Although touted as a useful tool to combat drunk and drugged driving, on-the-spot saliva drug screening is a war-on-drugs development that aims to target everyone, even the innocent. While the goal is to expand the saliva test to the workplace, the schools, and the family courts and programs, the roll-out will target random drivers. Rather than contribute to the decrease in impaired driving incidents, however, the practice will likely criminalize legitimate medication therapies by identifying miniscule and sub-therapeutic levels of some drugs.
This technology is being sprung onto the public ahead of any validation studies that connect a positive screening test in the field to actual impairment, but that has not stopped its premature use. House Bill 5385 in Michigan, for example, was set to force people to have this test, and this test exclusively, on demand. On Thursday, granting Michigan a temporary reprieve from this chicanery, state Rep. Mike Callton (R.MI) announced that the saliva test amendment would be dropped from the legislation based on the inaccuracy of the test. But it isn’t just about accuracy. It’s about targeting drivers randomly for non-impairment.
Drug testing ordinarily follows a two-pronged approach: a screen, and then a confirmation. Drug screening of body fluid is achieved by Enzyme Immunoassay (EIA)/Enzyme-Linked Immunosorbent Assay (ELISA), followed by confirmation, if the initial screen is positive. Confirmation takes longer and utilizes gas or liquid chromatography (typically), ie: GC/MS or LC/MS/MS, but it is more accurate and can serve to rule out false positive screens. There are limits of detection for each specified substance, and these are listed in each manufacturer’s FDA-regulated package insert; values below the detectable limits for commonly prescribed drugs are not of toxicological (or therapeutic) interest.
As the drug testing industry expands and takes on a life of its own that has little to do reality, the limits of detection are an issue. The saliva tests are not FDA approved, nor are there any clear methods or limits of detection anywhere, not to mention any connection to actual driving impairment or even any clear description of targeted parent drugs versus metabolites. There are no uniform guidelines for calibration, or specimen handling, and no algorithms exist to ensure chain of custody. The gaps between oral fluid detection and blood level confirmation and actual impairment are neatly filled in with “predictive toxicology.”
Furthermore, on Point of Care Testing (POC), even the Department of Transportation (NHTSA) explains that saliva tests are inaccurate:
THE FUTURE IN DETECTING DRUGS IN DRIVERS
Having an immediate drug test result obtained from a POCT-type test would permit the officer to confront the driver with the drug test result and make the DUID charge. At this time, however, only the urine based POCT technology appears to provide the accuracy and reliability required, and use of this technology is not yet widespread. With the advent of more “zero tolerance” laws, we may see the use of this technology grow. The development of sweat and oral fluid technology holds great promise for the field, but the most recent evaluations indicate that it may be a few more years before the desired sensitivity, specificity, accuracy, and reliability are attained.
That a drug test isn’t exactly proven, however, hasn’t stopped the forensics/police/prosecutor community in the past. Just a few years ago, a urine test to determine alcohol (EtG test) use was pimped as the gold standard. Many doctors, nurses and other professionals in supervised treatment programs as well as others who were on probation or parole supervision had to submit to this test, to determine their compliance in the supervised programs. Professional licences were revoked or people went to jail, for ‘non-compliance,’ based on the ‘gold standard’ urine alcohol test. The courts were sold.
But then, the test was deemed to be bogus.
SAMHSA has issued an Advisory that cautions licensure bodies, other monitoring organizations, and staff in criminal justice settings that a widely used test for alcohol consumption is “scientifically unsupportable” as the sole basis for legal or disciplinary action.
Unfortunately, that did not help some people, because the courts had decided that the test was reliable.
The urine alcohol thing was a miserable failure, but the forensics industry is pushing forward, undaunted. Now, there is a huge move afoot, essentially, to find anything in the blood, and prosecute accordingly. Namely, the various versions of synthetic cannabis are the target. The limits of detection for the various substances have not been worked out, and the protocols have not been worked out, and connection to driving impairment has not been worked out, but that’s okay because the passing public makes a pretty decent lab rat, and if any other molecules of any sort are detected along the way, those are thrown in as well.
The marketing ploy for the saliva test is, “It’s just like a portable breath test.” The potential is endless, especially given that most Americans take medicine for some reason. Literally everyone can go to jail. Workers, school kids, drivers, professionals. There’s just one thing though. The saliva spot test for a given machine make and model, if positive in the field, will be sent to one lab, who will do another screening. Not a confirmation. Just a ‘confirmatory’ screen. This is actually in the product insert for one of the machines, the Dreager 5000. Draeger covers its ass nicely by saying that the actual result must be confirmed in the lab:
Positive results can be confirmed with a second oral fluid sample via an independent, third-party laboratory analysis using the gold standard method
for evidential tests. Results are available online in a matter of days.
Also note that the product is for “law enforcement only,” and that there is little information available about the machine, because the process is “proprietary.” The lab in this instance that stands to gain a fortune by re-testing the saliva in the lab is NMS Labs.
As it turns out, the Director of Forensics for NMS Labs, a person named Barry Logan, is instrumental in working with the government, to push for random, no-reasonable suspicion traffic stops and mandatory random screening of not just illicit drugs but also things like common anti-depressants, anti-seizure drugs…These are to be tested with limits of detection that are sub-therapeutic. Dr. Logan and others in the law enforcement and crime lab community are pushing for per se laws on everything. To justify the new voodoo drug war expansion, the government recently funded a traffic study. Passing it off with the fatuous excuse that they were performing a “traffic study” to combat drunk and drugged driving, they sent off-duty cops into 60 cities in several states last last fall, to flag down random motorists and collect DNA and body fluids as well as personal histories.
This unethical experiment on motorists that left towns speechless, was based on some Guidelines for research on drugged driving. The guidelines were the handiwork of an ‘expert’ panel- Dr. Barry Logan of NMS Labs is on the toxicology section of the panel. The goal is new laws for random mandatory body fluid (ie, saliva) testing and per se laws on illicit as well as therapeutic medicines (and various over-the-counter medicines), regardless of impairment. This includes miniscule amounts of cannabis.
Issue 11. What are minimum analytes to be tested and maximum cut-off concentrations in urine? Urine specimens provide a basis for further investigations in blood of relevant drug classes. Detection limits should be as low as analytically feasible.
Note that they mention urine, but the guidelines suggest blood for study purposes, with saliva as well, even though saliva is iffy. In the end, if they call it “Science” and go with saliva for the new gold standard, people will be none the wiser, and it’ll be just like CSI.
By the way, there is also a push for alcohol at .01 detection limit and a .05 BAC limit for driving, so anyone who had a glass of wine in a restaurant would go to jail. Also, before Dr. Logan failed upward to work with the government on driving policy and oversee a lucrative, huge private for-profit lab, he left Washington State’s crime lab, pretty much resigned in disgrace, because the workers under his purview at that lab were falsifying calibration papers on…you guessed it- portable breath machines.
State toxicology lab chief resigns over DUI errors
Published: Feb 14, 2008 at 3:38 PM PDT Last Updated: Sep 27, 2010 at 12:53 PM PDT
On Thursday, the BOJ released some new incarceration numbers. The US continues to incarcerate and prosecute more people than any other country in the world, by a substantial margin. There are also sickening, heartbreaking articles about the mentally ill incarcerated being locked in solitary and left there. Strip searches and forced body cavity searches are still common.
Even though a recent London study determined that the US war on drugs is a dreadful failure that has created immense damage, the war on some drugs that was always a war on some of the people is picking up steam. And it is fundamentally flawed throughout.
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