Detecting Parental Substance Use Gns 2011

Detecting Parental Substance MisuseDrug and Alcohol Analysis for Child Protection and Custody Cases

Graham Sievers

August 2011

CGP7450 Ed.001

Profile of Concateno TrichoTech

• Providing drug testing services since 1993

• Perform over 100,000 tests every year on over 15,000 samples– and hold the widest range of accredited drug groups in Europe

• Most experienced team of toxicologists and expert witnesses in the UK

• Laboratory located in Cardiff – tighter chain of custody and greater access to expertise and advice than overseas laboratories

• Member of the Concateno group specialising in drug testing

Incorporation of Drugs into Hair

• After a drug enters the body the drug is absorbed into the blood stream

• Each hair follicle has its own blood supply

• As hair grows drugs are incorporated into the hair

• Drugs will remain in the hair almost permanently

• Sweat and sebum can also contribute to levels detected

Comparison of Drug Use History

Hair

Urine

Oral

Fluids

Blood

0-3 days

1- 4 days

Up to 24hrs

Up to 1 year +

Days: 0.1 1 10 100 1000

Possibly longer depending on the drug

Depending on the drug

Depending on the length of hair

Incorporation of Drugs into Hair

Epidermis

Hair Follicle

Sebaceous Gland

Biological fluids

Drug

Notes: as a drug circulates the blood stream it is fed into the core of the hair

Incorporation of Drugs into Hair

Epidermis

Hair Follicle

Sebaceous Gland

Biological fluids

Drug

Notes: as the hair grows out of the body, for example through the scalp, so any drugs absorbed into the hair core will also grow out of the body

Incorporation of Drugs into Hair

Epidermis

Hair Follicle

Sebaceous Gland

Biological fluids

Drug

Notes: it takes about 7-10 days for hair to grow out of the scalp, and along with that the strand, in its core, traces of drugs taken a week ago or more

Incorporation of Drugs into HairRegular Use

Epidermis

Hair Follicle

Sebaceous Gland

Biological fluids

Drug

Notes: if someone takes drugs regularly then traces of the drugs will be in the core of the hair strand along the length of the hair

Growth Rates & History of Drug Use

• Hair grows at approx. 1 cm per month

• 3cm section = 3 months, (analysed as a whole or sectioned into individual months)

• Consecutive sections provide a retrospective history of drug use

• Drug use history can be attained as long as the hair allows

e.g. 12cms of hair = 1 year

The Telogen Effect

• About 90% of head hair is in anagen or actively growing phase

• About 10% of head hair is in telogen or resting phase

• Telogen phase hair will contain drug from an earlier period than anagen phase hair

• Body hair samples have more telogen phase hair – about 40-60%

- making estimations of time of ingestion less accurate

Hair Analysis: Strengths

Unique long window of detection

Segmental analysis can show trends and patterns for an individual

Drugs remain locked in hair

Simple & quick sample collection, easy storage and less evasive than other tests

Commonly used and accepted in child protection, child residence and family law cases

Hair Analysis: Limitations

Not appropriate for the detection of recent use, time line in months.

Not currently possible to determine specific drug purity, dose used or frequency of use.

Unable to determine the route of administration.

Cannot pinpoint use such as what time of day and which day of the week.

Drugs in Hair

Class A Controlled Drugs• Cocaine and Crack Cocaine• Diacetylmorphine (heroin)• Lysergic acid diethylamide (LSD)• Methadone• Methamphetamines (ecstasy, crystal meth)

Class B Controlled Drugs

• Amphetamine

• Barbiturates

• Cannabis

• Mephedrone

Class C Controlled Drugs• Benzodiazepines• Ketamine

Sobriety to Excess Alcohol Tests

Choose the appropriate testing that best fits the purpose

• Sobriety/Abstinence

• Chronic excessive alcohol abuse

Alcohol in Hair – Excessive Alcohol Use

• No single test can provide a definitive result

• Two markers: Fatty Acid Ethyl Esters (FAEEs) and Ethyl Glucuronide (EtG)

• Supports the assessment of chronic excessive alcohol consumption

• If FAEE’s & EtG are detected in the hair sample this is consistent with alcohol consumption, recommend in corroboration with blood tests

• International cut-off values and segments 0-3cm up to 6cm also possible

• If FAEE/EtG not detected it is not conclusive that no alcohol consumed

• Head hair only – body hair is not a suitable alternative

• Hair analysis should be used in conjunction with a carbohydrate-deficient transferrin (CDT) test and a liver function (LFT) test

Sobriety Testing

• Urine analysis for alcohol (ethanol) and EtG

• Time period covers up to 4 days

• Continuous testing (3 times a week) recommended

• Breath alcohol tests also possible to use

For more information enter ‘sobriety to excess’ into search engine

Case Study 1: Methadone Treatment

• The mother was a known heroin addict on a methadone treatment programme.

• She insisted that she had only been taking her methadone and regular (once weekly) oral fluid tests had shown this was the case.

• The court wanted to determine whether this was true as the father maintains allegations of heroin use.

Hair Drug Profiling

Heroin and Methadone use in monthly sections of hair over a 6 month period

0

1

2

3

4

5

6

7

8

Jul-

09

Au

g-0

9

Sep

-09

Oct

-09

No

v-09

Dec

-09

Leve

l of d

rug

(ng/

mg

of h

air)

Heroin Methadone

Case Study 2: Does the father use drugs?

• A mother made allegations that the father (separated) was using drugs and asked the police to investigate him.

• Police questioned the father and found no evidence of drugs in his home.

• The mother maintained these allegations, and used them as a reason to prevent the father from unsupervised contact with his children.

• The solicitor acting for the father instructed us to perform a hair strand test for drugs.

Conclusion and Outcome

• The father was tested for a number of different drugs, and the results shown he was not a drug user.

• The father continued to enjoy unsupervised contact with his children.

• If the father had not agreed to have the TrichoTest® , the mother’s allegations could have affected his contact with his children.

Sample Collection

• Concateno Trained Collectors- based throughout the UK

- fully trained in sample collection

(incorrect sample collection may delay proceedings)

- follow strict legally defensible ‘chain of custody’ procedures

- sample can be collected at a time convenient to you.

- flexibility in regards to collection location.

(for example your office, social services office etc)

• Other Collectors- GP’s/Nurses.

- Solicitors/Social Services.

Interpretation of Results

• Certificate of Analysis

- provides a concentration value of the drugs detected

- indicates ‘detected’ or ‘not detected’

• Expert Witness Report

- recommended when case may go through court

- detailed description of the process from collection

through to results

- interpretation of results

• Expert Witnesses

- available to attend court hearings

- can explain tests in more detail and clarify results

• Can body hair be used if no head hair is available?

• What are the effects of bleach and hair dyes?

• Can someone become positive due to passive smoking?

• Can a hair test help in claims of one-off use (“my drink was spiked”)?

Frequently Asked Questions

Thank you for listening

Graham Sievers

[email protected]

+44 (0) 7813 706 759

www.trichotech.com

www.concateno.com

+44 (0) 29 2054 0542