Drugs of Abuse F O R E N S I C S C I E N C E - - M E D I C I N E A N D Steven B. Karch, MD,SERIES EDITOR DRUGS OF ABUSE:BODY FLUID TESTING edited byRaphael C. Wong and Harley Y. Tse,2005 A PHYSICIAN’S GUIDE TO CLINICAL FORENSIC MEDICINE:SECOND EDITION edited byMargaret M. Stark,2005 FORENSIC MEDICINE OF THE LOWER EXTREMITY:HUMAN IDENTIFICATIONAND TRAUMA ANALYSIS OF THE THIGH, LEG, AND FOOT,by Jeremy Rich, Dorothy E. Dean, and Robert H. Powers, 2005 FORENSIC AND CLINICAL APPLICATIONS OF SOLID PHASE EXTRACTION,byMichael J. Telepchak, Thomas F. August, and Glynn Chaney, 2004 HANDBOOK OF DRUG INTERACTIONS:A CLINICALAND FORENSIC GUIDE,edited by Ashraf Mozayani and Lionel P. Raymon, 2004 DIETARY SUPPLEMENTS:TOXICOLOGYAND CLINICAL PHARMACOLOGY,edited by Melanie Johns Cupp and Timothy S. Tracy, 2003 BUPRENOPHINE THERAPY OF OPIATE ADDICTION, edited by Pascal Kintz and Pierre Marquet,2002 BENZODIAZEPINES AND GHB: DETECTIONAND PHARMACOLOGY, edited by Salvatore J. Salamone,2002 ON-SITE DRUG TESTING, edited by Amanda J. Jenkins and Bruce A. Goldberger, 2001 BRAIN IMAGING IN SUBSTANCE ABUSE:RESEARCH, CLINICAL,AND FORENSIC APPLICATIONS, edited byMarc J. Kaufman,2001 TOXICOLOGY AND CLINICAL PHARMACOLOGY OF HERBAL PRODUCTS, edited byMelanie Johns Cupp,2000 CRIMINAL POISONING:INVESTIGATIONAL GUIDEFOR LAW ENFORCEMENT, TOXICOLOGISTS, FORENSIC SCIENTISTS,AND ATTORNEYS, byJohn H. Trestrail, III,2000 A PHYSICIAN’S GUIDE TO CLINICAL FORENSIC MEDICINE, edited byMargaret M. Stark,2000 Drugs of Abuse Body Fluid Testing Edited by Raphael C. Wong, , MS MBA Branan Medical Corporation, Irvine, CA Harley Y. Tse, , PhD MBA Department of Immunology and Microbiology, Wayne State University School of Medicine, Detroit, MI © 2005 Humana Press Inc. 999 Riverview Drive, Suite 208 Totowa, New Jersey 07512 www.humanapress.com All rights reserved. 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Printed in the United States of America. 10 9 8 7 6 5 4 3 2 1 e-ISBN: 1-59259-951-6 Library of Congress Cataloging in Publication Data Drugs of abuse : body fluid testing / edited by Raphael C. Wong, Harley Y. Tse. p. cm. -- (Forensic science and medicine) Includes bibliographical references and index. ISBN 1-58829-435-8 (alk. paper) 1. Drugs of abuse--Analysis. 2. Forensic pharmacology. 3. Body fluids--Analysis. I. Wong, Raphael C. II. Tse, Harley Y. III. Series. RA1160.D785 2005 614'.1--dc22 2005000317 Preface Although not exactly a common topic for social conversations, drug test- ing directly and indirectly touches the lives of many people. Circumstances surrounding employment, traffic accidents, sports, and perhaps encounters with law enforcement inevitably involve some facets of drug testing. During the past two decades, drug testing has been greatly facilitated by the development of lateral flow immunoassays that simplify the testing procedures and make test results available in a timely fashion. Urine has been the biological speci- men of choice for testing. However, recent technological advances have now made it possible to use alternative body fluids for this purpose. Subsequently, the field of drug testing has flourished as a science. It is with this view in mind that the present volume, Drugs of Abuse: Body Fluid Testing, is written. It is intended to be both informative and timely. Its audience includes not only professionals and scientists, but also cursory readers interested in understand- ing the societal impact as well as the limitations of drug testing. Drugs of Abuse: Body Fluid Testing begins with a historical recounting of events that have led to the establishment of federal regulatory policies spe- cifically pertaining to drug testing. This is followed by a broad description of the various body fluid specimens suitable for use in testing for illicit drugs. These two initial chapters are both informative and interesting to read. The next three chapters are designed for the technically minded. Chapter 3 presents a comprehensive review of all commonly used analytical technologies and their utilities in drug testing, both in laboratory-based and on-site settings. Chapters 4 and 5 then provide rather detailed accounts of the structural as well as manu- facturing aspects of on-site testing devices based on lateral flow immunoas- says. Because the use of urine as a testing matrix has been exhaustively discussed over the years in numerous publications, we have chosen in this volume to avoid repetition and concentrate on the use of other body fluids, such as saliva and sweat, and hair. The advantages as well as the pitfalls of using these specimens are the subject matter of Chapters 6–11. Of the alternative biological speci- mens, oral fluid has the best potential of succeeding urine as the next matrix of v vi Preface choice for drug detection. Therefore, four popular saliva testing devices are selected for discussion. Following this section is Chapter 12, the author of which adopts the viewpoint that drug testing is, in practice, information transfer and argues that, to comply with privacy and accuracy issues, the processes of drug testing should be automated with as little human intervention as possible. On the application of drug testing in the legal system, Chapter 13 describes what occurs within the drug court system with intriguing statistics. Finally, any dis- cussion on drug testing cannot be complete without an appreciation of the cur- rent status of sample adulteration. Two chapters are devoted to this purpose. Because drug addiction is not just a problem confined to the United States, the next two chapters of this volume bring the reader up to date on how the Euro- pean Union deals with this problem. A large-scale roadside drug-testing pro- gram (ROSITA) was undertaken, the results of which would benefit not just the European Union, but also countries worldwide. Thus, this book covers a wide spectrum of issues related to body fluid testing of drugs of abuse, and is written by experts in their respective fields. The subject matter should appeal to a wide variety of readers. Raphael C. Wong Harley Y. Tse Contents Preface....................................................................................................v Contributors ..........................................................................................ix CHAPTER 1 Historical Aspects of Drugs-of-Abuse Testing in the United States Lawrence A. Reynolds...............................................................................1 CHAPTER 2 Specimens for Drugs-of-Abuse Testing Leo J. Kadehjian......................................................................................11 CHAPTER 3 Drug-Testing Technologies and Applications Jane S-C. Tsai and Grace L. Lin ...........................................................29 CHAPTER 4 The Use of Nitrocellulose Membranes in Lateral-Flow Assays Michael A. Mansfield..............................................................................71 CHAPTER 5 Antibody–Label Conjugates in Lateral-Flow Assays Paul Christopher, Nikki Robinson, and Michael K. Shaw..................87 CHAPTER 6 Lateral-Flow Assays: Assembly and Automation David Carlberg.........................................................................................99 CHAPTER 7 Oral-Fluid Drug Testing Using the Intercept® Device R. Sam Niedbala and Keith W. Kardos................................................115 CHAPTER 8 Dräger DrugTest®: Test for Illegal Drugs in Oral-Fluid Samples Stefan Steinmeyer, Rainer Polzius, and Andreas Manns..................133 vii viii Contents CHAPTER 9 On-Site Oral-Fluid Drug Testing by Oratect® Raphael C. Wong...................................................................................145 CHAPTER 10 Saliva and Sweat Testing With Drugwipe®: A Review Franz Aberl and Robert VanDine........................................................161 CHAPTER 11 Hair Analysis in Drugs-of-Abuse Testing Michael I. Schaffer and Virginia A. Hill............................................177 CHAPTER 12 Instrumented Urine Point-of-Collection Testing Using the eScreen® System Murray Lappe........................................................................................201 CHAPTER 13 Adulteration of Drugs-of-Abuse Specimens Amitava Dasgupta .................................................................................215 CHAPTER 14 Adulteration Detection by Intect® 7 Raphael C. Wong and Harley Y. Tse...................................................233 CHAPTER 15 Drug Testing and the Criminal Justice System: A Marriage Made in Court John N. Marr.........................................................................................247 CHAPTER 16 Drug-of-Abuse Testing: The European Perspective Alex Yil Fai Wong.................................................................................259 CHAPTER 17 The Results of the Roadside Drug Testing Assessment Project Alain Verstraete.....................................................................................271 CHAPTER 18 Trends in Drug Testing: Concluding Remarks Raphael C. Wong...................................................................................293 Index....................................................................................................297 Contributors FRANZ ABERL • Securetec Detektions-Systeme AG, Ottobrunn, Germany DAVE CARLBERG • Kinematic Automation Inc., Twain Harte, CA PAUL CHRISTOPHER • British BioCell International, Cardiff, Wales, UK AMITAVA DASGUPTA • Department of Pathology and Laboratory Medicine, University of Texas-Houston Medical School, Houston, TX VIRGINIA A. HILL • Psychemedics Corporation, Culver City, CA LEO J. KADEHJIAN • Biomedical Consulting, Palo Alto, CA KEITH W. KARDOS • OraSure Technologies Inc., Bethlehem, PA MURRAY LAPPE • eScreen Inc., Beverly Hills, CA GRACE L. LIN • Roche Diagnostics, Indianapolis, IA ANDREAS MANNS • Dräger Safety AG & Co. KGaA, Lübeck, Germany MICHAEL A. MANSFIELD • Millipore Corporation, Danvers, MA JOHN N. MARR • Johnson City, TN R. SAM NIEDBALA • Chemistry Department, Lehigh University, Bethlehem, PA RAINER POLZIUS • Drägerwerk AG, Lübeck, Germany LAWRENCE A. REYNOLDS • LAR Consulting, San Jose, CA NIKKI ROBINSON • British BioCell International, Cardiff, Wales, UK MICHAEL I. SCHAFFER • Psychemedics Corporation, Culver City, CA MICHAEL K. SHAW • Department of Immunology and Microbiology, Wayne State University School of Medicine, Detroit, MI STEFAN STEINMEYER • Dräger Safety AG & Co. KGaA, Lübeck, Germany JANE S-C. TSAI • R&D, Roche Diagnostics, Indianapolis, IN HARLEY Y. TSE • Department of Immunology and Microbiology, Wayne State University School of Medicine, Detroit, MI ALEX YIL FAI WONG • Frost & Sullivan, London, UK RAPHAEL C. WONG • Branan Medical Corporation, Irvine, CA ROBERT VANDINE • Secutetec Contraband Detection & Identification Inc., South Williamsport, PA ALAIN VERSTRAETE • Clinical Biology Laboratory, Ghent University Hospital, Gent, Belgium ix
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