Drug Screens

Goal- why is this important to us?

Drug testing provides accountability, acts as a deterrent for drug use, and is the most objective way to identify relapse. Having a standardized method for drug testing that conforms to treatment parity standards helps protect our residents by providing the best care.

Each program may have additional instructions for drug screens. If you have any questions, please contact your Program Coordinator.

Ingredients- what do I need to get started?

A drug screen instant cup and/ or breathalyzer machine

Timeframe- about how long will this take?

Less than 15 minutes for instant testing

Contacts - who do I need to let know?

Program Coordinator (if necessary)

Steps- what do I do?

Drug Screen

1. Whenever possible, female staff should complete drug screens for female clients, and male staff should complete drug screens for male clients. Staff should stand OUTSIDE of the bathroom (or stall) with the door to the bathroom CLOSED.
2. Ask the client to leave coats, purses, bags, or other accessories outside of the bathroom, where staff will monitor them. Staff should also ask the client to empty their pockets.
3. Instruct client to fill the sample cup to the designated level and leave it on the back of the toilet when done.
4. Instruct client not to flush or run any water until test results are completed.
5. After client exits the bathroom, staff and client should activate the test strips and remain present until the results are finalized. This could take 5-10 minutes.
6. After results are read, have client empty cup into toilet, flush, and wash hands. Dispose of cup in bio-hazard bin.
7. If there is any dispute about drug screen results, have the client provide a second sample, or refer to Community Corrections for further testing. (SOP for Community Corrections testing is found to the left)

PBT (Breathalyzer)

1. Provide client with a straw for PBT machine.
2. Instruct client to insert straw into machine and blow for 10 seconds (Machine will beep when its time to stop blowing)
3. Record results shown on screen

Interpreting Results

The screen will begin to show a series of horizontal lines. Each line present indicates that the screen is negative for the corresponding drug. Missing lines indicate that the screen is positive for the corresponding drug. In order for the test to be valid, a line must be present next to the "C" control line. Faint lines, broken lines, or any indication of a line should be read as a negative result for that drug.

Staff should read the drug screen to determine if it is positive or negative for each drug. In the event of a positive read, staff should seek confirmation from another staff person, if possible. If either staff read the screen as negative, it should be regarded as a negative screen.

If a client disagrees with a positive result, staff should offer to complete another test using the same urine. If a client is paying for drug screening, staff should inform the client that if the second test is positive, the client is responsible for paying for BOTH of the drug screens used. If the second test is negative, then the entire process is considered a negative result, and the client is responsible for the cost of only one screen.

If only one staff person is present and there is disagreement about the result of the screen, staff should contact their supervisor prior to discarding the sample.

Other Considerations

Positive drug screens may result in discharge from treatment, with a referral for Detox. Staff can contact Detox to check on bed availability.

In residential treatment, if a client has a positive screen, denies use, and is at risk for discharge from treatment for use, staff may transport the client to Community Corrections as the earliest possibility for a new screen. This may require the client to remain in treatment for an additional day or two.

If the client is taking a prescription medication that may result in a positive drug screen, this should be documented in the client file, along with a copy of the prescription.

Staff should refrain from engaging in a debate with a client about the result of a drug screen. If a client is on probation and has a release for a Probation Officer, staff should state that the results of the screen will be provided to the PO. Dawn Farm cannot guarantee the accuracy of any drug screens, but we will report the results of the drug screen, using the procedures above. Staff can suggest that a client follow up with the PO, and can advise that the PO can contact Dawn Farm with any questions.

Follow-up - what loose ends do I need to wrap up?

Make sure you have documented the drug screen/ PBT results in the appropriate place.

If referral to Community Corrections is needed, refer to SOP for Drug Testing at Community Corrections

CARF Standard 2.A.26