Point-of-collection option grows

Technologies for an on-site drug testing option that has proven extremely convenient in criminal justice settings continue to become more readily available to addiction treatment programs, though many treatment centers still wrestle with whether it makes sense for them to devote the in-house time needed to process their own testing of clients and analysis of test results.

Point-of-collection testing is growing increasingly popular, particularly for criminal justice clients where an immediate determination of status is often necessary, says Bill Current, president of WFC & Associates, a national consulting practice for testing companies.

Current, who oversees the Ultimate Guide to State Drug Testing Laws subscription service, says use of point-of-collection devices that eliminate the need to send tests to an outside lab or to bring in outside collectors is somewhat more widespread in addiction treatment settings than in workplace drug testing.

“In the workplace, there are 50 million tests a year, and maybe 10% or so presently use point-of-collection devices,” says Current, who served as the first director of the Institute for a Drug-Free Workplace.

Legislative activity

According to Current’s State Drug Testing Laws Monthly e-newsletter, some individuals still mistakenly say from time to time that point-of-collection testing is not legal. In reality, only three states prohibit point-of-collection urine testing outright. They are Kansas, Minnesota and Nevada.

Significantly more common than an outright prohibition are state laws that place certain restrictions on point-of-collection testing, such as those statutes that allow point-of-collection testing only for pre-employment screening purposes.

A factor that addiction treatment programs always must take into account when examining state drug testing laws is whether the laws apply to all users of drug testing technology in a state or only to certain segments, Current says. “When most state drug testing laws were written, 10 years ago or more, they were geared specifically for the workplace market,” he says. Therefore, the answer to the question of whether any state restrictions on point-of-collection testing apply to addiction treatment organizations must be researched on a state-by-state basis, with a close examination of statute language.

In general, states are moving toward specifically permitting use of point-of-collection testing, Current says. “We’re going to see over the course of time more states revising their statutes to include standards for instant drug testing,” he says.

Developments in technology

As technology has advanced, point-of-collection devices for urine can produce results that are as accurate as those achieved in urine testing administered by a lab, Current says. Also, the science of point-of-collection testing for oral fluids continues to improve, although in general it has not completely reached the apples-to-apples comparison standard with lab testing in oral fluids. “Instant oral fluid testing does not detect marijuana at the same sensitivity levels as lab-based oral fluid testing,” Current says.

Another barrier to more widespread use of point-of-collection oral fluid testing has been that many states require use of instant testing technology that has Food and Drug Administration (FDA) clearance, and up until recently there were no such devices in the area of oral fluids, Current says. One device in point-of-service oral fluid testing has now received the FDA’s approval, he says.

Current adds, “In the employer market, the use of an FDA-cleared device is important to the end user.” Businesses want that stamp of approval for the technology they will be using, in that they are choosing to take on added responsibility and staff burdens by working the technology themselves rather than sending current or prospective employees to an outside lab or having outside collectors come to the corporate location to administer tests.

Program decision-making

Current says that to this point, instant urine testing has a broader audience than instant oral fluid testing. As with lab testing in these areas, the selection of an option often depends on factors such as how the respective technologies’ window of detection matches the needs of a program. Oral fluid testing detects the presence of drugs almost immediately after a subject’s use and has detection power of about one to two days. Urine testing’s window of detection starts about an hour after a drug is used and extends for about three to four days.

In an addiction treatment program’s decision-making on whether to use point-of-collection technology, an examination of the typical client population and its needs becomes highly important. The technology essentially offers an instant determination on status, which could be significant for treatment programs that might have to report results to local drug courts for mandated clients, Current says.

Going to the point-of-collection option of course requires a commitment of staff time and in-house resources, although expenses are saved in terms of not needing to work with an outside lab. However, it often can be prudent for programs to pursue outside confirmation of results gained in point-of-collection testing.

“Even in the treatment profession, if you’re using the results of instant testing to make a determination on legal status, you will want to confirm those,” Current says.

Finally, proper training of in-house staff also is a must, so that those administering the tests know how to respond when any nuances in the testing protocol appear, Current adds.