According to news reports, inmates in Attica, New York, were wrongly accused of using buprenorphine (generic for the active medication in Suboxone and, Subutex). Apparently their urine drug screening system had a glitch, and nearly fifty inmates had these false positive screens. The prisoners, their lawyers, and their families badgered the Department of Corrections to investigate further, and when they did question the drug testing company, the unexpected results were found to be due to lab error. Until the error was acknowledged, inmates received sanctions and punishments including solitary confinement. It took a little over a month to discover the tests were in error, but at least the error was caught and acknowledged.
This is a good example of the lack of credibility addicts and inmates have. If a known addict protests a positive drug screen, much of the time they’re assumed to be lying. It’s not only law enforcement personnel who think this way; treatment center personnel can begin to believe all addicts are lying when they say their drug test results are wrong.
We must remember that no test is 100% correct and there will be false positives (the test shows drug use where none occurred) and false negatives (drug use occurred but wasn’t detected by the test) on screening tests. Granted, the rates of error are fairly low, but if you do enough tests, some addicts will be falsely accused of using drugs that they didn’t use.
That’s why secondary testing is crucial for contested results.
Most drug testing has two parts. The first screening test is quick, cheap, and relatively accurate. Most of the time, this test is sufficient. But in situations where positive tests have major negative consequences for the person being tested, a second, more accurate (and more expensive) test should be offered.
The second test is usually based on gas chromatography. If chain of custody has been maintained, the results of this test meet the legal standard of “beyond a reasonable doubt.” In other words, while no test is 100%, this test is so close that the courts accept it as proof.
At the opioid treatment programs where I’ve worked, many patients claim that their positive screening tests are in error, and they haven’t used the drug in question. That’s when the second test should be offered. However, gas chromatography is more expensive, and the issue becomes who should pay this extra thirty to forty dollars – the treatment center or the patient?
At one treatment center where I’ve worked, staff tells the patient that the second test will be done if the patient requests, but if the test is confirmed as being a true positive, the patient pays the cost of the second test. If the second test does NOT confirm the questioned result, the treatment program bears the cost. Thus, most people who know they’ve used the drug in question don’t request the second test because it’s a waste of their money. And patients who know they haven’t used are understandably eager to have the second test done on their sample, so they can prove their continued abstinence from drugs.
Drug testing is essential in the treatment of addiction, but treatment centers should make sure their tests are done by a certified lab and interpreted by a trained physician if questions arise. Confirmatory testing should be offered as an option to patients who question screening results.