Testing for illicit drug use in mental health services

Abstract

SummaryTesting for illicit drug use is used in pre-employment checks, the criminal justice system, sports medicine and for screening and confirmatory purposes in patients with physical and mental illnesses. The types of drugs tested for and the methods used vary depending on the indication. This article focuses primarily on blood, urine and oral fluids, which are specimens more commonly used in mental health settings, although hair and sweat are increasingly used in medico-legal cases and in child protection issues. The main drugs and their metabolism are discussed to gain a better understanding of the methods used and for accurate interpretation. Methods to ensure validity during sample collection are explored. False-positive and false-negative tests are common and possible confounders are discussed.

When the grass isn’t greener: a case series of young children with accidental marijuana ingestion

“…[19][20][21] While pattern and symptom recognition obtained through experience can reduce unnecessary investigations, acute marijuana intoxication should remain only one facet of a broad differential diagnosis when assessing young children with altered mentation. Urine drug screens can be misleading, with positive results occurring many days post-exposure, 22 and do not demonstrate impairment.…”