A PI’S LOOK AT CLINICAL TESTING
DRUG & ALCOHOL TESTING
CHILD ENDANGERMENT TESTING
PATERNITY & DNA TESTING
INFIDELITY TESTING
CRIMINOLOGY
8/15/2016
TAG
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HOUSE KEEPING
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THE ARTIMES GROUP
WHO ARE WE
The Artimes Group is an independent laboratory coordination and consulting firm
specializing developing laboratory and clinical solutions for our client base, which
includes, physicians, hospital systems, DOT regulated industry, educational institutions,
municipalities, social work, and the legal sector.
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Court Ordered Drug Testing
Drug & Alcohol Testing
Drug Identification
Child Guard & Environmental Exposure Testing
Hair Follicle & Nail Testing
Paternity & DNA Testing
Infidelity Testing
Environmental Drug Detection Assessments
Forensic Assessments
Unknown Substance Testing
DRUGS - WHAT’S WHAT?
 ALCOHOL: Alcohol, while a legal drug, is often abused and habitual use can lead to
addiction and significant physical and psychological health problems. Alcohol can
only be detected through testing for a relatively short period due to its rapid
metabolization and elimination. generally, detectable levels of alcohol intoxication
are gone within 12-18 hours. Consequently all alcohol tests must be performed
during or shortly after consumption.
 AMPHETAMINES:(AMP) Amphetamines are central nervous stimulants whose
effects include alertness, wakefulness, increased energy, reduced hunger and an
overall feeling of well being. Large doses and long term usage can result in higher
tolerance levels and dependence. The most common source for amphetamine are
the prescription diet pills (Phentermine).
 COCAINE: (COC) Cocaine is made from coca leaves. Its effects include alertness,
wakefulness, increased energy and an overall feeling of euphoria. Cocaine may be
smoked, inhaled ("snorted") or injected. Cocaine can be a very addictive drug.
Cocaine is metabolized by the body into the chemical compound Benzoylecgonine
 METHAMPHETAMINE: (MET or M-AMP) Methamphetamine is a stimulant drug
which is quickly metabolized to amphetamine. It is used in pill form, or in powdered
form by snorting or injecting. Crystallized methamphetamine is inhaled by smoking
and is a considerably more powerful form of the drug. Some of the effects of
methamphetamine use include: increased heart rate, wakefulness, physical activity
and decreased appetite.
DRUGS - WHAT’S WHAT CONT.
 OPIATES: (OPI) Opiates are any of the addictive narcotic drugs derived from
the resin of the poppy plant. Opiates are analgesics (pain reducers) which work
by depressing the central nervous system. They can also depress the
respiratory system. Doctors often prescribe them for severe or chronic pain.
Opiates are very addictive, both physically and psychologically. Use for only a
short time normally results in addiction. Heroin accounts for the majority of the
illicit opiate abuse. Opiates reduce attention span, sensory and motor abilities,
produce irrational behavior, depression, paranoia, and other psychological
abnormalities.
 THC , MARIJUANA: (THC) Tetrahydrocannibinol (THC) is an active component
in marijuana. Marijuana, a hallucinogen, is commonly ingested by smoking, but
it may also be eaten. Marijuana may impair learning and coordination abilities.
Marijuana is most commonly the drug of choice among teenagers and young
adults. The hallucinogenic effect of Marijuana can lead to irrational behavior,
disorientation, and paranoia. Low concentrations of THC persists in urine at a
detectable concentration for many days after smoking. Marijuana is the most
common recreational drug of abuse.
DRUGS - WHAT’S WHAT CONT.
 METHADONE: (MTD) Although chemically unlike morphine or heroin, methadone
produces many of the same effects. Methadone is primarily used today for the
treatment of narcotic addiction. The effects of methadone are longer-lasting than
those of morphine-based drugs.
 MDMA (ECSTASY): (MDMA) Methylenedioxymethamphetamine (Ecstasy) is a
designer drug first synthesized in 1913 by a German drug company for the treatment
of obesity. Those who take the drug frequently report adverse effects, such as
increased muscle tension and sweating. MDMA is not clearly a stimulant, although it
has, in common with amphetamine drugs, a capacity to increase blood pressure and
heart rate.
 BARBITUATES: (BAR) Classified generally as depressants, barbiturates produce a
state of intoxication that is remarkably similar to alcohol intoxication. Symptoms
include slurred speech, loss of motor coordination and impaired judgment.
 BENZODIAZEPINES: (BZO) Also classified as depressants, benzodiazepines are
used therapeutically to produce sedation, induce sleep, relieve anxiety and muscle
spasms and to prevent seizures. In general, benzodiazepines act as hypnotics in
high doses, as anxiolytics in moderate doses and as sedatives in low doses. Like the
barbiturates, benzodiazepines differ from one another in how fast they take effect
and how long the effects last.
SIGNS AND SYMPTOMS OF USAGE
 Abrupt changes in attendance, quality and output of work, and general
discipline
 General changes in attitude or mood (irritability)
 Withdrawal from responsibility
 Deterioration of physical appearance and grooming
 Tendency to wear sunglasses at inappropriate times (possibly to hide
dilated or constricted pupils)
 Reluctance to wear short-sleeved attire at appropriate times, particularly in
hot weather (possibly to hide needle marks)
 Association with known substance abusers
 Unusual requests for loans from friends, co-workers or parents
 Theft of small items from employer, co-workers or home
 Secretive behavior toward actions and possessions
 Poorly concealed attempts to avoid attention and suspicion, such as
frequent trips to storage rooms, closets, rest rooms and basements
(possibly in order to use drugs)
PRIVACY
CONFIDENTIALITY
Drug testing records are confidential, and can only be released during
certain legal matters, if conducted in the Work Place. Federal law requires
records be kept in a separate, confidential medical file. During legal issues
regarding a drug test, it is legal to release test records to courts,
government agencies or arbitrators.
TESTING
Screening conducted at our facility, by referral from a client’s attorney, is
available to the client, and to counsel providing donor has signed a Waiver
of Release they are provided at the time of testing.
ALCOHOL TESTING
 Standard Alcohol Testing Options Include:
– Breath Alcohol, represents what is currently
happening in the donor’s system.
– 80-Hour Etg, represents what the donor has
consumed over the past 80-hours. This test
included a 10 Panel Drug Test.
– Hair Follicle Alcohol, this represents approximately
how much alcohol a donor is consuming daily,
weekly, monthly.
– Blood Spot – “Peth” – is a blood spot, similar to
diabetic test, to identify alcohol consumption and
“binge” drinking
BREATH ALCOHOL
 Used as a random tool for Zero Tolerance.
 Documents current levels of alcohol.
 0.02 is the cut-off limit for Zero Tolerance,
general population is 0.08 is considered
intoxicated.
 Does not measure mouth alcohol, or
diabetic alcohol.
 Cannot be adulterated or tampered with.
 Requires certified personnel.
80-HOUR ALCOHOL
 Is conducted by urine sample.
 Documents alcohol use over the past 80-hours.
 Includes a 10 Panel Lab Based Drug Test,
including THC/COC/AMP/METH/OPI/OXY/BAR/BZO/PCP/MTD.
 Often used for Zero Tolerance Agreements, and
Diversion Programs.
 Often conducted Randomly.
 Results in approximately three (3) days.
 Should be administered by trained personnel.
HAIR FOLLICLE - ALCOHOL
 The most advanced hair follicle testing available.
 Documents approximately how many drinks a
donor is consuming per day, or per week, on
average, over a three (3) month period.
 Can take 10 – 14 days for biomarkers to be
deposited in the hair root & emerge past the
scalp.
 This test takes five (5) full business days for
processing.
 Should be conducted by a Trained Technician.
PETH TEST
 PEth (Phosphatidylethanol Alcohol Biomaker (whole
blood or blood spot). (FOS-FATE-TIE-DIE-ETH-A-NOL)
 Measured by the presence of an abnormal phospholipid
molecule that is formed ONLY in the presence of
ethanol, created and captured in the red blood cell
membrane. The more alcohol someone drinks the more
PEth is present.
 This test is often utilized to determine the amount of
alcohol consumed over a three (3) week period to
identify potential “binge” drinking or risky alcohol
consumption behavior.
 Typical results are available in 5 – 8 days.
ALCOHOL NAIL TEST
 Indicates multiple occurrences of high
alcohol consumption during a three month
period of time.
 High consumption according to USDTL
Lab, is six or more consumption days, with
levels above 0.08% BAC.
 1.5 inches of specimen is required.
ALCOHOL SUMMARY
 Think 3 / 3 / 3 when selecting the best
alcohol testing option.
– Within 3 days of consumption = Urine
– Within 3 weeks of consumption = Blood
– Within 3 months of consumption = Nails/Hair
Individuals with alcohol disorder outnumber
those with drug use disorder by a factor of
over 4 to 1. (USDTL Winter 2015 Magazine)
DRUG TESTING OPTIONS
 Hair Follicle – provides historical use data.
 Urine Based – is the gold standard,
documents what is currently in the system.
 Saliva Based – second to urine,
documents what is currently in the system.
 Finger Nail / Toe Nail – provides historical
use data, and environmental exposure.
HAIR FOLLICLE DRUG TEST
 Hair Follicle Drug Test with Expanded Opiates.
 This test provides “historical” drug use for the past 30-90
days, depending on the length and selection of hair
utilized for the sample
 Average sample is 1/2 inch = 30-days.
 The test screens for five main classes of drugs with
expanded opiates and includes –
THC/COC/AMP(Meth)/PCP/OPI+(OXY/HYD/HMOR/COD).
 This test takes approximately three (3) business days for
processing. Typical delays can be caused by lack of
response, by the donor, when contacted by the MRO.
URINE BASED TESTING
 Ten Panel Instant – provides instant test results and can
be faxed or emailed to any attorney upon completion.
MRO services for confirmation are offered for any
unexpected positive. This test screens for –
THC/COC/AMP/METH/MTD/OPI/OXY/BZO/BAR/PCP
 Five Panel Instant – provides the same instant results as
above, designed to screen for a small panel of drugs and
includes – THC/COC/OPI/METH/AMP
 Ten Panel + Etg – A laboratory based test and is
confirmed by GC/MS analysis. Screens for ten classes of
drugs and provides the donor’s alcohol level for the
previous 80-hours. This is best designed for Zero
Tolerance.
REASONABLE SUSPICION
TESTING
 Wipe & Spray Drug Detection
– Allows detection in an environment that a
child maybe in, car or home.
– Drugs Eligible for Detection:
 Cannabinoids
 Cocaine
 Methamphetamines
 Heroin
 Amphetamines
 LSD/Herosol/Opium
REASONABLE SUSPICION
TESTING – CON’T
 How it is done
– A Simple “wipe and spray” of the environment is
performed.
– Reagent Detection Paper and Spray are utilized to
determine the reaction or non-reaction of the tested
surface.
 Application
– When a parent suspects another parent or care giver
of drug use, this medium is a great resource for
testing surfaces without accusing the user.
CHILD GUARD TESTING
 When a child is exposed to illegal substance abuse,
in the home or their environment. They often also
face other coexisting obstacles to a normal life - neglect,
abuse, violence, and other vulnerabilities. Substance
abuse is a disease, one that often prevents adults from
doing what is in a child’s interests.
 Hair & Nail Environmental Exposure testing detects both
native drugs and metabolites, from passive exposure.
 Drug metabolites are produced in the body only if drugs
have been ingested. Children are most often not drug
users themselves, so metabolites are typically absent in
child samples being tested for exposure. Child Guard
reports a positive result if either native drugs or drug
metabolites are detected.
CHILD GUARD – CON’T
 A child hair and nail test can provide evidence of drug
use in a child’s environment for the past 3 months.
 A positive test result suggests that the child has
experienced one or more of the following: passive
inhalation of drug smoke, contact with drug smoke,
contact with sweat or sebum (skin oil) of a drug user,
contact with the actual drug, and accidental or intentional
ingestion of illegal drugs.
 Our partner offers a research-based, forensic test for
passive exposure is the first and only test of its kind.
 Should be collected by a trained technician.
(Reference - http://www.usdtl.com/testing/child-hair-nail-drug-test-labs)
CHILD GUARD – CON’T
 Depending on the drug of concern will
depend on the specimen requested.
– Marijuana smoke, hair is the better option.
– Methamphetamine, hair or nails are both
acceptable mediums for collection.
– Special instructions should be followed prior
to presenting the minor child for testing.
CHILD GUARD – CON’T
 Nicotine Testing – Exposure
– Smoke Free Cars for Children’s Act – Senate
Bill 130 - February 2015.
– No smoking in a car with a Minor Child 15
years of age or under.
– In Legislation now, will be a misdemeanor.
– How dangerous is it, and what options are
there?
CHILD GUARD – CON’T
 Second Hand Smoke & Exposure Testing
– Testing available, via urine specimen to
determine use and exposure.
– Testing takes up to 10 business days for
results.
– Best result is through a two step testing
process:
 Test the parents – both user and non-user
 Test the children
FINGER NAIL TESTING
 Highly stable, fingernails provide a test sample that is at
the cutting edge of drug and alcohol testing.
 Fingernails are made up of keratin, the same material
that hair is made of. As the nail grows, substances can
pass from the blood vessels below the nail into the
keratin fibers where they become trapped.
 Fingernails are four times thicker than the typical strand
of hair and often capture more of a substance than hair
can. Biomarkers become locked in keratin fibers along
the entire length of the nail, and can be detected up to 36 months after drug or alcohol abuse.
FINGER NAIL – CON’T
 Environmental exposure to illicit substances can be detected
immediately in nail samples.
 When drugs or alcohol are ingested, biomarkers can be found in
nails as early as 1-2 weeks after.
 The time period during which drug or alcohol ingestion can be
detected depends on the substance used, the amount used, and
personal metabolism. Fingernail samples are clipped and collected
by the donor in front of a trained collection staff member.
 A clipping of 2-3 mm long (about the width of a quarter) from all ten
fingernails will give about 100 mg of sample, the ideal amount for
screening and confirmation.
 Toe Nail Clippings can detect drugs up to 12-14 months or more,
depending on the health of the donor.
 Testing is available for up to 15 Drugs, including alcohol.
INFIDELITY TESTING
 Semen Detection Testing – indicates whether an item
is positive or negative for the presence of semen, by
screening for a protein exclusively occurring in sperm.
This is NOT a DNA test.
 DNA Detection Test – Detects whether DNA is present,
and whether there is enough for comparison.
 DNA Detection + Y Chromosome – Detects male
DNA’s presence and determines if there is enough for
comparison.
 DNA Comparison – Compares DNA extracted from a
reference sample (as in above) to a provided specimen
from an alternative source, to potentially rule a spouse in
or out as the donor of the specimen in question.
DNA TESTING
 DNA can be extracted from a variety of
items, including:
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Condoms / Feminine Products
Tissues / Mucus
Clothing / Towels / Bedding / Fabrics
Diabetic Test Strips / Bandages / Gauze
Ear Swabs
Toothbrushes
Razors
Gum
Cigarette butts
Drinking straws / Drinking glasses
DNA – RULE OF THUMB
 DNA Testing is sensitive, when clients have
questions, we have answers, but don’t delay –
here are some Golden Rules:
– Don’t store specimens in plastic of any kind
– Don’t dry clean or wash any articles prior to
testing
– Don’t let anyone else handle the specimen
– Don’t touch it without gloves
– Don’t over handle the article/item in question
– Don’t wait – contact us as soon as possible
OTHER DNA OPTIONS
Additional screening that is available includes:
 Grand-Parentage
 Child DNA
Safeguarding
 Immigration Testing
 Semen Detection
 Infidelity Testing
 Ancestry Testing
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DNA Comparison
Avuncular Testing
Blood Stain Testing
Genetic Reconstruction
Unknown Substance
Testing
 Bodily fluid, tissue and
cellular screening
available
OTHER
 There are many other testing options and
needs:
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Murder
Sexual Assault
Suicide
Wrongful Death
Reasonable Suspicion
 We have options for all situations, our labs are faster then GBI and
more accessible, if you have a need and are unsure, call us for help.
Who Done It
 What are you options when your client
thinks they have been poisoned? Or
worse, when your client’s loved one is now
deceased?
 There are countless scenarios that more
advanced testing maybe required to
uncover the truth.
Who Done It – Part II
 What’s available and how do you choose?
– Poisons
– Toxins
– Unknown Drug Testing
– Heavy Metals Testing
CONTROLLING COSTS
Litigation is expense – Lab Services
shouldn’t be.
For any testing presented here today, your
valued clients will be offered discounts over
normal pricing, if your office schedules their
testing, and mentions this presentation.
CALL 1.800.492.9484
FOR QUESTIONS
 Dedicated Professionals are available for
questions, or to establish services by
calling: 1.800.492.9484.
 Help is available by email at
[email protected]
 Answers to FAQ’s are available at
www.labtestservices.com
HOW TO SCHEDULE
TESTING
 Testing is available at a variety of Patient
Service Centers, we will ARRANGE a
collection for your client regardless of
where they are located throughout the
United States.
 Call 1.800.492.9484.
 Set up an account, helping expedite
services for your clients.
GOT LITIGATION?
 Worried about your evidence being
admissible in Court?
– Most of our partners have Litigation Packages and
Expert Testimony available.
– All the partners we work with are Accredited in their
area of specialty.
 Worried about cost?
– Rely on and leverage our relationships with a variety
of labs to negotiate the best, most cost effective
option for your client.
– An outline of base/sample pricing is available in your
handout.
THANK YOU
The Artimes Group
&
Lab Test Services
Kelly L. Martinez
Managing Director, Clinical Services
1.800.492.9484
[email protected]