12 July 2012
Continuing with its program of professional development workshops for OHS personnel and management, MARCSTA secured the participation of Professor Steve Allsop, Director, National Drug Research Institute, to co-ordinate a comprehensive program to provide a full understanding and appreciation of the rapidly escalating epidemic of drug usage in the community and how this might translate to workplace risk.
The workshop was fully interactive involving small group discussions and exercises.
Issues for consideration were:
Patterns of drug use in the community and how this might translate to workplace risk
Models of drug use and their relevance to the workplace
Rationale for responding in the workplace
Evidence about the range of strategies for response
Designing a response for your workplace
Strengths and limitations of most common drug testing methodologies
The processes required for quality drug testing practice
The role of Government, services available, treatment options
Presentations available from the workshop are below:
Professor Steve Allsop
Dr Charles Appleton
Clarification from Dr Appleton:
During my presentation, a lady asked me a question and I realised after I left that I had given her an incomplete answer.
Could you please forward this to all attendees to ensure that she receives the full picture?
She asked if any oral adulterants work, that is if there is anything that can be taken orally to assist the user in having his drug use go undetected.
I told her that the chemically active substances are either too toxic to ingest or are inactivated within the body so that they are ineffective as urinary adulterants. The substances which are advertised to do this simply work through requiring the subject to wash them down with a large volume of water and thus produce a relatively dilute urine.
This remains correct but I overlooked that methamphetamine and amphetamine users will take urinary alkalinisers such as sodium bicarbonate or Ural to reduce the urinary concentration of their drugs. This is not an adulterant effect but simply capitalises on kidney and sympathomimetic amine physiology.
Amphetamines are must efficiently excreted into acid urine and if the urine is alkaline, the kidney will actually reabsorb some of the filtered amphetamine and hence lower the concentration in the urine. Thus if the subject takes Ural, from half an hour through the next 3 hours after the dose, the urine will be alkaline and the kidney will hold back some of the amphetamine and the residual material which remains in the urine may be below the detection threshold and will pass beneath the radar.
In effect, whereas under normal circumstances I would expect to detect amphetamine use for 3-4 days after a dose, if the subject alkalinises his urine I would only expect to detect use within 36-48 hours of urine collection.
These urinary alkalinisers are usually used to control the stinging symptoms associated with a urinary tract infection, and so as UTI is common in women, use of Ural in a lady is not unduly suspicious.
However UTI is rare in males, and a male who claims he is taking Ural for recurrent UTI is likely to either have a pathological urinary tract condition or be trying to hide amphetamine/methamphetamine use.
What I generally suggest if Ural use is reported is to arrange collection of another sample a few days later. If the subject is using frequently, he will be caught at some stage.
I hope that this clarifies the situation.
Within the laboratory, we actually check the acidity of the urine so we recognise that the urine may be quite alkaline, but the Ural effect never pushes the urine pH out of the human normal range so an alkaline urine is not a suspicious enough finding if found as a once-off to trigger any special action on the lab’s part.
Not at work, mate
Foundation House, the Construction Industry Drug and Alcohol Foundation Treatment Centre, provides alcohol, drug and gambling services specially targeted to the needs of construction industry personnel, members of their families and the general public.
For further information visit http://www.btgda.org.au/