What are the drug detection periods in urine?

Answer: Drug abuse testing by urine is designed only to detect whether or not a specific drug or drug metabolite is present at the biological moment the sample is collected. While there are very broad estimates as to how long a particular drug may have been in the system, the drug test is not intended to include a time variable. The following chart illustrates typical drug detection periods. For reasons noted, the range stated is necessarily broad. Generally however, chronic use of marijuana by individuals with a high body fat count, low metabolism rate (older) and in poor general health will place drug clearance periods at the higher range.

Urine Drug Detection/Clearance Times
Target Drug	Minimum	Maximum
Alcohol (not EtG test)	1 hour/drink	<=6-12 hours
EtG Alcohol	Depends on volume consumed	Up to 3 days, possibly 5 days
Amphetamines	2-7 hours	2-4 days
Anabolic Steroids	4-6 hours	Oral: 2-3 weeks / Injected: 1-3 months (Naldrolene 8 months+)
Barbiturates	2-4 hours	Short acting type (Alphenal, Amobarbital, Allobarbital, Butethal, Secobarbital) 1-4 days. Long acting type (Phenobarbital Barbital) 2-3 weeks or longer
Benzodiazepines	2-7 hours	Infrequent user: 3 days / Chronic user: 4-6 weeks
Cannabinoids (THC-Marijuana)*	6-18 hours	*Infrequent user: up to 10 days / Chronic user:30 days or longer
Cocaine Metabolite	1-4 hours	2-4 days
LSD	2 hours	A few hours
Mescaline	1-2 hours	2-4 days
Methadone	2 hours	2-6 days
Methamphetamines	1-3 hours	2-4 days
Methaqualone	3-8 hours	Up to 10 days
MDMA (ecstasy)	1 hour	2-3 days
Opiates (Heroin, Morphine, Codeine)	2 hours	2-3 days
Oxycodone	1 hour	1-2 days
Phencyclidine (PCP)*	5-7 hours	*Infrequent user: 6-8 days / Chronic user: 21-28 days+
Propoxyphene	4-6 hours	1-2 days
Psilocybin (Mushrooms)	2 hours	1-3 days
Rohypnol	1 hour	< =8 hours
GHB	1 hour	< =8 hours
Tricyclic Antidepressants (TCA)	8-12 hours	2-7 days

Question: If a urine drug test is positive, can you determine how long ago the drug was taken and over what period of time?

Answer: No. The test can only detect whether or not a specific drug or drug metabolite is present at the time the test is performed. While there are very broad estimates (see chart above) as to how long a particular drug may have been in the system, no fluid based drug test, regardless of method, is intended to include a time variable. Many factors unique to the individual being tested determine the actual half-life of the particular drug including such variables as age, weight, sex, metabolic rate, overall health, body hydration, amount of drug consumed over what period of time, etc. Therefore, no conclusions can be drawn as to when a particular drug was taken or how much was consumed with these types of drug of abuse tests. Only assumptions can be made.

Question: Will a person tests positive for marijuana when claiming exposure to “second hand smoke?”

Answer: No. Urine concentrations of THC above the cutoff sensitivity level of the test, or a positive result, are not possible by exposure to second hand smoke. This is not a valid claim for any smokable form of drug.

Question: Can an individual test positive for opiates if they have been eating poppy seed bagels or other food products containing poppy seeds?

Answer: No. Sensitivity standards were raised to eliminate the possibility of false positive results that were possible from consumption of large quantities of poppy seeds or poppy seed paste at the lower sensitivity level.

Frequently Asked Questions — Hair Testing

Question: How are drugs incorporated into hair?

Answer: Drugs are incorporated into hair by 3 main routes: First is environmental exposure. If an individual is exposed to drug smoke or particulate matter, the drug will physically transfer the parent drug to the hair and bind to it. Second is from the sweat and oil of the scalp. The sweat and oil from the scalp contain drug and drug metabolites. As these fluids bathe the hair shaft, they deposit the drug onto the hair where it binds and is available for analysis. Third is from the blood. As the blood travels through the follicle, it deposits drug and drug metabolites into the core of the hair.

Question: How long after a drug is ingested before it will show in the hair?

Answer: It takes approximately 4-5 days from the time of drug use for the affected hair to grow above the scalp and for the drug to start to show up in a person’s hair. The thickness of the scissors used to cut the hair as close as possible to the scalp is a factor. Adding this to the hair growth rate, the test results will not indicate any drug use in approximately the first two (2) weeks starting with the date the hair was collected. In other words, your window of detection starts two (2) weeks before the hair was collected.

Body hair growth rates are generally slower and cannot be utilized in the same manner as head hair to determine a timeframe of drug use. Body hair grows for 7 to 12 months and then becomes dormant. It falls out and new hair begins to grow. Although the lab report will state approximately 12 month window of detection, it is by no means a 12 month test.

Question: How long are drugs detected in hair?

Answer: Once the drug and drug metabolites are incorporated into hair, they begin to slowly leach out due to normal daily hygiene and exposure to the elements. Head hair grows on average at 0.5 inches per month. After approximately 3 months, most drugs have leached out below the level of detection or to a level not representing an accurate indication of drug use. As such, a standard head hair test covers a period of approximately 90 days.

Question: How much hair is needed for a drug test?

Answer: A standard test with GC/MS confirmation requires 60+ milligrams
of hair or approximately 90 to 120 strands. The thickness of different types of head hair (thick coarse vs. thinning fine) is one reason for this variation.

Question: How long does the head hair sample need to be?

Answer: The optimum length of head hair is 1.5 inches. The hair sample is cut as close to the scalp as possible and the most recent 1.5 inches are tested. Upon receipt at the laboratory, the root end is identified and the specimen is cut at 1.5 inches, which is representative of approximately 3 months of growth. The excess length of hair is sealed and remains with the original sample by most labs. 1.5 inches in length and 90 to 120 strands of hair allows for an initial immunoassay test, 2-3 confirmation tests and a small amount left over for a referee lab, if needed, for re-test.

Question: Can body hair be used if there is no or insufficient head hair?

Answer: Body hair can be used if there is no or insufficient head hair for a test. If body hair is used, the timeframe represented by the test is approximately one year, due to the different growth pattern in hair below the neck. (Refer to previous explanation regarding body hair for more details.)

Question: Does body hair give the same type of results as head hair?

Answer: Yes, body hair can be used to test for the drug classes, though body hair growth patterns are different than head hair. Most body hair is replaced within approximately one year. This means a test done with body hair will be reported as drug usage during approximately a one year timeframe.

Question: Can hair collected from a brush be used?

Answer: Yes. But a timeframe of use cannot be determined and normally the test results from a brush are not admissible in court.

Question: Does the lab perform a confirmation test of all positive hair results in the initial screen?

Answer: Yes, automatic confirmation utilizing GC/MS, GC/MS/MS or LC/MS/MS for all specimens that screen positive in the initial test.

Question: What drugs are included in the standard hair test?

Answer: The standard hair test is a 5-drug panel test which consists of:

• Cocaine and its metabolites
• Methamphetamine, amphetamine, MDMA (Ecstasy), MDA (Ecstasy metabolite)
• Opiates, morphine, codeine
• Phencyclidine (PCP)
• Marijuana

The following additional drugs can be tested for in the hair:

• Benzodiazepines (diazepam metabolites)
• Barbiturates
• Opiates, (additional prescribed not listed above)

• Methadone and EDDP (metabolite)
• Propoxyphene metabolite
• Oxycodone
• Meperidine
• Tramadol
• Fentanyl
• Sufenanil

Question: What are the cut-off levels used for hair testing?

Answer: The cut-off level for each drug varies depending on the type of drug and the lab conducting the test. The standard 5-panel test includes the following drugs and cut off levels:

Drug Class	Screening Cut off level	Confirmation Cut off level
AmphetaminesAmphetamine, Methamphetamine & Ecstasy	500 pg/mg hair	500 pg/mg hair
CocaineCocaine & Benzoylecgonine	500 pg/mg hair	500 pg/mg hair
OpiatesCodeine, Morphine & 6-MAM (Heroin Metabolite)	500 pg/mg hair	500 pg/mg hair
PhencyclidinePCP	300 pg/mg hair	300 pg/mg hair
MarijuanaCarboxy- THC	1 pg/mg hair	0.3 pg/mg hair

Pg/mg= picogram per milligram of hair

Question: Do the results of the hair test tell us anything about the individual’s drug usage?

Answer: Yes. The following chart provides an approximate usage rate based on level reported on the lab report.

Drug	Confirm cut off	Low use(Recreational)	Medium use(weekends/ daily)	High Use(constant or daily)
Amphetamines	500 pg/mg hair	500 pg/mg hair	2500-7500pg	7500+pg
Cocaine	500 pg/mg hair	500 pg/mg hair	500-2000pg	10000+pg
Opiates	500 pg/mg hair	500 pg/mg hair	2000-8000pg	9000+pg
PhencyclidinePCP	300 pg/mg hair	300 pg/mg hair	500-1000pg	2000+pg
Marijuana	1 pg/mg hair	0.3 pg/mg hair	Qualitative – amount does not correlate to usage

Question: Can hair be affected by cross-reacting substances such as over-the-counter medications?

Answer: Enzyme-immunoassay antibodies (EIA), similar to those used to test urine, are used for the initial screening test for drugs of abuse in hair; therefore the potential for substances such as over-the-counter medications to cause a false positive screening result does exist. To eliminate the possibility of reporting a false-positive due to cross-reactivity, the lab automatically confirms by GC/MS, GC/MS/MS or LC/MS/MS all positive initial tests.

Question: Does external exposure to certain drugs, like marijuana or crack smoke, affect the hair results?

Answer: All hair samples are washed extensively to remove external contamination before screening begins. The lab tests for the metabolite of the parent drug to rule out environmental contamination or exposure. For example, to rule out the possibility of external contamination for marijuana, the most labs detect only the metabolite (THC-COOH) which is only produced by the body and cannot be an environmental contaminant. If the ratio of the wash solution is greater than 10% of the confirmation result, the lab will consider this sample still contaminated. If the ratio of the wash solution is less than 10% of the confirmation result, the lab will consider the sample as positive.

One lab will test for exposure with a test called Child Guard. Meaning if only the parent drug is found and no metabolites, the report will state positive. This test can be used to determine if a child or infant has been exposed to illegal drug use by the parent or others. It is important not to wash the child’s hair after exposure and before collecting the sample to be tested. The test will indicate the presence of the parent drug and not the metabolite proving the child is in the environment where drugs are being used.

Question: Will a one-time use of an illegal drug be positive on a hair test?

Answer: It takes multiple uses to test positive under normal drug use, therefore a one-time use will not be above the cutoff level. A person claiming he or she used one time is not a valid claim for a positive test results. The exception may be a person on a continuous binge for several days and that person claims that as a one time use.

Question: Does treatment of the hair affect test results?

Answer: Extensive bleaching, perming and dyeing may damage the protein matrix of hair allowing a portion of the drug within the hair to be extracted, thus lowering the final quantitative result with certain drugs. Normal hair washing helps to remove external contamination. Commonly used hair products (shampoos, conditioners, sprays, mousses or gels) have no significant effect on hair results.

Question: Can you buy adulterants, such as shampoos, to alter the results of a hair test?

Answer: Some shampoos designed and sold with the intent to cleanse the hair of drugs and other toxins have varying degrees of effectiveness. One product on the market will cut the level of drug in half each time it is used. The chemical in the shampoo will burn the scalp or skin after several applications preventing extensive use. A chronic user can lower the level but probably can not eliminate the drug below the cutoff level. But a recreational user, starting with a low level, will probably be below the cutoff level resulting in a negative hair test.

Question: Can hair be affected by cross-reacting substances such as over-the-counter medications?

Answer: Enzyme-immunoassay antibodies (EIA), similar to those used to test urine, are used for the initial screening test for drugs of abuse in hair; therefore the potential for substances such as over-the-counter medications to cause a false positive screening result does exist. To eliminate the possibility of reporting a false-positive due to cross-reactivity, certified labs confirm all positive results by GC/MS, GC/MS/MS or LC/MS/MS

Question: How does hair testing compare to urinalysis?

Answer: In side-by-side comparison studies with urinalysis, hair drug testing has uncovered significantly more drug use. In two independent studies hair drug testing uncovered 4 to 8 times as many drug users as urinalysis.

The primary reason for this difference is due to the longer window of detection for hair compared to urine. Drug users are very educated on drug testing. He or she will refrain from drug use for several days when they know a urine test is imminent resulting in a negative urine test. They will substitute or adulterate the urine sample if the collection is not witnessed resulting in a negative test. Many people will buy shampoos to cleanse the hair but still fail the test as explained previously.

Frequently Asked Questions — Nail Testing

Question: Is fingernail and toenail drug testing new?

Answer: No. Drugs of abuse actually have been measured in nails since 1984. However, it is relatively new to the drug testing industry in the US. Several reasons can be attributed to this. One is the need for longer detection periods that nail test provides. But probably more significant was the increase number of products on the market to negate urine testing and individuals shaving their head and body to avoid a hair test. This has brought the nail testing to the forefront as a needed and useful alternative.

Question: How do drugs get into the nail?

Answer: Like hair, fingernails and toenails are composed of a hard protein called keratin. Drugs are incorporated into nails from the blood stream and remain locked in the nail as it grows. Nails grow in both length and thickness. Drugs enter the nail from the base (cuticle end) as the keratin is formed and via the nail bed that extends under the full length of nail.

Question: How do you obtain the nail for testing?

Answer: Fingernails and toenails can be clipped, or, if length does not allow, the surface can be shaved. Nail polish and acrylic nails must be removed prior to collecting the nail sample.

Question: What is the method for testing fingernails for drugs?

Answer: The method of screening for drug use in nail tests is the same as hair, Immunoassay. The nail is put in a chemical solution to remove external contaminants and is then liquefied. All drugs found in the initial screen are confirmed by on the methods previously explained.

Question: Over what period of time will the fingernail test show drug ingestion?

Answer: Drugs can be identified in nail clippings 2-4 weeks following ingestion and can be detected from 3 to 8 months.The broad range is based on many factors. Fingernails grow (approximately .12 inches per month) faster than toenails (approximately .042 inches per month), longer fingers grow faster than short fingers, age and gender of the person, the time of year, the food the person eats, the dominant hand grows faster than the other hand, etc.

Question: Are there products that one can buy to beat the nail drug test?

Answer: There is one product on the market that purports to ensure that the drug abusing individual passes the fingernail test. It has not proven to be effective at this time.

Question: Can you have a positive nail test from exposure to cocaine?

Answer: Yes, if the person handles cocaine on a regular basis. Nails are porous allowing the cocaine to absorb into the nail. It is important to remember that the nail test results will only be positive for the parent drug cocaine at a very low level and NOT the metabolites of cocaine which are norcocaine and benzoylecgonine.

If the metabolite cocaethylene (alcohol) is positive on a nail or hair test, it proves that the person consumed alcohol at the same time as the cocaine.

Frequently Asked Questions – Alcohol EtG Test

Question: What are the problems with detecting alcohol in the body using the current blood, breath, saliva and urine methods?

Answer: Alcohol is rapidly eliminated from the body at a rate of approximately one drink per hour. Whether looking for alcohol in breath, blood, saliva or urine, using the standard technology, the rapid elimination limits the detection of alcohol to a matter of hours.

For example, an individual who was “under the influence” of alcohol using standard technologies (breath, blood or saliva > 0.8%) at 10 PM would likely test negative the next morning at 9 AM due to the rapid elimination of alcohol from the body.

Question: Is there a test that can detect alcohol consumption for a period longer than a few hours.

Answer:Yes, the EtG test. After years of research, Ethyl Glucuronide (EtG) was found to be a direct metabolite of the alcohol (ethanol). EtG has emerged as the marker of choice for alcohol and due to the advances in technologies is now routinely available. Its presence in urine may be used to detect recent alcohol consumption, even after ethanol is no longer measurable using the older methods. The presence of EtG in urine is a definitive indicator that alcohol was ingested.

Other types of alcohol, such a stearyl, cetyl and dodecanol, metabolizes differently and will not cause a positive result on an EtG test.

Question: How long can EtG be detected in urine?

Answer: The EtG test has become known as the “80 hour test” for detecting any amount of consumed ethyl alcohol. This is not totally true. It is true that EtG can be detected in chronic drinkers for 80 hours or even up to 5 days. During this period of chronic use, the EtG level can exceed 100,000 ng/mL. Two primary factors to determine the window of detection is based on volume of alcohol consumed and the time between each drink. A person that consumes 3 drinks can only have a detectable level of EtG for approximately 20 to 24 hours and peaks at approximately 9 hours with an EtG level around 15,000 ng/mL.

Therefore, the presence of EtG in urine indicates that ethanol was ingested. EtG is a more accurate indicator of recent consumption of alcohol than measuring for the presence of ethanol itself.

Question: How stable is EtG in urine?

Answer: EtG is stable in urine for more than 4 days at room temperature. Recent experiments indicate that heating urine to 100 degrees C actually increased the stability of EtG. Therefore, heat does not cause the breakdown of EtG, it actually increases stability. In addition, no artificial formation of EtG was found to occur following the prolonged storage of urine at room temperature fortified with 1% ethanol.

Question: How accurate and reliable is the EtG test?

Answer: EtG is a direct metabolite of alcohol (ethanol), and its detection in urine is highly specific, similar to testing for other drugs. The typical lab utilizes the most sophisticated, sensitive, and specific equipment and technology available, LC/MS/MS, to screen, confirm, and quantitate EtG. This methodology provides highly accurate results.

Question: Can residual EtG be detected in the urine of long-term alcoholics who abstain?

Answer: Studies indicate that alcoholics in abstinence have no detectable levels of EtG in their urine after approximately 80 hours of detoxification.

Question: Is there a problem in the test results caused by the urine alcohol produced by fermentation?

Answer: EtG is only detected in urine when alcohol is consumed. This is important since it is possible to have alcohol in urine without drinking. Alcohol in urine without drinking is due to the production of ethanol in vitro. Ethanol in vitro is spontaneously produced in the bladder or the specimen container itself, due to fermentation of urine samples containing sugars (diabetes) and yeast or bacteria. Since the ethanol produced is not metabolized by the liver, EtG will not be produced and will therefore not be detected in a urine containing alcohol as a result of fermentation.

Question: Will the use of incidental alcohol, such as mouthwash, over-the-counter (OTC) cough syrups or non-alcoholic beer, trigger a positive result?

Answer: Yes. Tests show that “incidental exposure” to the chronic use of food products (vanilla extract), hygiene products, mouthwash, or OTC medications (cough syrups) can produce EtG concentrations in excess of 100 ng/mL. However, if measurable ethanol is detected (greater than .04 gm%) in the urine, and EtG is also detected in excess of 250 ng/mL, then this is very strong evidence that beverage alcohol was consumed.

Labs will allow you to select 100, 250 or 500 ng/mL as the cutoff level. It is strongly recommended that only the 500 ng/mL level be used. This avoids and eliminates any claim by the donor that the positive EtG test is a result of incidental or unintentional exposure. All testing performed on products or foods classified as incidental or unintentional exposure has never produced a positive EtG level greater than 500 ng/mL.

Question: What are the key benefits of using the EtG test?

Answer: The benefits include:

• Detects recent usage more accurately and for a longer period of time than standard testing
• No false positives
• No EtG found in non-drinkers
• Ideal for zero tolerance and abstinence situations
• Strong indicator of alcohol ingestion within the previous 3 to 5 days
• EtG is only evident when alcohol is consumed and is not produced as a result of fermentation
• Allows monitoring in alcohol treatment programs
• Acts as an early warning system to detect trends towards relapse

Frequently Asked Questions — SCRAM

Question: What does SCRAM mean?

Answer: SCRAM (Secure Continuous Remote Alcohol Monitor) is a tool that helps courts and agencies continuously monitor their alcohol offenders to ensure they’re not drinking. It was developed by a company that calls itself Alcohol Monitoring Systems, Inc.

Question: How does the SCRAM system work?

Answer: The SCRAM device is worn as an ankle bracelet, and while in place the device monitors the subject’s blood alcohol transdermally, meaning it measures the migration of alcohol through the offender’s skin. The measurements obtained are then converted from a perspiration alcohol level to a blood alcohol content. While the common acronym for blood alcohol is BAC, and for breath BrAC, AMS saw fit to trademark a new acronym TAC for this purpose, which now means transdermal alcohol content.

Question: How does the transdermal alcohol testing work?

Answer: Transdermal alcohol monitoring means that alcohol is measured “through the skin.” Transdermal testing measures the concentration of alcohol present in the insensible perspiration that is constantly produced and given off by the skin. If an individual has been drinking, it shows up in the level of ethanol vapor present in this insensible perspiration.

While transdermal testing cannot determine exact blood alcohol concentration (BAC) levels, it can qualitatively determine whether a person drank a little, a moderate, or a large quantity of alcohol (transdermal alcohol content or TAC). TAC results correlate well with BAC results. However, because of the way alcohol is absorbed and processed by the body, TAC peaks typically are reached 30 minutes to two hours after BAC peaks.

Question: What are the components of the SCRAM?

Answer: there are three components to the SCRAM:

• The SCRAM bracelet
• The SCRAM modem
• SCRAMNET

Question: What is the SCRAM bracelet?

Answer: The patented SCRAM ankle bracelet is attached to the offender with a durable and tamper-proof strap. It is worn 24/7 by the individual for the duration of his or her court-ordered abstinence period. The bracelet weighs 8 ounces and is strapped around someone’s ankle.

Twice an hour, the bracelet captures transdermal alcohol readings by sampling the insensible perspiration collected from the air above the skin. The bracelet stores the data and, at pre-determined intervals, transmits it via a wireless radio-frequency (RF) signal to the SCRAM modem.

Attributes

• Tamper and water resistant
• Samples insensible perspiration every 30 minutes (2x per hour)
• Automatically collects, stores, and transfers all data via the SCRAM modem on a predetermined schedule (at least 1x/day)
• Date- and time-stamps readings for easy reporting and analysis

Question: What is the SCRAM modem?

Answer: The SCRAM modem is the mechanism by which the data that is collected by the SCRAM bracelet gets transmitted to Alcohol Monitoring Systems (AMS) for analysis and reporting.

When the SCRAM bracelet is installed on the offender’s ankle, he or she also receives the SCRAM modem, which plugs into an analog telephone line – usually in the individual’s home or place of work. At a pre-scheduled time(s) each day, the SCRAM bracelet “communicates” with the SCRAM modem, and the modem retrieves all available data from the bracelet. The modem also downloads monitoring and reporting schedules to the bracelet.

Attributes:

• Plugs into any telephone LAN line
• Stores alcohol readings, tamper alerts, and diagnostic data uploaded from the SCRAM bracelet
• Sends all data to SCRAMNET over the phone line
• Downloads monitoring and reporting schedules from SCRAMNET to the SCRAM bracelet

Question: What is the SCRAMNET?

Answer: When data is received from the SCRAM modem, it is stored in SCRAMNET, the web-based application managed by AMS where offender data is collected, analyzed, and maintained in a secure, central location.

Where the SCRAM bracelet is the heart of the SCRAM system, SCRAMNET is the brains. It is the information hub that not only houses all offender data, but lets you manage it in the way that is the most effective for your offender management program.

SCRAMNET provides a wide range of reports and graphs at your fingertips – from a snapshot of a single event to a comprehensive view of an offender’s behavior over time. SCRAMNET lets you customize and easily tailor the reporting that best suits your needs and individual cases, and helps reduce your workload through exception-based reporting.

Attributes:

• Can be accessed around-the-clock, from any location, using a standard web browser
• Provides exception-based reporting to reduce workload
• Flags and graphically depicts any alcohol ingestion, tampers, or removal attempts
• Lets you easily customize testing, synchronization, and reporting schedules for each offender
• Provides customized reports and graphs to best suit your information needs
• Allows you to cost-effectively monitor and manage numerous offenders simultaneously

Question: What does SCRAM cost?

Answer: There is a $75 fitting fee. Thereafter, the cost per month is approximately $360.00 ($12.00 per day).

Question: Can the person take the bracelet off to avoid the testing?

Answer: Once the bracelet is strapped on with a locking clip, the client cannot take it off.

Question: Can the individual bathe with the SCRAM bracelet on?

Answer: The SCRAM bracelet is water-resistant, so the individual does not have to remove the bracelet to shower. However, it cannot be submerged in water, such as bathtubs or hot tubs.

Question: What happens if the person consumes alcohol?

Answer: Alcohol consumption or attempts to obstruct the device’s measuring capabilities are immediately reported via computer, and local authorities or attorneys in a family case, are notified.

Question: Is the individual monitored 24 hours a day?

Answer: Yes. The readings offer a round-the-clock glimpse into the individual’s life. You can tell when the individual is a asleep and when they get up.

Question: Can the SCRAM bracelet detect if the individual is attempting to distort the readings?

Answer: Yes. Besides measuring ethanol vapor and temperature, the bracelet also contains an infrared distance detector that can tell if an offender has tampered with the device, such as trying to shove an obstruction between his ankle and the bracelet.

Question: What are the advantages of using the SCRAM system over other methods of monitoring?

Answer: SCRAM offers significant advantages to the courts and supervising agencies that use them, as well as to the clients themselves. Some of the key benefits of SCRAM include:

Continuous Testing

While blood and breath tests only measure sobriety at a specific point in time, SCRAM samples the offender’s sweat as often as every half hour. This gives you complete 24/7 coverage, rather than just a snapshot look at when alcohol offenders are on their best behavior.

Increased Accountability

Because SCRAM gives a complete, around-the-clock data on whether or not the individual is consuming alcohol, they can’t drink around testing schedules or lie about their actions. In fact, SCRAM makes it very difficult for them to consume alcohol or tamper with the device without being caught.

Non-Invasive, Automated Testing

Because SCRAM’s testing process is automated, it requires no labor on your part or appointments to administer tests. Once it’s installed on the offender’s ankle, it does all the work for you.

Question: Have the Court’s accepted the SCRAM technology?

Answer: Yes. Continuous transdermal alcohol monitoring technology has been accepted in evidentiary hearings across the country. In Texas the first Frye or Daubert hearing was in July 2007, and several thereafter. Texas courts have recognized that the device is accurate, reliable, and generally accepted.

Question: What kind of impact can the SCRAM technology have on the individual wearing the bracelet?

Answer: SCRAM is an effective assessment tool that lets you better gauge drinking patterns and evaluate addiction levels to tailor individualized treatment programs.

SCRAM is an effective deterrent to keep individuals from drinking and gives them the opportunity to finally get – and stay – sober. Combining that with treatment gives them the best chance for long-term change, and allows them to maintain family obligations, hold jobs, and contribute positively to the community.

Question: How can SCRAM help Family Law Judge?

Answer: Judges are in a precarious position of figuring out how to balance giving a parent a chance to stay sober and parent while protecting the child if the parent is unable to do so. While the Judge may want to give the alcohol offenders the benefit of the doubt that they’re staying sober as directed, it’s hard to know for sure what they’re doing unless you monitor them around the clock.

SCRAM lets Judges:

• Gauge offender drinking patterns more effectively
• Assess levels of addiction to appropriately tailor fair and individualized treatment
• Be more confident in giving offenders the benefit of the doubt
• Better balance the offender’s needs with the need to protect the child

Question: How can SCRAM help the attorney that is representing the alcoholic parent?

Answer: Attorneys can use the SCRAM as a valuable tool to help prove their clients are staying sober. Savvy attorneys are using the data generated by SCRAM to factually assess offenders for alcohol misuse issues and, more importantly, provide solid evidence that shows their clients can – and are – abiding by court-ordered abstinence. Attorneys can also use SCRAM results to better assess individual client treatment needs.

Question: Can SCRAM be used by a consulting expert?

Answer: In Texas, Recovery Healthcare Corporation is the exclusive service provider for SCRAM. The principals of RHC are Larry Vanderwoude, LCDC and is a consulting expert for all dependency issues. Vickers L. Cunningham, Sr. is a retired Texas District Judge and is available as co-counsel and/or consulting expert witness.

Attorney Tips

Tip: Educate yourself regarding drug/alcohol usage and testing.

The first step in handling a family law matter involving substance abuse is to educate yourself regarding drug/alcohol usage and the various types of testing so that you can appropriately and adequately represent your client. If you are not educated regarding drug/alcohol usage and testing, then you may harm your client’s case from the very beginning. The information provided in the “Frequently Asked Questions” part of this paper will provide you with the working knowledge that you need to handle a case involving substance abuse.

Tip: Know your client’s substance abuse history.

You should know your client’s drug/alcohol history before you either ask for drug/alcohol testing of the opposing party and/or put your client on the stand to testify. If your client alleges that the other party has a substance abuse problem, then take the time to explore what involvement your client has had with drugs/alcohol. If one party is using illegal drugs, there is a high likelihood that the other party is, or has, also used illegal drugs. Remember what is good for the goose is good for the gander. If you ask for drug/alcohol testing of the opposing party, it is probable that the opposing counsel will ask that your client be tested as well. Make sure you are knowledgeable regarding your client’s drug/alcohol history so that you can avoid any surprises and know how to proceed in the case.

Tip: Determine a strategy for handling your client’s substance abuse problem.

If your client acknowledges a substance abuse problem, then it is likely that the opposing counsel will bring this issue to light if there is a hearing. For this reason, you may want to consider cushioning the impact of this fact by having your client admit to his/her substance abuse history up front. By doing so, the Judge will get to hear the story first through your own client instead of through the opposing counsel. A prevailing theme should be that your client is taking responsibility for his/her actions and is seeking the appropriate treatment.

Tip: Take action if you believe that your client is using illegal drugs but won’t admit this fact to you.

Many clients will lie to his/her attorney about drug use. If you have reason to believe that your client is using illegal drugs but they do not admit to this fact, you may want to pre-test the client prior to a court hearing. Many pre-tests are positive. It is not uncommon for the attorney to call the testing facility for an explanation as to why the client tested positive when the client has denied that he/she has never used drugs. The answer given by the testing facility is simple – ” your client is lying”.

If you are going to pre-test your client, test your client today not tomorrow. Do not give your client the opportunity to alter the results as explained earlier in this paper. Even if your client acknowledges a substance abuse problem, you may still want to consider sending your client for drug/alcohol testing or treatment before filing an action or appearing for a court hearing.

If you elect to pre-test your client, make sure you take the appropriate steps to shield the test results from discovery.

Tip: Know when to raise the issue of the opposing party’s substance abuse.

If you are seeking temporary orders, consider whether you want to include a request for drug/alcohol testing in the pleading requesting temporary orders. By requesting drug/alcohol testing in a pleading, you are giving the opposing attorney and party notice of an impending test. This pre-warning gives the opposing party the opportunity to stop his/her usage and to take steps to alter the results of a future test. If the Court in your jurisdiction will issue an order for drug/alcohol testing without a pleading on file if the issue is raised at a hearing, then you may want to wait and raise the issue at the time of the hearing.

Tip: Formulate a plan for questioning the opposing party regarding his/her use of drugs/alcohol.

In deciding whether to order testing, Judges will be evaluating the credibility of the testimony before them. Most litigants are not familiar with the technical nuances of the various drug-testing methods. As such, they do not understand the ramifications of their answers to questions regarding drug/alcohol usage. If your questioning of the witness is to provide information that is valuable in determining what test to use and whether the witness is being truthful regarding his/her drug/alcohol usage, then you must have a good working knowledge of the types of drugs, the length of detection time and the various testing methods.

How you approach the issue of drug/alcohol usage with the witness will have a significant impact on the information that you are able to obtain. If you commence the questioning with a question like “have you ever used illegal drugs” you are giving the witness an opportunity to lie with the very first question asked. It is important to very specifically question the witness regarding his/her drug/alcohol usage so that you can determine what test(s) needs to be administered and what the result should be based on the testimony. If the witness tests positive for an illegal drug or alcohol when based on his/her testimony the result should have been negative, then the credibility of the witness is negatively impacted.

The following are example questions to use with a witness that you believe has in the recent past abused illegal drugs. The answers to these questions will provide you with the information you need to determine the type of test(s) to request that the Court order and what the results of the test should be based on the testimony.

• When is the last time you used illegal drugs?
• What drug(s) did you use?
• How much?
• How did you injest the drug? (inject, smoke, snort)
• Who was present with you when you used the drugs?
• Do you have friends that use drugs?
• Do you go to events, locations, etc where other people are using drugs?
• When is the last time you used illegal drugs before the last time you just told me about?
• (then repeat sequence above if there was a prior usage)

If appropriate continue with the following questions:

• Based on the testimony you just gave me, it would appear that you should be negative on a drug test. Is there any possibility that you could be positive on a drug test administered today?

In addition, you may want to question the witness about the following topics which may provide additional information regarding whether there is a substance abuse problem:

• Arrest record
• Criminal convictions
• Treatment for drug usage
• Reports to CPS
• Car wrecks
• Allegations of family violence

Tip: Request the Judge to issue certain orders to insure that the drug/alcohol test result is valid.

There are many different ways a person may try to “beat” a drug/alcohol test. Before the Judge sends the witness for the test, you should request that the Judge issue certain orders to help prevent the witness from altering the test results. The following are several examples of orders/findings of fact that the Judge can issue to help insure the validity of the test:

• If hair testing is to be used:
  • Do not cut your hair.
  • Do not bleach or dye your hair.
  • The testing facility may use body hair if there is insufficient head hair.
  • If there is no, or insufficient head hair, then do not shave your body hair.
  • Issue a finding on the color and length of hair before the party leaves the courtroom.
• If fingernail testing is to be used:
  • Do not cut your nails.
  • Issue a finding on the length and condition of the nails before the party leaves the courtroom.
  • Do not apply artificial nails.
  • If the party has her nails polished or has artificial nails, order that the polish and/or artificial nails be removed.
• If urine testing is to be used:
  • Order that the testing facility witness the collection of the urine.
  • Do not drink any liquids before the testing, unless so instructed by the testing facility.
• For any test:
  • Order that the witness appear at the testing facility in a specific time frame for the test.
  • If the witness does not have sufficient cash to pay for the test at the time of the test, order that the sample be given in the time frame ordered and that payment be made within a specific period of time. (In Dallas County, the testing facility will then hold the sample for the specified period of time. If payment is made, the sample is then submitted for testing).

Tip: Terms that should be included in the Order for drug/alcohol testing.

Depending on the facts of your case, some, or all of the following terms should be included in an order for drug/alcohol testing:

• Testing facility – Specifically identify the testing facility, including name address and telephone number.
• Testing method – Identify the specific test(s) to be administered. If prescriptions are abused, make sure the order includes the specific drug or drugs so the drug testing company will request the correct testing panel. Testing panels are not the same at each drug testing company or lab.
• Frequency of testing – If the testing is to occur more than once, then the frequency of the testing needs to be specifically set forth in the order.
• Logistics of testing and cost of testing – Two major factors affecting a party’s ability to comply with drug testing is the cost of the testing and the logistics surrounding the testing. For, example, the work schedule of the party may need to be balanced with the availability of transportation and the hours of operation of the testing facility.
• Who is to pay for the testing – The testing Order should specifically set forth who is to pay for the test. If the opposing party is to pay for the test, then you need to add provisions that address when payment is to be made and the consequences if the opposing party fails to pay.
• Length of testing – The testing Order should specifically provide how long the drug/alcohol testing is to occur.
• Who is entitled to receive the test results – The opposing party and/or attorney will want a copy of the test results directly from the testing facility. The testing facility will either want a release signed by the party or an order to this effect.
• Confidentiality of test result -It may be appropriate that the test results remain confidential and that the test results be limited to the adjudication of custody and visitation matters. You may want your temporary order to specify that the results may be released to specified, authorized persons, such as experts, the mental health professionals involved in the case, etc.
• Consequences of a positive result or failure to comply with the orders regarding the testing– Compliance with testing is enhanced when the party is clearly informed of the consequences of noncompliance and the details of the testing requirements. As such, the testing Order needs to be as specific as possible with respect to testing time, testing protocol and consequences. Possible consequences that may be included in an order include:
  • Failure to appear for the test or an invalid test result will be treated as a positive test result.
  • Visitation may be limited to no overnights.
  • Visitation may be supervised.
  • Visitation may be abated until further order of the court or agreement of the parties.
  • The party may be ordered to commence treatment.

The unwritten consequence of noncompliance with the testing Order is that the credibility and trustworthiness of the party is negatively impacted in the eyes of the Court.

Tip: Make sure you and your client understand the Court’s ruling regarding drug testing before you leave the courtroom.

It is critical that you as well as your client understand the Court’s ruling regarding drug testing before leaving the courtroom. If you or your client fail to do so, then your client may not properly comply with the Court’s ruling and suffer adverse consequences.

Tip: Use a reputable drug testing company.

You should not just pick a testing facility out of the phonebook. All drug testing facilities are not the same. Make sure you use a drug testing facility that you can trust and that is accessible to you to answer any questions you have. It is also important that the drug testing facility takes the necessary action to confirm the identity of the donor and checks the validity of the sample.

Tip: Provide your client with information to give to the testing facility.

Drug testing results are of no benefit if you do not receive the results from the testing facility. You should provide your client with your phone number, fax number and even your name so it can be given to the collection site to send results. Many times the donor does not know this information. He/she must call the attorney or office to get the information but usually just leaves it blank. The collection site, may or may not, search for the required information to get the results to the attorney.

Court Cases Discussing Hair Testing

Child Custody

1. Raney v. Raney, Warren App. No. CA98-07-084, unreported (February 1, 1999)(1999 WL 58162)(Ohio App. 12 Dist.) Drug testing may be ordered or agreed to when the best interest of a child is at stake. *3. Under Chandler v. Miller, 520 U.S. 305 (1997), a court may order drug testing based on “individualized suspicion” of a person. Id. Based on testimony of wife that husband used drugs and husband’s admitting to prior drug usage, order for husband to submit to drug testing not an abuse of discretion. Id.

2. In the Matter of the Adoption of Baby Boy L, 157 Misc. 2d 353, 596 N.Y.S. 2d 997 (1993) Based on evidence presented to the court, the court found the process of Radioimmunoassay testing of human hair, when used in conjunction with GCMS confirming procedures, had been accepted by the scientific community as a reliable and accurate method of ascertaining and measuring the use of cocaine by human subjects. Baby Boy L, 596 N.Y.S. 2d 997, 1000. Thus the results of Radioimmunoassay testing of human hair may be offered into evidence. Id. The ultimate acceptance of such results or the weight to be accorded those results is to be resolved by the trier of fact who may consider any challenge to the particular method of hair sampling or to the soundness, propriety or accuracy of the particular lab’s work or to any substantial testing defect that may produce a suspect result. Id.

3. Burgel v. Burgel, 141 A.2d 215, 533 N.Y.S. 2d 735 (1988) A broad scope of reasonable discovery is permitted by the New York courts when the welfare and best interest of a child is at stake. Burgel, 141 A. 2d 215, 217. Trial court did not improvidently exercise its discretion in granting husband’s request for a physician to conduct the minimally invasive Radioimmunoassay test because the material sought is relevant, and reasonable grounds exist for the request. Id. at 218-19.

Employment/Unemployment

4. Matter of Brown v. City of New York, 250 A.D.2d 546, 673 N.Y.S.2d 643 Speculative assertions by Appellant that minimum standards of hygiene were not maintained in the collection of a hair sample and a negative second hair test whose results were not certified are of minimal probative value to prove the City acted in bad faith by firing Appellant for a positive hair sample drug test. Brown, 250 A.D.2d 546. Additionally, the use of hair sample drug tests on probationary employees but not tenured employees does not violate the due process rights or equal protection of the probationary employees. Id. at 546-47.

5. Bass v. Florida Department of Law Enforcement, 627 So.2d 1321 (Fl.1993) Per curiam opinion simply holds the evidence submitted by Bass should have been admitted in the initial administrative proceeding. Bass, 627 So.2d 1321. In a concurring opinion which gives more facts than the per curiam, the court determined the Radioimmunoassay hair testing is generally accepted in the scientific community and, therefore, meets the test for admissibility of novel scientific evidence as held in Frye v. United States, 293 F. 1013 (D.C.Cir.1923). Id. at 1322 (concurring).

6. Brinson v. Safir, 680 N.Y.S. 2d 500, 255 A.D. 2d 247 (1998). The use of hair analysis drug testing was previously held as reliable by the court and the record in this case supported the determination that there was reasonable suspicion to order petitioner to undergo drug testing. Brinson, 255 A.D. 2d 247. Additionally, the record in this case supports the court’s finding that neither a mistake in transcribing the subject identification number nor the improper placement of test tubes in the centrifuge (which resulted in retesting), in any way affected the accuracy of the test results. Id.

7. Nevada Employment Security Department v. Holmes, 914 P.2d 611 (Nev. 1996) Court held that Radioimmunoassay testing, especially when coupled with a confirmatory GC/MS test, is an accepted and reliable scientific methodology for detecting illicit drug use. Holmes, 914 P.2d 611, 615.

Probation/Parole

8. United States v. Medina, 749 F. Supp. 59 (E.D.N.Y. 1990) Extensive research and writings on the Radioimmunoassay hair analysis establish its reliability and its acceptance in the field of forensic toxicology when used to determine drug use in probation violation proceedings. Medina, 749 F. Supp. 59, 61. In addition to determining a general theoretical soundness before admitting relatively novel scientific evidence, the court should determine that (1) the sample was properly obtained, (2) the particular laboratory technique used was sound and (3) the laboratory was careful and accurate in its use of that technique. Id. at 61-62.

Most Recent Cases

9. U.S. v. Bush, 47 M.J. 305 (U.S. Armed Forces, 1997) No abuse by the lower court by allowing Bush’s positive hair testing in as evidence. First such case in a military court to use hair testing to uphold a conviction rather than a urinalysis.

10. In re Brown, 952 P.2d 715 (Cal. 1998) The drug hair test was not specifically challenged by the Defendant but the Court stated in a footnote that its admissibility would have been upheld if challenged. Brown, 952 P.2d at FN12.

11. Jones v. City of Boston, 829 N.E.2d 264 (Mass. App. 2005) Other jurisdictions have admitted hair tests in cases involving employee’s termination for drug use. Jones, 829 N.E.2d at FN8. This Court specifically cited to Nevada Employment Security Department v. Holmes, 914 P.2d 611 (Nev. 1996). Id.

12. Tauck v. Tauck, 2007 WL 1053922 (Conn. Superior 2007) Collection, testing and measuring on hair testing for drug abuse is scientific. *6.

13. In re A.L.E., 279 S.W.3d 424 (Tex.App.-Houston [14^th Dist.] 2009, n.p.h.) This case did not specifically rule on the admissibility of the hair test. It was a review of an order requiring a mother to undergo three types of drug tests periodically to retain visitation with her children, one of the tests being a hair test. A.L.E., 279 S.W.3d at 432.