Has this person used Heroin in the past 3 months?

Obtaining reliable evidence from Drug and Alcohol tests in care proceedings is a complex issue.

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:

• The correct test profile is applied to each case
• The results are considered in context of all influencing factors
• Experts with the necessary skills and experience in the application of testing in child care proceedings investigate these factors and the test data thoroughly
• The expert is willing to produce an opinion based on the balance of probabilities as to whether drugs and/or alcohol could be a factor in the parent’s ability to provide a safe environment for the child

Instruction: Provide an overview for the last 3 months to establish if the client was using Heroin.

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.

Alternative laboratory results

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”

FTS observation

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.

FTS Investigation: Thorough investigation and comprehensive test profile.

Establishing key facts with our detailed client questionnaire

The 35 minute client interview established in summary:

• The client had previously used heroin but claimed to have stopped 4 months ago.
• Frequent and recent use of bleach and a permanent hair dye every 3 to 4 weeks with the last use 2 weeks prior to sampling. Hair straighteners were also used regularly.
• Client taking 40ml of Methadone daily and had been for 5 months, having previously been on 60ml daily.

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 laboratory results

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.”

Concluding Comments

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.