Time & Location
Dec 13, 2024, 9:00 AM – 4:00 PM
Zoom
About The Event
Morning: The Principles of Drug Testing, Alcohol Biomarkers, Principles of Oral fluid Testing
Afternoon: Xylazine, Fentanyl and Marijuana Delta trends and Q&A
The Principles of Urine Drug Monitoring (UDM)
“The Principles of Urine Drug Monitoring (UDM)” reviews the fundamentals (“101s”) of UDM and result interpretation in the treatment of substance use disorders. This informative presentation reviews the differences between presumptive and definitive testing methodologies, how biological and validity markers can assist when determining specimen integrity, utilization of the laboratory report for result interpretation and monitoring for drug use, and why Creatinine-Adjusted Values (CAVs) are necessary for assessing for abstinence or continued use.
Objectives
1) Compare and contrast the differences between presumptive and definitive urine drug testing methodologies.
2) Differentiate between presumptive and definitive methodologies on the result report.
3) Explain why false positives may occur by EIA.
4) List three examples of how a patient may attempt to falsify a urine drug specimen.
5) Identify what quantitative drug levels can and cannot be used for.
6) Utilize the laboratory interpretive report when interpreting and assessing results.
7) Define creatinine and understand its impact on detected drug levels.
8) Monitor use of substances with long elimination windows (e.g., marijuana) utilizing Creatinine-Adjusted Values (CAVs).
Alcohol and Urine Drug Monitoring (UDM)
“Alcohol and Urine Drug Monitoring (UDM)” provides a comprehensive review on alcohol, result report interpretation, and how urine testing of alcohol can assist in monitoring for recent alcohol use and assessing abstinence in the treatment of alcohol use disorder. This introductory presentation reviews testing for ethanol and the alcohol biomarkers, Ethyl glucuronide (EtG) and Ethyl Sulfate (EtS), ethanol fermentation and post-collection EtG synthesis, “incidental” alcohol exposure, and using definitive EtG and EtS LCMSMS testing and Creatinine-Adjusted Values (CAVs) to differentiate between potential sources of a detection.
Objectives:
1) Explain why urine drug monitoring is a useful objective tool for monitoring alcohol use and assessing abstinence.
2) Define ethanol fermentation and one strategy shown to reduce the chance of it occurring after collection.
3) Explain the advantages of testing for Ethyl glucuronide (EtG) and Ethyl Sulfate (EtS) over ethanol when monitoring for alcohol use.
4) Define post-collection EtG synthesis and why an EtS detection rules out post-collection synthesis as the source of an EtG detection.
5) Counsel individuals about incidental alcohol exposure and avoiding use of ethanol-based products.
6) Identify a false positive on the result report and explain why a false positive EIA result may occasionally occur.
7) Use the result report to differentiate between drinking, incidental exposure, ethanol fermentation, and post-collection EtG synthesis as potential sources.
The Principles of Oral Fluid Testing
This is an instructive presentation reviewing the essentials of oral fluid testing. Participants will learn about the strengths and limitations of oral fluid testing, windows of detection, disposition of key drugs in oral fluid, dry mouth syndrome, adulteration, and the collection procedure.
Objectives
1) Compare and contrast key differences between oral fluid testing and urine drug monitoring.
2) List factors that may affect whether a prescribed medication is detected despite adherence.
3) Discuss important differences between specific drug classes in oral fluid and apply that knowledge when interpreting results.
4) Define “dry mouth syndrome”.
5) Explain why individuals should refrain from eating or drinking anything for 10 minutes prior to collection.
6) List ways that individuals may attempt to adulterate an oral fluid test.
7) Demonstrate proper technique for administering an oral fluid swab.
A Look at Current Drugs of Misuse: Fentanyl, Xylazine, and Delta-8-THC
“A Look at Current Drugs of Misuse: Fentanyl, Xylazine, and Delta-8-THC” is aimed at keeping participants up to date and informed about notable drugs of misuse. This educational presentation provides a detailed review on fentanyl, xylazine, and delta-8-THC, including information on monitoring and assessing for use of these substances.
Objectives
1) Describe fentanyl and why its use is driving the increase in overdose deaths in the United States.
2) Discuss counterfeit pills and why users may not know that they are misusing fentanyl.
3) Identify the potential for extended detection windows in urine following chronic and/or heavy illicit fentanyl use and how to use Creatinine-Adjusted Values to compare over time to assess for abstinence or new use.
4) Describe xylazine and how it may be misused.
5) Identify the substances that xylazine is commonly added to.
6) Counsel on the risks of using xylazine in combination with opioids (e.g., fentanyl).
7) Explain why the opioid rescue medication naloxone is not expected to be effective in a xylazine overdose.
8) Identify a notable adverse effect associated with xylazine use that can be used to screen for potential xylazine use in the absence of testing.
9) Discuss the availability of xylazine test strips that can protect users from unknowing xylazine exposure.
10) Describe delta-8-THC and how it compares to delta-9-THC.
11) Identify different delta-8-THC formulations and where they may be obtained.
12) Discuss the lack of regulatory oversight in the production of delta-8-THC and the potential risks associated with use of an unregulated product.
13) Use the laboratory result report to distinguish between a delta-8-THC and delta-9-THC detection.
14) List potential sources of a delta-8-THC detection and apply this information when interpreting THC results.
Arthur J. Rodrigues, Director of Clinical Services Clinical Pharmacist, RPh, graduated in 1980 with a Bachelor of Science from the University of Rhode Island’s College of Pharmacy. He was a practicing pharmacist for 20 years before becoming the current Director of Clinical Services at Dominion Diagnostics, a national medical laboratory based in Rhode Island. Mr. Rodrigues served on the faculty at the North Carolina School for Alcohol and Drugs Studies, and has presented clinical diagnostics and pharmacology lectures at numerous State and National meetings.
Jennifer Lee, Supervisor of Clinical Services, Clinical Pharmacist, RPh, graduated in 1994 with a Bachelor of Science degree from the University of Rhode Island’s College of Pharmacy. She began her career practicing in community pharmacy, and quickly found she had an interest in clinical work. She moved to Denver, CO where she worked for Kaiser Permanente Anticoagulation Services Department for 11 years. In this role she managed a patient panel of approximately 500 patients, adjusting anticoagulation medication doses, and providing extensive education. Upon returning to Rhode Island, Jennifer performed prior authorization reviews for CVS/Caremark. In addition to her role there, she developed a pharmacy technician certification course and organized continuing education seminars for the pharmacist staff. Since 2010 she has worked for Dominion Diagnostics’ Clinical Services Department. As part of their team of clinical pharmacists, she educates providers and assists with results interpretation of urine and oral fluid drug testing. She is also responsible for writing educational resources that are utilized as an adjunct to phone or email consultations. These include a wide array of informative quick reference documents pertaining to drugs of misuse and testing, as well as bimonthly clinical communications aimed towards keeping the readers abreast of relevant clinical information.
Lisbeth O’Brien, Clinical Services’ Education Coordinator, Clinical Pharmacist, RPh, PharmD.After receiving a Bachelor of Arts in Psychology and French Language and Literature from Boston College, Lisbeth O’Brien attended Massachusetts College of Pharmacy and Health Sciences where she received her Doctor of Pharmacy degree in 2014. Following graduation, she worked as a community pharmacist and developed a passion for patient education and counseling, as well as for training pharmacy technicians and precepting student pharmacists. This included a preceptor role with Fairleigh Dickinson University’s School of Pharmacy while working as a pharmacy manager in New Jersey. During this time, Lisbeth hosted and precepted student pharmacists at her practice site during their Introductory and Advanced Pharmacy Practice Experiential rotations. In 2021, she joined Dominion Diagnostics’ Clinical Services department. As part of their team of clinical pharmacists, she leverages her pharmacy background and education to assist with drug monitoring and result interpretation in the treatment of substance use disorders and chronic pain. In line with her commitment to education, she is responsible for organizing and presenting Clinical Services‘ educational presentations to clients of Dominion Diagnostics looking to enhance their knowledge of urine drug testing and monitoring.
Credit: 6 Hours
Audience: Art Therapists, Alcohol and Drug Abuse Counselors, Licensed Professional Counselors, Social Workers, Mental Health Counselors, School Counselors, Marriage and Family Therapists, and Medical Professionals
Fee: Subject to agency of employement. See below.
Employees of agencies not part of Region 1: Please purchase a Standard $75 Ticket
Employees of Region 1 301 Agencies: Please purchase a Region 1 Employee Ticket (A/OBHS, BHSPC, CCCADA, The Forrester Center, HealthyU, ReGenesis, Phoenix Center, Cornerstone, Westview, Gateway, Spartanburg Area Mental Health Center and Anderson/Oconee/Pickens Mental Health)
Payment options:
Offline payment (Preferred):
Checks made out to BHSA Region 1 and mailed to:
Attn. Mandy Hadsell PO Box 1948 Greenville, SC 29602.
Pay online with credit card
(refunds subject to 2.9% + 0.30 processing fee and will be refunded via check)