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Monday, August 25 Drugs of Abuse and Testing

Fraser A.D.
Toxicology Laboratory, Queen Elizabeth II Health Sciences Centre and Dalhousie University, 1278 Tower Road, Halifax, Nova Scotia, Canada B3H 2Y9

In the province of Nova Scotia, Canada, governmental authorities in the Ministries of Community Services and Justice were concerned about the adverse effects of drug use by parents on the welfare of their children. Parents with a demonstrated history of substance abuse where the family was being assessed by social service agencies may be required to submit to random urine drug testing as ordered by the Family Courts of this province. The objective of this presentation is to discuss this programme and the results of drug testing from 1994 - 1996. Drug and alcohol testing was performed on 125 clients on behalf of seven social service agencies in Nova Scotia. Urine specimens were collected in the home (on a random basis) under observation by a nurse and transferred directly to the Toxicology Laboratory by the collector or by a courier. All specimens were screened for illicit and prescription drugs by EMIT and TLC followed by GC-MS confirmation. Test results were sent to the client's social worker and interpretative reports are provided by the forensic toxicologist. In the 3613 urine specimens collected from 125 clients and analyzed in this period, 50.2% of specimens were negative, 45.6% were positive for one or more drug/metabolite and 4.2% of specimens were dilute (creatinine <2.2 mmol/L). The distribution of positive findings were as follows: cannabinoids - 11.5%, cocaine metabolite - 5.0%, benzodiazepines - 14.5%, codeine and morphine - 7.1%, codeine - 6.6%, diphenhydramine - 2.2% and ethyl alcohol - 1.6%. Based on the findings, the programme had been modified as follows in 1997: a comprehensive drug scren is performed once on each new client, EMIT and GC-MS cut-off values for opiates (codeine and morphine) has been increased from 300 to 2000 ng/mL and testing for PCP has been discontinued. Codeine is available without a prescription in Canada and PCP is not a popular drug of abuse in Nova Scotia. The introduction of urine drug testing for this programme has been considered a success by the social services agencies for the following reasons: testing provides an objective indication of recent drug use (compared to self-reporting of drug use) and the prevalence of drug use in this population with a chronic history of drug use has reduced. The number of specimens submitted for analysis has increased from 10 - 15 per week in January 1995 to 120 per week in December 1996.

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