1. Saliva Drug Screening in W.A. Correctional Settings Hayley Taylor Kati Kraszlan Christine Anderton May – October 2004

2. Department of Justice  Feb 2003 DoJ hosted the Drugs Roundtable Forum. - Justice Drug Plan developed – reduce drug demand/supply/harm in Prisons. - Conduct a review of drug testing technologies.  Oct 2003 the report on alternative drug testing was completed (Gobetz and Wallengren, 2003). - reviewed drug testing technologies and determined those viable for use within correctional settings. Investigated hair, sweat, saliva, urine. - the report indicated that the use of saliva for drug detection may have some validity in a correctional setting and required further investigation.

3. Saliva Drug Testing  Potential advantages of saliva: - Relatively non-invasive - Easily accessible - Unlikely to be susceptible to adulteration (10 minute saliva turnover rate) - No requirement for specialised venues - Either gender can supervise - On-site results in a matter of minutes

4. W.A. Saliva Trial Aims: 1)To establish secure procedures for saliva drug screening in correctional facilities. 2)To assess the validity of two commercially available on- site immunoassay procedure for the detection of drugs in saliva. 3)To evaluate the use of saliva drug testing as an accurate and viable alternative to urinalysis.

5. Sample Population  6 month trial commenced May 2004  1175 random on-site saliva drug tests conducted across 5 sites: 1)Bandyup - Women’s Prison 2) Hakea – Maximum Prison 3) Wooroloo – Minimum Prison Farm 4)Acacia – Privately-operated Prison 5)Perth Drug Court – Community Setting  Variation in population and setting

6. Recruitment  Drug Court/Acacia – offenders/prisoners participated in the saliva trial voluntarily. All saliva samples had accompanying urinalysis results.  Hakea/Bandyup/Wooroloo – prisoners were randomly selected to participate in the saliva trial (Regulation 26b of the Prisons Act). Urine samples were only collected upon the indication of a positive on-site saliva test or refusal to provide a saliva sample. *** All of the offenders/prisoners and officers that participated in the trial completed a brief questionnaire to determine attitudes towards saliva drug testing.

7. Saliva Products  Of the 1175 saliva samples collected:  575 saliva samples tested with the Cozart RapiScan ® (Bioscience Ltd, Abingdon Oxfordshire UK) - 73.7% male  600 saliva samples tested with the UltiMed SalivaScreen ™ (UltiMed Products GmBh, Ahrensburg, Germany) - 72.7% male

8. Product 1 - UltiMed SalivaScreen ™  Detected 5 drugs: methamphetamine, cannabis, cocaine, morphine, methadone  3-step procedure  Device does not come with a suitable storage container  A second saliva sample had to be collected for GC-MS confirmation

9. Product 2 – Cozart RapiScan ®  Detected 5 drugs: amphetamines, benzodiazepines, opiates, cocaine, cannabis.  Multiple steps involved  Suitable storage container supplied  Adequate sample for GC-MS confirmation

10. Sample Distribution Drug Court WoorolooBandyupAcaciaHakeaTotal UltiMed23011510510050600 Cozart200100 75100575 Total4302152051751501175  Sample target per product: Drug Court (n=200) and Prisons (n=100) ** Hakea/Acacia target was not achieved

11. UltiMed Positive Test Results (n=113) Meth adone Metham- phetamine CannabisMorphineTotal DC (n=219)22219355 Bandyup (n=104)2720029 Acacia (n=98)1004115 Hakea (n=49)42017 Wooroloo (n=113)60017 Total (n=583)69 (61%) 25 (22.1%) 13 (11.5%) 6 (5.4%) 113  No Cocaine positives recorded  Methadone positives were prescription based  A total of 15.5% of saliva tests at DC and 3.02% of saliva tests at Prisons tested positive for an illicit drug.

12. Cozart Positive Test Results (n=58) BenzoAmphetCannabisOpiateCocaineTotal DC (n=197) 176145042 Bandyup (n=100) 100012 Acacia (n=75) 002002 Hakea (n=99) 312006 Wooroloo (n=99) 311106 Total (n=570) 24 (41.4%) 8 (13.8%) 19 (32.8%) 6 (10.3%) 1 (1.7%) 58  A total of 12.7% of saliva tests at DC and 2.4% at Prisons tested positive for an illicit drug.

13. Positive saliva on-site test results compared to urinalysis True PositiveFalse Positive UltiMed n % Methamphet (n=25) 23 92% 2 8.0% Morphine (n=6) 6 100% 0 - Cannabis (n=13) 5 38.5% 8 61.5% Cozart n % Opiate (n=6) 5 83.3% 1 16.7% Cannabis (n=19) 16 84.2% 3 15.8% Amphet (n=8) 5 62.5% 3 37.5% Benzo (n=17) 14 82.4% 3 17.6% Cocaine (n=1) 0 - 1 100%

14. Negative saliva on-site test results compared to urinalysis True NegativeFalse Negative UltiMed n % Methamp (n=243) 223 91.8% 20 8.2% Morphine (n=258) 242 93.8% 16 6.2% Cannabis (n=253) 184 72.7% 69 27.3% Cozart n % Opiate (n=269) 260 96.7% 9 3.3% Cannabis (n=258) 209 81.0% 49 19.0% Amphet (n=267) 248 92.9% 19 7.1% Benzo (n=258) 209 81.0% 49 19.0%

15. Sensitivity, Specificity and Accuracy Sensitivity (>90%) Specificity (>90%) Accuracy (>95%) UltiMed Morphine27.310093.9 Cannabis6.895.871.0 Methamphet53.599.191.8 Cozart Opiate35.799.696.4 Amphetamine20.898.892 Cannabis24.698.681.2 Benzodiazepine22.298.681.1

16. Time Taken To Collect Saliva Sample Mean time required to collect a saliva sample with UltiMed (sec) Mean time required to collect a saliva sample with Cozart (sec) Overall36132.7 Drug Court29.1100.5 Acacia31.7149.2 Hakea33.8155.7 Wooroloo39.6131.6 Bandyup45.7126.7

17. Time Taken To Obtain Saliva Test Result Mean time required to obtain a test result with UltiMed (min) Mean time required to obtain a test result with Cozart (min) Overall9.2212.16 Drug Court8.4312.18 Acacia9.1012.16 Hakea9.5612.14 Wooroloo10.4612.16 Bandyup8.5512.16

18. Offenders Attitudes Easier to provide (n=563) Easier to have collected (n=578) Prefer to provide (n=545) Easier to tamper (n=350) Saliva88.1%90.6%86.1%15.8% Urine6.7%6.6%8.4%73.6% Both5.2%2.8%5.5%10.6%  Attitude data combined for the two saliva products

19. Officers Attitudes  57 officers participated in the trial: - 87.7% less time to collect saliva sample compared to urine sample - 82.4% prefer to collect a saliva sample rather than a urine sample - Advantages of saliva testing: both genders can supervise, testing is less intrusive, quicker, easier and negates time involved with strip searches. - Disadvantages of saliva testing: window of detection, limited number of drugs detected and urine still had to be collected.

20. Cost Analysis  Current costs for saliva screening and confirmation tests are considerably more expensive than the current costs for urinalysis testing.  When comparing the costs involved with staff time, saliva testing is currently 67%-70% more costly to implement than urinalysis. However, this is a generalised cost as some urine samples take considerably longer to collect, which would significantly impact on the costing methodology.

21. Conclusions  Prisoners, offenders and prison officers clearly indicated that saliva testing was less intrusive, less embarrassing, easier to conduct and less likely to be tampered with than urinalysis.  Although the low number of positive results limits general conclusions, the data clearly indicates that saliva tests do not currently meet a standard to replace urines as the primary drug-screening tool.  The high cost of saliva screening tools currently makes them financially unviable for wholesale implementation into correctional settings.

22. Recommendations  Urinalysis remains the primary drug-testing tool as the current saliva-screening tools failed to demonstrate sufficient accuracy.  Continue to monitor developments in saliva drug testing as improvements in technology may make it more viable.  Continue to investigate alternatives to laboratory-based urinalysis for drug testing in correctional settings and examine the optimal approach for drug testing throughout different settings.  Investigate the development of a full cost methodology including costs for drug testing throughout W.A. correctional settings.

23. Further Information Please contact Christine Anderton for any further information concerning Drug Strategies within the Department of Justice. Email: Christine.Anderton@justice.wa.gov.au Phone: 9278 1048