OPAM Workshop: Medical Review Officer Training Course: Toxicology Testing and the MRO, A Physician's Role in the Prevention and Treatment of Substance Abuse-285274

Video Transcription

Video Summary

Barry Sample discusses the advantages and disadvantages of drug testing using alternative matrices—primarily oral fluid and hair—compared to traditional urine testing. With extensive experience in clinical and forensic toxicology, he outlines the processes involved in specimen collection, analysis, and interpretation. Urine testing, while long-established, has its drawbacks, such as a short detection window and easy adulteration due to unobserved collections. Alternative matrices offer benefits like less invasive collection, longer detection windows, and observed sampling, making subversion difficult. However, they face challenges, including lower drug concentrations that require more sensitive analysis methods.<br /><br />Oral fluid testing is non-invasive and effective for recent drug use detection, correlating more directly with blood concentrations. It is advantageous for post-accident or suspicion testing due to its faster appearance of drugs compared to urine or hair specimens. The federal guidelines for oral fluid testing highlight requirements for specimen collection and preservation, as the scientific community gradually incorporates these methods. Despite having a shorter detection period, oral fluid samples show higher positivity rates, especially for marijuana, indicating their robustness against attempts to subvert the test. Sample emphasizes that oral fluid results do not correlate with impairment, and regulatory processes still have room to support broader adoption of alternative testing methods.

Keywords

drug testing

alternative matrices

oral fluid

hair testing

urine testing

specimen collection

detection window

sensitive analysis

positivity rates