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Concateno Newsletter - February 2012

Concateno Newsletter - February 2012

Articles in this month's Concateno Newsletter:

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Name:

Methadone is also known as Symoron, Dolophine, Amidone, Methadose, Physeptone, Heptadon, Phy and others.1

Properties:

Methadone is a synthetic opioid originally developed during the Second World War in Germany.2 It was later brought into production in 1947 for use as pain relief and as a treatment for heroin addiction. It is prescribed as a substitute for heroin as it has similar effects but doesn’t deliver the same high. This helps reduce the withdrawal symptoms from heroin and allows the user to overcome their psychological addiction.3

In the UK methadone is a highly controlled prescription drug. If a person doesn’t have a valid prescription it is classified as a class A drug. The maximum jail sentance for possessing the drug is seven years plus an unlimited fine; supplying the drug can lead to life imprisonment and/or an unlimited fine.4

Effects:

Methadone, like other opioids, is a sedative that suppresses the nervous system. It has similar effects to heroin including a feeling of warmth, relaxation, detachment and euphoria that removes physical and emotional pain. It relieves heroin cravings and reduces the feeling of withdrawal symptoms for 24 to 36 hours.5

Usage:

It is usually drunk as a green syrup but can also be found in tablet form or as a liquid to be injected.6 It can be prescribed by a doctor as part of Methadone Maintenance Therapy (MMT).7

Over 143 000 people were prescribed methadone in England in 2008/098, with recent studies showing that MMT has more than an 85% chance of reducing deaths among opioid users if they remain in treatment for more than 12 months.9

Risks:

When a large amount of methadone is taken it can produce side effects similar to those of heroin. It is common for a user to experience confusion, nausea, vomiting, drowsiness, suppression of breathing and pupil constriction. If excessive quantities are taken or if it is mixed with other sedatives it can lead to a coma and eventually death.10

If a course of methadone prescription is prematurely stopped, opiate cravings and withdrawal symptoms will begin again.  This can result in some people remaining on methadone for prolonged periods, with a high chance of relapse if they stop taking it.11

There have been cases reported where pregnant women prescribed with methadone give birth to babies addicted to the drug.  Some mothers are encouraged to choose breast feeding, as the methadone present in breast milk helps the baby to withdraw from the drug.12

Availability:

Medically prescribed methadone is subject to stringent controls, where the strength is dependent on the individuals programme. Some clinics will only prescribe if the individual consumes the methadone onsite. The purity of illicitly bought methadone can never be guaranteed and can lead to overdose. On average the cost of methadone on the street is £1 per 10ml.13

Concateno can provide testing for methadone in urine, oral fluid and hair. Contact us to find out more.

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What you need to think about

In the previous Concateno newsletters we have talked about the changing rationale for drug and alcohol testing in the workplace and how it encompassed business critical as well as safety critical activities. This enlarged role addresses more fully the physical, social, financial and environmental risks posed by drug and alcohol misuse. It also serves to encourage higher levels of responsibility and standards of behaviour amongst an organisation’s employees.

Testing for drugs and alcohol has an important role in achieving these outcomes, but it must be introduced and implemented correctly. In this edition of the newsletter we briefly summarise key issues which need to be considered if you intend to set up drug and alcohol testing in the workplace.

From the start, it is important to recognise that there is no single way to do this, since every company has its own requirements. There are, however, general guidelines which apply to all situations and these are what we outline below.

The first step in setting up a testing programme is the policy. This is created via a consultation process, from which decisions on who to test and when will evolve. A mechanism to achieve consensus over the value, purpose and outcomes sought from drug and alcohol testing is a cross departmental working party which also includes union, staff and legal representatives. Inclusion is the watchword of a successful testing environment.

Testing should be seen to be proportionate, fair and unbiased. If only some of your staff are to be tested it must be made clear why this is the case and how selective testing is in everyone’s interests.

A key element of the policy is what the outcome will be if an individual has a positive result. This is where support mechanisms like an employee assistance programme can contribute, but in some circumstances it may be more appropriate to have zero tolerance for any positive result.

The consultation group needs to determine the type of testing the organisation needs. Testing types include:

  • Screening potential recruits (pre-employment)
  • Unannounced testing based on impartial random selection
  • Testing if and when a staff member’s behaviour appears out of the ordinary (‘for cause’ testing)
  • Testing after an incident at work to help identify whether drugs or alcohol may have been a contributing factor (‘post incident’ testing)
  • Monitoring abstinence – either after treatment, or a first positive result

The type of testing you decide to carry out will have an impact on which samples and testing services you will use. The primary difference between the various sample types is the different detection timeframe they can provide. Hair testing can give several months’ worth of information on drug  use so is often considered for screening potential employees. Urine and oral fluid testing give a much shorter detection window and can therefore be better suited to random, for cause or post incident testing.

There are further differences between testing types, which a testing organisation will be able to discuss with you as part of an initial consultation. These include the different sensitivities to drug types in urine and oral fluid and for either sample, whether an initial screen is better carried out onsite immediately after a collection or whether it is best sent back to a laboratory. If you choose to send samples back to a laboratory you will need to decide whether you outsource the sample collections or carry them out yourselves.  Point of care testing can be carried out by collectors as well.

When choosing a supplier, be certain that their test results will stand up in an employment tribunal. A supplier should follow the European Workplace Drug Testing Society (EWDTS) guidelines and its laboratories should be externally accredited to the International Standard ISO/IEC 17025:2005 by UKAS.

If you have any questions on setting up a drug and alcohol testing policy or on implementing a testing programme, contact us.

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High Court sees how a strong chain of custody, comprehensive records and accreditation from the industry leader underpins the legal process.

At a recent high court hearing for children’s proceedings held before the President of the Family Division, Concateno TrichoTech’s drug tests used in the case were accepted as the only accurate and reliable evidence provided when compared with Trimega Laboratories’ results.

Concateno TrichoTech’s Cardiff laboratory is currently the only UK facility accredited to quality standard ISO 17025 to test for over forty drugs and metabolites in hair. It has held this benchmark for hair drug testing since 2004, audited annually by UKAS to ensure its high standards are maintained, and possesses Europe’s largest hair test reference database.

Collections:

The secure TrichoTest® process starts at the collection stage when donors’ samples are cut by trained collection officers. Collecting a hair sample requires attention to detail to ensure its integrity – that is, has enough sample been collected, has it been cut as close to the scalp as possible, and packed correctly maintaining orientation, before sealed twice in a tamper-evident bag and envelope, then dispatched. Contracting out this service or asking health centres to carry out the task can often weaken the chain of custody.

Analysis:

The sample packs are dispatched directly to the Cardiff laboratory and the bar codes are scanned to ensure the right packs have been received from the expected sender (lost or stolen packs can be discovered at this stage). They are checked for evidence of any tampering or incorrect handling, and photographed if there are any queries. The samples are then analysed at Cardiff, and reported on by scientists based at the same site. Every stage is recorded, and anyone or any analysing instrument that handles the sample in its journey from arrival through to results is trackable and their part in the process recorded.

The chain of custody is therefore strong, and the reporting scientists can consult with lab analysts directly. The benefits of such attention to quality and to detail were seen when Concateno TrichoTech were able to provide substantial evidence – over 500 exhibits – in support of its test results in a recent High Court case. The case arose when another provider, Trimega Laboratories, first analysed a sample with strikingly different results to TrichoTech’s test performed a month later. In September, with each company maintaining their results were correct, both were asked to explain the discrepancies.

Concateno TrichoTech investigated and retested the remaining hair sample to find a similar trend to its first analysis. It suggested a third independent laboratory test another sample from the same donor to corroborate their results. Throughout this process Trimega Laboratories – which to date lacks ISO 17025 accreditation for hair drug analysis – maintained its test results were correct, repeatedly reinforced by their expert witnesses and by their laboratory manager. Trimega retracted its position the day before the hearing and agreed that their results were in error and only Concateno TrichoTech’s test could be relied upon.

Four legal parties to the case applied for a court order seeking reimbursement from Trimega Laboratories for the publicly funded costs incurred.

Click here to find out more about hair testing or call us on +44 (0)29 2054 0542.
If you would like more information on accreditation or would like to see the drugs and tests Concateno TrichoTech are accredited for, visit www.ukas.com (laboratory reference number 2212).

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The Alere™ DDS®2 Mobile Test System is a portable oral fluid drug screening system, making drug testing as easy as A, B, C.

The Alere™ DDS®2 Mobile Test System has been developed to meet the high performance demands of law enforcement agencies, drug treatment centres and workplace environments. The result is a drug testing solution which combines speed, ease of use and reliability.

The system provides a rapid on site screen for drugs of abuse and/or metabolites in an oral fluid sample and consists of a portable analyser that is used in conjunction with the Alere™ DDS®2 Test Kit.

A printer can be connected to the analyser to provide a hard copy of the results at the time of the test, and allows reprinting of stored results. Test data can also be downloaded to a PC using the Alere™ DDS®2 Data Manager software for additional data management options.

Alere™ DDS®2 Mobile Test System & Analyser

Test Procedure

Feature:
A. Insert test cartridge into analyser
B. Collect oral fluid sample
C. Insert sample into test cartridge within analyser

Benefit:
Intuitive process, easy to use, minimal training required.

For more information view the DDS2 flyer  |  Visit www.dds2.com  |  Email dds2@concateno.com

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Article References

Did you know? - reference:

UK and Republic top European binge-drinking list, Irish Times [online] [accessed 20th February] 

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Feature drug: methadone - references:

1. Wikipedia, Methadone [online] [accessed 20th February]
2. Do You Know... Methadone, Centre for Addiction and Mental Health [online] [accessed 20th February] 
3. Methadone. Wikipedia
4. Methadone, Talk to Frank [online] [accessed 20th February] 
5. Joseph, H., Stancliff, S. Langrod, J. (2000), “Methadone maintenance treatment (MMT): a review of historical and clinical issues”,
   The Mount Sinai Journal of Medicine 67: 347-64
6. Methadone, Talk to Frank [online] [Accessed 08/12/2011]
7. Methadone Maintenance Treatment, Centre for Addiction and Mental Health [online] [accessed 20th February]
8. Country Report - United Kingdom, EMCDDA [online] [accessed 20th February]
9. Cornish, R., Macleod, J., Strang, J., Vickerman, P. and Hickman, M. (2010), 'Risk of death during and after opiate substitution treatment in primary care: prospective observational study in UK General Practice Research Database', BMJ 341, p. c5475
10. Methadone, Talk to Frank [online] [Accessed 08/12/2011]
11. Hepatitis C and injecting drug use: impact, costs and policy monograph Monograph, EMCDDA [online] [accessed 20th February] 
12. Methadone, Netdoctor [online] [accessed 20th February] 
13. Methadone, Talk to Frank [online] [Accessed 08/12/2011]

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