Case Study
Has this person used Heroin in the past 3 months?
See how FTS model of best practice played a part in the court’s decision-making process regarding a child’s residence.
The following is a case history, demonstrating that drug testing does not always find the right answer to the important question; whether drugs are a factor in the case.
They show that when the incorrect test profile is used and an interpretation of the results is made simply on whether drugs are above or below a defined cut-off in the hair sample tested, then frequently the wrong conclusions are made and consequently the court can often be misled.
Test results should not be taken at face value or they can be very misleading unless:
An alternative laboratory carried out a simple standard test with no additional detailed investigation
A hair sample was collected early in January to carry out a test for opiates to cover a 3 months history. Hair sample cut to a single section of 3cm (un-segmented). No detailed client interview conducted.
Heroin and metabolite morphine were below the cut-off, interpreted as Negative and concluded:
“The Negative result indicates that none of the substances for which testing was performed were detected at concentrations equal to or greater than their cut-off levels. The results did not provide evidence of controlled substance use on multiple occasions by the client during this approximate 90-day time period”
This testing assessed opiate use only, not “controlled substances” generally and is therefore misleading. The hair was not segmented providing a “blunt instrument” to assess the pattern of drug use in this case. However, this standardised form of testing and reporting is simple and is frequently requested and used by other laboratories because it reduces costs, despite providing a frequently misleading outcome. All parties and the court assumed that the client had not been using heroin during the 3-month period; October to December. This result was to be the determining factor in the decision-making process with regards to the child’s residence.
Establishing key facts with our detailed client questionnaire
The 35 minute client interview established in summary:
The matched hair sample and also a urine sample were tested by FTS, who carried out a hair strand test and urine test for opiates and methadone to establish a 3 months history immediately prior to sampling.
Hair sample cut to 4cm and segmented into 4 x 1cm segments
FTS completed the testing and investigated all factors that could influence the outcome of the test results. The profile of significantly increasing methadone levels from hair section 4 to section 1 mirrored by the heroin, codeine and morphine levels, in context with the type of hair treatments, frequency and period of their use, in combination with the low wash to extract ratio and positive urine test enabled FTS to come to the following conclusion based on the balance of probabilities:
FTS experts reveal a Positive result over the same period and concluded:
“These results are compatible with the client using heroin on multiple occasions throughout each approximate 4-week index period up to the point of sample collection. These results do not appear to be consistent with the clients’ declaration.”
When the appropriate test profile is used and results interpreted in context with key factors (in particular methadone levels, hair treatments and wash ratios), FTS come to a very different conclusion from other laboratories despite the analysis finding relatively the same levels in the hair, leading to a different decision. Cost should not compromise the thoroughness of the investigation and testing.