USAF Urinalysis Program: Deter Or Detect 1985

the overall mission of the Air Force depends on the effectiveness of its people all of them if some work with their abilities impaired to any degree by drugs we all have a problem their co-workers their command the Air Force the nation that depends on the Air Force as one of its prime defense [Music] capabilities [Music] oh [Music] drug use is not a problem of critical proportions in the Air Force but it is a problem and that is unacceptable so something effective is being done about it this is the Air Force drug testing laboratory at Brooks Air Force based Texas it's the only Air Force lab that handles your analysis for drug detection it's a distinguished facility and has established an impressive scientific track record it's been working as a drug lab for over a decade processing close to 5 million samples morning thank [Music] you it works in close conjunction with the Armed Forces Institute of pathology in order to meet the demanding standards set by that world recognized organization this facility tests for several different types of drugs but by far the greatest volume of testing is for marijuana what you're about to see is the why and the how of the Air Force's Ur analysis program why and how it provides an accurate scientific and reliable means of identifying drug users as we go through it step by step you'll see for yourself what I mean the first step in the process is the selection of personnel to provide urine samples for testing there are several reasons why a given individual might be selected there is testing for probable cause testing done at the discretion of the Commander testing done for medical reasons but the most likely of all is inspection testing can I have everybody's attention our branch has been selected to participate in the analysis inspection testing program our commander has just notified me that we need to report to the clinic immediately for testing are there any questions the random checks of inspection testing are the Commander's tool for detecting a drug use problem and deterring anyone who might be tempted to use drugs okay let's go hello hi I've been instructed Port here for your analysis testing from the first moment the security of a sample is assured each person who provides a urine sample is accompanied by an observer who makes sure that the sample is not adulterated and that it is in fact a sample from the particular provider the sample is then labeled in a way designed to eliminate any possibility of a mixup each sample bottle must have the social security number and the initials of the provider in his or her own hand and the of the Observer then each sample is further marked to identify it by date and base number with each specimen thus identified there's no chance of one sample being mistaken for another as a further precaution tamperproof tapee is placed across the bottle lid to reveal any premature or unauthorized access into the sample all right thank you next a urine sample chain of custody document is prepared with all of the identifying information for each sample as they are organized into packages of up to 12 samples for shipment each package is then securely sealed with tape and the packager signature is inscribed across the tape seal the package is then shipped to the lab by mail or other carrier as each package is delivered to the receiving area it is inspected for any indications of tampering if there are none the package is accepted and signed for by the responsible laboratory staff from the start sample security has been safeguarded by chain of custody procedures the term chain of custody is familiar to those accustomed to preserving evidence for legal purposes in simple terms it means that right from the start none but authorized Personnel have access to urine samples and everyone who is authorized is also accountable as the samples arrive from the various bases each one is carefully inspected to ensure that it has not been adulterated samples are then organized into batches and given a unique laboratory assession number or batch number every week samples arrive from bases throughout the US these shipments include quality control samples provided by the Armed Forces Institute of pathology or afip this is located at Walter Reed Army Medical Center afip sends these to the bases to be randomly mixed in with a regular sample sent to the Brooks lab approximately 30% of the quality control samples contain a measured amount of drug residue these are used to check on the lab's effectiveness in detecting that drug the other 70% contain no drug residue that is they are negative samples these samples ensure that the laboratory is not falsely identifying drug-free samples as positive The Testing Lab does not know which bottles in a given batch contain the afip control samples in addition the afip sends samples directly here to the lab for testing the test results are sent back to evaluate the quality of the analysis the documentation and the reproducibility of the test results results additional quality control is provided by samples which the lab itself prepares and intermixes throughout each batch of urine samples in this case the quality control section of the laboratory can identify all the control samples and the people who do the actual testing know the location of several of them they use them to get an immediate check on the acceptability of an analysis if both the positive and the negative controls are acceptable then the specimens tested along with them are deemed acceptable for reporting the control samples whose locations are not known to the testing Personnel are used by the Quality Control Function to provide an in-house check on the quality of the testing the afip control samples plus those introduced by the lab itself provide a multiple check on the accuracy of the test results on a continuing basis here I'll show you what I mean test result evaluators at Brooks would immediately spot a discrepancy with regard to the in-house control samples and the entire testing would be ruled invalid and the testing done over again and if by chance the disc discrepancy with the inhouse samples was not detected or was misinterpreted the afi's careful check of every test report would show up the discrepancy with the known values of their own control samples and they would require the lab to investigate and report back this lab's extensive in-house quality control from 10 to 25% depending on the type of testing will Spotlight any batch that needs to be retested to ensure accuracy with quality control samples from in-house and afip mixed into every batch of samples tested there is a constant and reliable yard stick against which to measure overall testing accuracy now let's take a look at the actual steps involved in preparing and testing urine samples to determine drug residue content first Alo quing an Alo quat is a small measured amount of urine poured from the sample bottle into another container to provide an appropriate volume for testing here as everywhere great care is taken in handling the samples to ensure that chain of custody security is maintained contained only one sample is opened at a time to avoid any possibility of mixing sample liquids or getting the sample bottle covers mixed up Alo quats are prepared for each testing of a sample but the original samples themselves never leave the custody of the receiving division where they are kept secure under chain of custody procedures the first test procedure is designed to weed out those samples which are for the purposes of the program free of drug residues and to identify what are called presumptive positives this testing methodology is called radio imuno assay or raia ra is a very specific and reliable screening type test because its results are obtained through the use of antibodies that attract only metabolites of the drug being tested for and nothing else in preparing Alo quats for R testing Auto pip hitting equipment provides a reliable means of handling a large number of samples with extreme accuracy to the aliquat of urine very precisely metered amounts of drug specific antibody and a drug metabolite with a radioactive isotope ATT attached are added this is mixed very thoroughly if there are any drug metabolites already in the urine they will compete with the radioactive ones for the measured amount of antibodies forming an antigen antibody complex a refrigerated centrifuge is used to separate the complex from the solution [Music] [Music] the concentrator precipitate that remains is then tested using equipment which measures with with extreme accuracy and sensitivity the level of radioactivity present the lower the radioactivity the higher was the content of metabolites in the original urine sample the print out values which meet the initial test decision level are then identified as presumptive positives that is they show clearly a significant presence of drug residue in the urine sample radioimmunoassay and other testing methodologies used by the Brooks laboratory are universally accepted scientific procedures routinely used through throughout the world for specific and sensitive clinical analysis of sample content the presumptive positives are identified for further testing to confirm Beyond Reasonable Doubt the presence of drug residues all other samples are discarded these are control samples put into the batch by Brooks lab quality control section they give us an immediate way to check analytical accuracy any of these other presumptive positives could also be quality control samples from afip no one at Brooks lab knows which ones those are however you can be sure the afip does and they provide a closely monitored external quality check on the drug testing done by the Brooks lab the fact is the whole testing program is systematically waited to favor the individual besides the quality controls both internal and external and chain of custody procedures to ensure there are no mistakes as to which sample is which the initial test decision levels are purposely conservative and the confirmatory test decision level set High to eliminate falsely identifying anyone as a drug abuser for example the testing reagents used by the Brooks lab can be formulated to detect marijuana residue down to a level of 5 nanog 5 billionth of a gram but the initial test decision level for a positive raia initial test report for marijuana is set at 100 n 20 times the amount the reagents and Equipment are capable of detecting once the presumptive positives identifi through radio amuno ASD they are evaluated they are always confirmed by further testing here at Brooks or an independent contract lab using different equipment and methodology nothing is taken at first glance or at face value the testing must leave no room for doubt from each sample identified as presumptive positive new Alo quats are poured using the same care as before to maintain meticulous chain of custody the method used to confirm the Ria test results is gas chromatography with mass spectrometry gcms for short this method that is highly specific in confirming the presence of drug residues in urine it focuses on a particular drug metabolite that is most prevalent in urine the first step in preparing the aliquat for gcms testing is the extraction process which uses a resin to isolate the drug from the urine next follows centrifugation to separate the urine and the resin washing to release the drug into the final solvent and to rization to prepare the metabolite for the gcms analysis finally the extract is dissolved in a small amount of solvent for analysis when the prepared solution is injected into the gas chromatograph it is vaporized mixed with a carrier gas and passed through a long narrow tube to separate the components of the mixture at the end of the tubing the compound we are looking for is converted into the mass spectrometer where it is bombarded with a stream of electrons breaking the molecules into ion fragments each drug has a characteristic fingerprint or pattern of distribution of fragments if the drug is present a specific pattern or fingerprint is produced thus allowing the drug to be positively identified all of this information is displayed on a hard copy computer print out the computer monitor gcms instrument fingerprints molecules thus positively and specifically identifying the chemical compounds the confirmation of a positive identification by means of gcms ensures Beyond reasonable doubt that there has been no mistake the presumptive positive first revealed by radio imuno assay and confirmed by gcms analysis is indeed a valid positive identification of drug residues in a particular urine sample these results are not simply reported back to the commands instead tests and the accuracy of all the recordkeeping and accountability papers from start to finish are reviewed by several different people each scrutinizes every detail closely because each is accountable for the records and the test results that he or she will sign for any of these reviewers and evaluators are required to send any questionable result back to repeat the testing any discrepancy can result in doing the whole test over again the UR analysis program is succeeding achieving both of its defined objectives deterrence and detection of drug use by Air Force people when testing for the marijuana metabolite THC first began it was a short sharp rise in positive identifications of marijuana users as people became aware of how well the testing program could identify users the positive started to decline indicating a substantial drop in the use of marijuana we find the same Trend in the use of other drugs the UR analysis program correctly accurately and fairly identifies drug users it uses state-of-the-art technology operated by a highly trained staff performance is constantly monitored through both internal and external quality controls chain of custody is very carefully maintained from start to finish the accuracy of all test results and all recordkeeping is checked and rechecked all along the way the result is a program that works it enables commanders to detect fairly and with great reliability the use of drugs within their unit and because the program effectively detects its very existence effectively deters the individual who knows that drug use is likely to be discovered and proven [Music] pap la