Drug Testing for Criminal Justice Involved Individuals in Michigan

Transcription

1 Drug Testing for Criminal Justice Involved Individuals in Michigan Oakland County Drug Court Professionals Barbara M. Hankey, Manager Oakland County Community Corrections

2 Session Goals O To present the best practices in the area of drug testing. O To gain a better understanding of how these best practices fit within drug court and the criminal justice system as a whole. O To educate individuals about drug testing practices so informed decisions can be made about program utilization. O To ensure drug testing programs meet the 10 Principles of a Good Testing Program

3 Why is Drug Testing so Important? O Drug Testing is the 5 th Key Component of the 10 Key Components of Drug Courts O Done incorrectly it can severely undermine the integrity and credibility of your program O Studies show that fidelity to the model is crucial for the success of a program.

4 Drug Testing Methodologies O Oral / saliva testing O Sweat patch O Hair testing O Urine testing O Immunoassay Drug Screening O Point of Contact (Instant) Testing Devices O Automated testing

5 Reading a POC test

6 Testing Procedures O Collection site O Specimen collection O Monitoring O Staffing

7 Donor Requirements O Responsibilities / expectations of the donor O Donor Identification requirements O Some programs provide a picture ID to the client O Some programs will allow a booking photo with identifying information printed on the document

8 The Sample O Adequate volume O 30ml or more O Temperature O no exceptions O Physical Characteristics O Color O Smell O General appearance

9 Adulteration Testing O All samples must be checked prior to additional testing O At a minimum an adulteration test should include creatinine, Nitrite, ph, bleach, and specific gravity

10 Response to Adulterated Samples O The donor is requested to provide subsequent samples until a normal reading is achieved O The test is noted as dilute and reported to the referring agency for action O Complete the immunoassay test and send the sample for GC/MS confirmation regardless of the initial test result

11 Test Results O Negative O Record on chain of custody O Client is free to go O Positive O Client is questioned about last date and time of use O To confirm or not confirm

12 Confirmation Testing Policy Options O All positives are sent for confirmation testing O Donor admits to recent drug use and therefore a confirmatory test is not necessary. O The donor is given the option of having the sample sent for confirmation. If the donor has provided a valid prescription for which a known cross reaction may occur. A confirmation in this instance may not be necessary each time the donor is tested. However random confirmations on these positive tests will ensure that no other substances are being used.

13 The Faint Line O The test band is barely visible, is broken, or is faint O Most manufacturers will advise that if the test band is visible at all, regardless if it is faint, broken or otherwise, that it is a negative test O Be CONSISTENT in it s interpretation

14 Cutoff Levels O Cutoff levels have been developed by professionals to ensure: O that the detection accuracy can be scientifically supported (avoids issues such as passive inhalation) O that legal protections regarding evidentiary admissibility are met. O Be sure all your testing programs are using the same cutoff levels

15 Cutoff Levels O A specimen that is found to contain a drug or drug metabolite in an amount above the established cut off level will yield a positive result. O A specimen that contains a drug or drug metabolite in an amount below the established cut off level, will yield a negative result O It is important to understand that a negative result does not necessarily mean that no drugs were detected. It simply means that the specimen yielded a drug concentration that was below the cut off level.

16 Using Cutoff Levels O Employing cutoff levels below the recommended levels may have therapeutic value O Under NO circumstances should a drug court ever sanction a client for levels that are below the cutoff level

17 Not only is the evaluation of urine drug levels in a negative sample the antithesis of the intent of drug testing, but it also violates standards of evidence admissibility. In short, this practice is unethical. A negative test result cannot be interpreted in any other manner than negative. Paul Cary

18 The Question of Levels O Levels should never be reported. In fact Federal Workplace Guidelines prohibit the use of levels in drug test reporting O Drug tests are designed to determine the presence or absence of drugs NOT their concentration It is almost certain that urine drug levels are being used inappropriately in the court s decision making process

19 The Answer O Eliminate the use of levels from all programs O Establish an elimination benchmark for THC O a period of time after which an offender / participant / client would be expected to test negative regardless of past usage (30 days) O New use v. Continued Excretion O Creatinine normalized approach O Non-normalized approach

20 Confirmation Testing O Any positive screening test result that is called into question by the donor or may result in a loss of freedom (incarceration) for the donor should be confirmed O Be sure that samples are being confirmed using GC/MS or LC/MS/MS only. O Some forensic labs do not use cutoff levels which can lead to confusion. Know what you are looking at and ask questions!

21 Understanding Lab Reports O The Confirmatory lab may list the analyte rather than the parent drug O For instance it may list Benzoylecgonine which is the analyte for cocaine O Forensic labs may not list positive or negative only the ng/ml level. O A report may show Cocaine 0 ng/ml Benzoylecgonine 150 ng/ml

22 Which lab? O Labs that employ O GC/MS and GC/MS/MS O LC/MS and LC/MS/MS O Have one of the following certifications O Substance Abuse and Mental Health Services Administration (SAMHSA) O College of American Pathologists (CAP) O College of American Pathologists (CAP) - Forensic Drug Testing (FDT) Certification O Clinical Laboratory Improvement Amendment (CLIA)

23 Alcohol Testing O PBT O Must be calibrated monthly (depending on usage) O Truncating of digits to 2 decimal places O Proper waiting period between tests O EtG / EtS O Should not be used as a confirmatory test for a positive PBT O There are no standardized cutoffs

24 What if? O A client blows a positive PBT O What is the program s policy? O Is there any liability? O Minors that blow positive PBT O.02 v.08

25 Testing Frequency and Randomness O It depends on the drug and the goals of the program O Clients should not be told how often they will be tested O Clients will eventually figure out how often they are being tested, therefore programs need to be proactive

26 Policy Considerations Dilute Samples O Consider the test a Positive and sanction according to policy O Consider the test a Dilute with unique sanctions O Consider the test a Tamper with more severe sanctions than a positive O Allow for one Dilute sample per phase / quarter, etc.

27 Policy Considerations Missed Tests O Under no circumstances should missed tests be tolerated in a drug / sobriety court setting O Missed tests should be treated as positives and sanctioned accordingly O Make-up Policy???

28 Policy Considerations Medications O Prescription medications will need to be tracked O Positive tests, as a result of medication, should not be reported as a negative test O Questions about cross reactively should be referred to the manufacturer O Medical Review Officers (MRO)

29 Policy Considerations Retention of Samples Retention of Records O Positive samples should be kept for a minimum of 90 days O Samples should be frozen O Programs need adequate space for positive samples O There are currently no standards O Suggested that programs keep testing results for a minimum 12 months

30 Confidentiality Drug Court Probation O Drug courts meet the definition of program and therefore test results are subject to federal confidentiality laws O The Court is not considered a program and therefore test results are not subject to confidentiality laws

31 Questions?? O SCAO distributed this manual as a Bench Book to all judges in the State of Michigan O Copies were provided in your registration packets O Barbara Hankey hankeyb@oakgov.com