Drug Testing in practise

Depending on the contract clinicians may need to fill in the chain of custody form, however, best practice is to treat every sample taken with the chain of custody in mind.

Clinicians should ensure that the testing pot is sealed and untampered with and that the sample pot is at room temperature.
The clinician should confirm the name, date of birth, and identity of the client.
The clinician should talk through the process and obtain consent before continuing.
The clinician should monitor the client throughout the sample being taken ensuring it reaches the minimum sample volume required. (Ideally mid-flow sample)
The clinician should then seal the sample using the appropriate sticker.
The clinician should check the side/front of the sample pot to ensure the sample is at body temperature this is normally indicated with green dots. (33- 38 degrees)
The clinician should remove the cap from the lid of the pot.
1. To activate the sample the clinician should: (Depending on test type)
  1. 1. Push the cap into the side of the sample pot until you hear a click.
    2. Push the cap into the sample pot and turn clockwise till you hear a click.
The clinician should remove the peel back the sticker on the results window after 5 - 10 minutes.
The clinician should review the results and document the results as appropriate.

If results are non-negative and the organisation uses the Chain of Custody the clinician should ensure that the form is fully filled in, that the process is explained to the client and that the clinician has documented/enclosed any current medications. And ensure the sample is stored safely and securely until collection from the courier.

What is being tested

MET - is methamphetamine (Inc MDMA). COC - is cocaine. THC - is cannabis

BZO - is benzodiazepine. TCA - is antidepressant. BAR - is barbiturates

PCP - is Phencyclidine. AMP is amphetamine

MOP is morphine. MTD is methadone

Negative

Two lines on both the C and T line indicates a negative result.

The shade/colour on the T line may vary however no matter how faint the T line is the result is negative

Non-Negative

A line on the C region but not on the T region indicates a non-negative result.

This indicates that the urine shows above expected levels of the substance indicated in the sample.

Some organisations will call this a positive result and will take appropriate action. As a clinician, you have a responsibility to ensure that any prescribed medications are discussed and disclosed to the employer explaining why a positive result may have been indicated.

Other organisations will request the sample be sent to a lab for further analysis to confirm the results.

Invalid

an invalid result is shown when a line appears on the T line but not the C Line.

Insufficient specimen volume or incorrect procedural techniques are the most common reason for invalid results.

The clinician should retest the client ensuring that the procedure is followed.

If the problem continues contact On-call immediately and discontinue testing until a solution is found.

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