Saliva Drug Screening in W.A. Correctional Settings

Hayley Taylor

Kati Kraszlan

Christine Anderton

May – October 2004

Department of Justice

Feb 2003 DoJ hosted the Drugs Roundtable Forum.- Justice Drug Plan developed – reduce drug demand/supply/harm in Prisons.

- Conduct a review of drug testing technologies.

Oct 2003 the report on alternative drug testing was completed (Gobetz and Wallengren, 2003).

- reviewed drug testing technologies and determined those viable for use within correctional settings. Investigated hair, sweat, saliva, urine.- the report indicated that the use of saliva for drug detection may have some validity in a

correctional setting and required further investigation.

Saliva Drug Testing

Potential advantages of saliva:

- Relatively non-invasive

- Easily accessible

- Unlikely to be susceptible to adulteration

(10 minute saliva turnover rate)

- No requirement for specialised venues

- Either gender can supervise

- On-site results in a matter of minutes

W.A. Saliva Trial

Aims:

1) To establish secure procedures for saliva drug screening in correctional facilities.

2) To assess the validity of two commercially available on-site immunoassay procedure for the detection of drugs in saliva.

3) To evaluate the use of saliva drug testing as an accurate and viable alternative to urinalysis.

Sample Population

6 month trial commenced May 2004

1175 random on-site saliva drug tests conducted across 5 sites:

1) Bandyup - Women’s Prison

2) Hakea – Maximum Prison

3) Wooroloo – Minimum Prison Farm

4) Acacia – Privately-operated Prison

5) Perth Drug Court – Community Setting Variation in population and setting

Recruitment

Drug Court/Acacia – offenders/prisoners participated in the saliva trial voluntarily. All saliva samples had accompanying urinalysis results.

Hakea/Bandyup/Wooroloo – prisoners were randomly selected to participate in the saliva trial (Regulation 26b of the Prisons Act). Urine samples were only collected upon the indication of a positive on-site saliva test or refusal to provide a saliva sample.

*** All of the offenders/prisoners and officers that participated in the trial completed a brief questionnaire to determine attitudes towards saliva drug testing.

Saliva Products

Of the 1175 saliva samples collected:

575 saliva samples tested with the Cozart RapiScan®

(Bioscience Ltd, Abingdon Oxfordshire UK)

- 73.7% male

600 saliva samples tested with the UltiMed SalivaScreen™

(UltiMed Products GmBh, Ahrensburg, Germany)

- 72.7% male

Product 1 - UltiMed SalivaScreen™

Detected 5 drugs: methamphetamine, cannabis, cocaine, morphine, methadone

3-step procedure

Device does not come with a suitable storage container

A second saliva sample had to be collected for GC-MS confirmation

Product 2 – Cozart RapiScan®

Detected 5 drugs: amphetamines, benzodiazepines, opiates, cocaine, cannabis.

Multiple steps involved

Suitable storage container supplied

Adequate sample for GC-MS confirmation

Sample Distribution

Drug Court

Wooroloo Bandyup Acacia Hakea Total

UltiMed 230 115 105 100 50 600

Cozart 200 100 100 75 100 575

Total 430 215 205 175 150 1175

Sample target per product: Drug Court (n=200) and

Prisons (n=100)

** Hakea/Acacia target was not achieved

UltiMed Positive Test Results (n=113)

Meth

adone

Metham-phetamine

Cannabis Morphine Total

DC (n=219) 22 21 9 3 55

Bandyup (n=104) 27 2 0 0 29

Acacia (n=98) 10 0 4 1 15

Hakea (n=49) 4 2 0 1 7

Wooroloo (n=113) 6 0 0 1 7

Total (n=583) 69 (61%)

25

(22.1%)

13

(11.5%)

6

(5.4%)

113

No Cocaine positives recorded

Methadone positives were prescription based

A total of 15.5% of saliva tests at DC and 3.02% of saliva tests at

Prisons tested positive for an illicit drug.

Cozart Positive Test Results (n=58)

Benzo Amphet Cannabis Opiate Cocaine Total

DC (n=197)

17 6 14 5 0 42

Bandyup (n=100)

1 0 0 0 1 2

Acacia (n=75)

0 0 2 0 0 2

Hakea (n=99)

3 1 2 0 0 6

Wooroloo (n=99)

3 1 1 1 0 6

Total (n=570)

24

(41.4%)

8

(13.8%)

19

(32.8%)

6

(10.3%)

1

(1.7%)

58

A total of 12.7% of saliva tests at DC and 2.4% at Prisons tested

positive for an illicit drug.

Positive saliva on-site test results compared to urinalysis

True Positive False Positive

UltiMed n % n %

Methamphet (n=25) 23 92% 2 8.0%

Morphine (n=6) 6 100% 0 -

Cannabis (n=13) 5 38.5% 8 61.5%

Cozart n % n %

Opiate (n=6) 5 83.3% 1 16.7%

Cannabis (n=19) 16 84.2% 3 15.8%

Amphet (n=8) 5 62.5% 3 37.5%

Benzo (n=17) 14 82.4% 3 17.6%

Cocaine (n=1) 0 - 1 100%

Negative saliva on-site test results compared to urinalysis

True Negative False Negative

UltiMed n % n %

Methamp (n=243) 223 91.8% 20 8.2%

Morphine (n=258) 242 93.8% 16 6.2%

Cannabis (n=253) 184 72.7% 69 27.3%

Cozart n % n %

Opiate (n=269) 260 96.7% 9 3.3%

Cannabis (n=258) 209 81.0% 49 19.0%

Amphet (n=267) 248 92.9% 19 7.1%

Benzo (n=258) 209 81.0% 49 19.0%

Sensitivity, Specificity and Accuracy

Sensitivity

(>90%)

Specificity

(>90%)

Accuracy

(>95%)

UltiMed

Morphine 27.3 100 93.9

Cannabis 6.8 95.8 71.0

Methamphet 53.5 99.1 91.8

Cozart

Opiate 35.7 99.6 96.4

Amphetamine 20.8 98.8 92

Cannabis 24.6 98.6 81.2

Benzodiazepine 22.2 98.6 81.1

Time Taken To Collect Saliva Sample

Mean time required to collect a saliva sample

with UltiMed (sec)

Mean time required to collect a saliva sample

with Cozart (sec)

Overall 36 132.7

Drug Court 29.1 100.5

Acacia 31.7 149.2

Hakea 33.8 155.7

Wooroloo 39.6 131.6

Bandyup 45.7 126.7

Time Taken To Obtain Saliva Test Result

Mean time required to obtain a test result with

UltiMed (min)

Mean time required to obtain a test result with

Cozart (min)

Overall 9.22 12.16

Drug Court 8.43 12.18

Acacia 9.10 12.16

Hakea 9.56 12.14

Wooroloo 10.46 12.16

Bandyup 8.55 12.16

Offenders Attitudes

Easier to provide (n=563)

Easier to have collected (n=578)

Prefer to provide (n=545)

Easier to tamper (n=350)

Saliva 88.1% 90.6% 86.1% 15.8%

Urine 6.7% 6.6% 8.4% 73.6%

Both 5.2% 2.8% 5.5% 10.6%

Attitude data combined for the two saliva products

Officers Attitudes

57 officers participated in the trial:

- 87.7% less time to collect saliva sample compared to urine sample

- 82.4% prefer to collect a saliva sample rather than a urine sample

- Advantages of saliva testing: both genders can supervise, testing is less intrusive, quicker, easier and negates time involved with strip searches.

- Disadvantages of saliva testing: window of detection, limited number of drugs detected and urine still had to be collected.

Cost Analysis

Current costs for saliva screening and confirmation tests are considerably more expensive than the current costs for urinalysis testing.

When comparing the costs involved with staff time, saliva testing is currently 67%-70% more costly to implement than urinalysis. However, this is a generalised cost as some urine samples take considerably longer to collect, which would significantly impact on the costing methodology.

Conclusions

Prisoners, offenders and prison officers clearly indicated that saliva testing was less intrusive, less embarrassing, easier to conduct and less likely to be tampered with than urinalysis.

Although the low number of positive results limits general conclusions, the data clearly indicates that saliva tests do not currently meet a standard to replace urines as the primary drug-screening tool.

The high cost of saliva screening tools currently makes them financially unviable for wholesale implementation into correctional settings.

Recommendations

Urinalysis remains the primary drug-testing tool as the current saliva-screening tools failed to demonstrate sufficient accuracy.

Continue to monitor developments in saliva drug testing as improvements in technology may make it more viable.

Continue to investigate alternatives to laboratory-based urinalysis for drug testing in correctional settings and examine the optimal approach for drug testing throughout different settings.

Investigate the development of a full cost methodology including costs for drug testing throughout W.A. correctional settings.

Further Information

Please contact Christine Anderton for any further information concerning Drug Strategies within the

Department of Justice.

Email: Christine.Anderton@justice.wa.gov.au

Phone: 9278 1048