On-Site Drug Testing

, by Jenkins, Amanda J.; Goldberger, Bruce A.; Finkle, Bryan S.; Golberger, Bruce A.

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ISBN: 9780896038707 | 089603870X
Cover: Hardcover
Copyright: 1/1/2002

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Today on-site drug testing is used widely in the workplace, the justice system (probation and parole), hospital emergency rooms, physician offices, and rehabilitation programs. In On-Site Drug Testing, scientists and forensic toxicologists critically evaluate the on-site devices currently available, their validation studies, and their use in a variety of settings. For each device, the expert contributors discuss its principles, materials and reagents, procedures and interpretation, and performance. The tests applied include both therapeutic drugs (lipid-lowering medications, antithrombotic medications, and anticoagulant drugs) at the point of clinical care and drugs of abuse (alcohol, amphetamines, benzodiazepines, cannabinoids, cocaine, and opiates) in the workplace and the criminal justice system. The well-versed contributors also address critical issues in sample collection and adulteration, and in program standards and legal requirements in workplace testing. Comprehensive and authoritative, On-Site Drug Testing illuminates the state of on-site drug testing today, and provides all those responsible a firm basis for choosing the best test devices and techniques most suited to their purposes.

Foreword

vii

Bryan S. Finkle

Preface

Contributors

xxi

Clinical Point-of-Care Testing for Drugs of Abuse

(10)

Jimmie L. Valentine

General Considerations

(1)

Pediatric Clinical Considerations

(1)

Adolescent Clinical Considerations

(2)

Adult Clinical Considerations

(2)

Physiological Considerations for Clinical Testing

(1)

Conclusions

(3)

References

(2)

On-Site Tests for Therapeutic Drugs

(14)

Alan H. B. Wu

Rationale for Therapeutic Monitoring and Need for On-Site Drug Testing

(1)

On-Site and Point-of-Care (POC) Drug Testing

(1)

Direct On-Site Testing Instruments and Devices for Therapeutic Drugs

(2)

Indirect On-Site Testing for Therapeutic Drugs

(7)

Monitoring of Lipid Lowering Medications

(3)

Monitoring of Antithrombotic Medications

(1)

Heparin

(1)

Oral Antithrombotic Therapy

(1)

On-Site Testing for Anticoagulant Drugs

(2)

Conclusion

(3)

References

(3)

On-Site Workplace Drug Testing

(12)

David Armbruster

Background

(5)

Conducting On-Site Workplace Drug Testing

(3)

The Future of On-Site Workplace Drug Testing

(4)

References

(3)

Program Requirements, Standards, and Legal Considerations for On-Site Drug Testing Devices in Workplace Testing Programs

(18)

Theodore F. Shults

Yale H. Caplan

Introduction

(1)

What Is ``On-Site'' Testing from a Standards Perspective?

(2)

Establishing Federal Standards for On-Site Drug Testing

(4)

Drug Testing Advisory Board (DTAB)

(2)

Collection Site

(1)

Collector/Tester

(1)

Collection Device/Test Device

(1)

Specimen

(1)

Collection Procedure

(1)

On-Site Testing

(1)

Laboratory Testing

(1)

Quality Control/Quality Assurance (QC/QA)

(1)

Reporting

(1)

Medical Review Officer

(1)

The DTAB End Game

(1)

The Legal Requirements for Confirmatory Testing in Private Sector On-Site Testing

(2)

The Legal Requirements for a Medical Review Officer in Private Sector On-Site Testing

(1)

New Liability Risks of Drug Testing Providers and On-Site Drug Testing-Another Factor in Establishing Standards

(4)

Conclusion

(4)

Notes

(3)

On-Site Testing Devices in the Criminal Justice System

(12)

Leo J. Kadehjian

James Baer

Drug Testing in the Criminal Justice Arena

(5)

Introduction

(1)

On-Site Testing

(1)

Use of Noninstrument Drug Testing Devices

(3)

Legal Admissibility, Evidentiary Weight, and Due Process

(4)

Standards for Admissibility of Scientific Evidence

(1)

Cases Addressing the Use of Noninstument Drug Testing Devices

(1)

Requirements for Repeat and/or Confirmation Testing

(2)

Conclusions

(3)

References

(3)

On-Site Testing Devices and Driving-Under-the-Influence Cases

(10)

J. Michael Walsh

Introduction

(1)

On-Site Testing in DUI Cases

(7)

Summary

(2)

References

(2)

Analysis of Ethanol in Saliva

(18)

Kurt M. Dubowski

Introduction

(2)

Saliva as a Specimen; Saliva Collection; Relationship of Saliva and Blood-Alcohol

(3)

Saliva Collection

(1)

Relation of Saliva-Alcohol to Alcohol in Other Body Fluids

(2)

Saliva-Alcohol Testing Principles and Procedures

(2)

Commercial Saliva-Alcohol Screening Test Devices

(3)

Quality Assurance

(4)

Testing Personnel

(1)

Interpretation and Use of Results

(4)

References

(4)

Analysis of Drugs in Saliva

(16)

Vina Spiehler

Dene Baldwin

Christopher Hand

Roadside or On-Site Saliva Drug Testing

(5)

Introduction

(1)

Saliva Collection

(1)

Cutoff Concentrations in Saliva

(1)

Amphetamines

(1)

Benzodiazepines

(1)

Cannabinoids

(1)

Cocaine

(1)

Opiates

(1)

Conclusion

(1)

Cozart RapiScan Saliva Drug Test System

100

(8)

Introduction

100

(1)

Testing Principle

100

(3)

Quality Control

103

(1)

Interpretation

103

(1)

Performance

104

(3)

Adulteration

107

(1)

Unique Features

108

(1)

References

108

(3)

AccuSign Drugs of Abuse Test

111

(12)

Johannes J. W. Ros

Marinus G. Pelders

Introduction

111

(1)

The AccuSign Test Slide

111

(4)

Summary of Studies

115

(5)

Nonpublished Pilot-Study

115

(1)

Duo Research Report

116

(1)

Performance of AccuSign Slide Test Near the Cutoff

117

(3)

Discussion

120

(1)

Conclusions

120

(1)

Product Contact Information

121

(2)

References

121

(2)

The EZ-SCREEN and RapidTest Devices for Drugs of Abuse

123

(20)

Santo Davide Ferrara

Luciano Tedeschi

Franca Castagna

Introduction

123

(1)

EZ-SCREEN

123

(7)

Principle

123

(2)

Materials and Reagents

125

(1)

Procedure and Interpretation

125

(1)

Performance Characteristics

125

(5)

RapidTest

130

(10)

Principle

130

(2)

Materials and Reagents

132

(1)

Procedure and Interpretation

133

(1)

Performance Characteristics

133

(7)

References

140

(3)

Frontline Testing for Drugs of Abuse

143

(10)

Serge Schneider

Robert Wennig

Introduction

143

(1)

Test Principle and Test Instructions

143

(2)

Test Principle

143

(2)

Test Instructions

145

(1)

Evaluation of the Frontline Tests

145

(5)

Crossreactivity and Cutoff Concentrations

147

(2)

Influence of Temperature

149

(1)

Evaluation of Frontline Tests

149

(1)

Conclusions

150

(3)

References

150

(3)

Abuscreen ONTRAK Tests for Drugs of Abuse

153

(10)

Laurel J. Farrell

Introduction

153

(1)

Principle of Abuscreen ONTRAK

153

(7)

Procedure

154

(5)

Quality Control

159

(1)

Performance

159

(1)

References

160

(3)

The OnTrak TesTcup® System

163

(22)

Dennis J. Crouch

Introduction

163

(2)

Product Design and Theory of Drug Detection

165

(1)

Analysis Method and Analysis Precautions

166

(2)

Method

166

(1)

Precautions

167

(1)

Interpretation of Results

168

(2)

Review and Discussion of the Literature

170

(11)

Study #1

170

(1)

Methods

170

(1)

Results

170

(2)

Discussion

172

(1)

Study #2

172

(1)

Methods

172

(1)

Results

173

(1)

Discussion

173

(1)

Study #3

173

(1)

Methods

173

(1)

Results

174

(1)

Discussion

174

(1)

Study #4

175

(1)

Methods

175

(1)

Results

175

(1)

Discussion

176

(1)

Study #5

176

(1)

Methods

176

(2)

Results

178

(1)

Discussion

178

(1)

Study #6

179

(1)

Methods

179

(1)

Results

179

(1)

Discussion

179

(1)

Study #7

180

(1)

Methods

180

(1)

Results

180

(1)

Discussion

180

(1)

Conclusions

181

(1)

Acknowledgment

182

(3)

References

182

(3)

OnTrak TesTstik Device

185

(14)

Salvatore J. Salamone

Jane S-C. Tsai

Introduction

185

(1)

Materials and Methods

186

(2)

Instrumentation and Reagents

186

(1)

Precision Study Methods

186

(1)

Clinical Evaluation and Comparative Study

187

(1)

Specificity

187

(1)

The TesTstik Device

188

(1)

Principle of Procedure

189

(3)

Procedure

192

(1)

Performance

192

(5)

Availability

197

(1)

Acknowledgments

197

(2)

References

197

(2)

Triage® Device for Drug Analysis

199

(14)

Rafael de la Torre

Introduction

199

(1)

Test Procedure

200

(6)

Solution-Phase Reaction

202

(1)

Solid-Phase Reaction

202

(1)

Cutoff Definition

203

(3)

Internal Quality Control

206

(1)

Clinical and Laboratory Evaluations

206

(7)

References

209

(4)

Visualine II™ Drugs-of-Abuse Test Kits

213

(6)

Scott A. Kuzdzal

James H. Nichols

Introduction

213

(1)

Principle

213

(1)

Description of Test Kits

214

(1)

Performance Evaluation

215

(2)

Management and Clinical Utility

217

(1)

Conclusions

218

(1)

Drugs-of-Abuse Test Devices: A Review

219

(34)

Robert E. Willette

Leo J. Kadehjian

Introduction

219

(2)

Background

219

(1)

Study Design

219

(1)

Study Devices

220

(1)

Results

221

(6)

Introduction

221

(1)

Analysis of Results

221

(1)

Interpretation of the Results

222

(3)

Operator Variability

225

(1)

Operational Characteristics

226

(1)

Summary

227

(26)

Table 1 Drug Cutoffs

228

(1)

Table 2 Amphetamine Test Results vs GC/MS-AOC Study, HHS Cutoffs

228

(1)

Table 3 Amphetamine Test Results vs GC/MS-AOC Study, AOC Cutoffs

229

(1)

Table 4 Cocaine Test Results vs GC/MS-AOC Study, HHS/AOC Cutoffs

229

(1)

Table 5 Opiates Test Results vs GC/MS-AOC Study, HHS Cutoffs

230

(1)

Table 6 Opiates Test Results vs GC/MS-AOC Study, AOC Cutoffs

230

(1)

Table 7 Cannabinoids Test Results vs GC/MS-AOC Study, HHA/AOC Cutoffs

231

(1)

Table 8 Phencyclidine Test Results vs GC/MS-AOC Study, HHS/AOC Cutoffs

231

(1)

Table 9 All Drugs Test Results vs GC/MS-AOC Study, HHS Cutoffs

232

(1)

Table 10 All Drugs Test Results vs GC/MS-AOC Study, AOC Cutoffs

232

(1)

Table 11 Amphetamines Test Results vs GC/MS-HHS Study, HHS Cutoffs

233

(1)

Table 12 Amphetamines Test Results vs GC/MS-HHS Study, AOC Cutoffs

233

(1)

Table 13 Cocaine Test Results vs GC/MS-HHS Study, HHS/AOC Cutoffs

234

(1)

Table 14 Opiates Test Results vs GC/MS-HHS Study, HHS Cutoffs

234

(1)

Table 15 Opiates Test Results vs GC/MS-HHS Study, AOC Cutoffs

235

(1)

Table 16 Cannabinoids Test Results vs GC/MS-HHS Study, HHS/AOC Cutoffs

235

(1)

Table 17 Phencyclidine Test Results vs GC/MS-HHS Study, HHS/AOC Cutoffs

236

(1)

Table 18 All Drugs Test Results vs GC/MS-HHS Study, HHS Cutoffs

236

(1)

Table 19 All Drugs Test Results vs GC/MS-HHS Study, AOC Cutoffs

237

(1)

Table 20 Variation in Test Results for Products Manufactured by the Same Company (from HHS Study, HHS Cutoffs)

237

(1)

Table 21 Product Descriptions, Operation, and Distributor Information, AOC and DWP Studies AOC Study

238

(6)

DWP Study

244

(9)

Sample Adulteration and On-Site Drug Tests

253

(12)

John T. Cody

Introduction

253

(2)

Dilution

255

(2)

Adulterants

257

(4)

Acid

257

(1)

Chromate

258

(1)

Glutaraldehyde

258

(1)

Nitrite

259

(1)

Other Adulterants

260

(1)

On-Site Adulteration Tests

261

(1)

Conclusions

262

(3)

References

262

(3)

Index

265

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On-Site Drug Testing

Summary

Table of Contents

Supplemental Materials