random drug testing activities -...

RANDOM DRUG TESTING ACTIVITIES

Dangerous Drug Abuse Prevention and Treatment Program

Department of Health

BENJAMIN P. REYES, DMD, MPHSupervising Health Program OfficerDepartment of Health

BOARD REGULATION No. 3Series of 2009

SUBJECT : GENERAL GUIDELINES FOR THE CONDUCT OF RANDOM DRUG TESTING FOR STUDENTS OF SECONDARY, TERTIARY, VOCATIONAL AND TECHNICAL SCHOOLS, AMENDING BOARD REGULATION NO. 6, SERIES OF 2003

1) Elaboration of the Guiding Principles under Board Regulation No 6, 2003

2) Flow Chart of Procedures in the Conduct of Drug Testing

-Notification

-Samples

-Selection of Samples

-Treatment of Random Drug Test Results

3) Treatment of Random Drug Test Results

1) Elaboration of the Guiding Principles under Board Regulation No 6, 2003

-Random drug testing for students is considered by the government as entirely a “health” issue and aims to provide services, to those who will be tested positive for dangerous drug use, that will help the student stop further use and abuse of the substance.

-Random drug testing is implemented primarily for prevention, data gathering and provision of needed rehabilitative services which include, but not limited to, counseling, family therapies, attendance to support groups and out-patient services.

-The drug testing program and results of testing shall guarantee the personal privacy and dignity of the students and shall not be used in any criminal proceedings

-Proper information shall be disseminated by supervising agenciesprior to the conduct of the drug testing activities to allow students to appreciate intentions of the activity. This includes a written notification to parents as provided for by the DDB Regulation.

1) Elaboration of the Guiding Principles under Board Regulation No 6, 2003

-Random selection of samples and treatment of results, as stipulated in the DDB Regulation shall be strictly enforced and observed bythe implementing agencies.

-Pursuant to the guiding principles enumerated under the Regulation, records of students who are randomly selected for the activity shall be treated with utmost confidentiality.

-Under no circumstances shall this activity be used to incriminate any student for further legal action which may result in having administrative/criminal records and/or incarceration.

-Implementors shall explain the objectives of the program to the student and if available, his/her parents, assuring and allaying fears of the activity.

Who are required to undergo RANDOM drug testing?

• Students of Secondary and Tertiary schools– Requisites:

• Pursuant to rules and regulations as contained in the schools student handbook

• With notice to parents• Government shall bear the cost of drug testing

(private or public schools

• Objectives

– Pursuant to Board Regulation No 6, 2003– As Amended by DDB Regulation No 3, 2009

• To determine prevalence of drug users among students• To assess the effectivity of school-based and

community-based prevention programs• To deter the use of illegal drugs• To facilitate rehabilitation of drug users and dependents• To strengthen collaboration efforts of identified

agencies against the use of illegal drugs

And IF FOUND POSITIVE…

• Board Regulation No 6, 2003

– Shall NOT be ground for expulsion or any criminal or disciplinary action

– Drug Testing is treated as a “Health” issue and not as a law enforcement issue

Random Drug Testing

• 2005 – 2ndary Level Students (8,670)

• 2007 – 3rtiary Level Students (7,499)

• 2009 – February- December for 2ndary, 3rtiary and Vocational Students (120,000)

Assumptions for the Conduct of Drug Testing for Dep Ed and CHED Students in 2005 and 2007

•Number of Clusters 17/region (Private and Public Schools)

•Total Respondents 340-510/region (Total No of Students

tested)

•Cluster Size 20-30 (Students tested per school)

•Estimated Prevalence 20% (based on 1998 DDB Survey)

•Confidence Coefficient 95%

-Using Cluster Random Sampling

Region Total Number of Students

Tested Positive

Total Number of Students Tested

Positive

Dep Ed Ched

1 0 2

2 0 43 2 4

4-A 6 0

5 1 0

6 2 47 10 38 2 0

9 1 1

10 13 711 10 1

12 7 1CARAGA 9 6ARMM 1 4

4-B 0 0

CAR 1 0

NCR 2 2

TOTAL 67 39

*2005 Random Drug testing of 8670 High School Students –yielded a 0.8% nationwide prevalence

*2007 Random Drug testing of 7,499College Students –yielded. 0.5% nationwide prevalence

Parameters Number NeededCluster Number 46 27 21 316 312Cluster Size 10 20 30 10 20Total Responses 460 540 630 3,160 6,240Estimated Proportion 50% 50% 50% 50% 50%Confidence Coefficient 95% 95% 95% 95% 95%Confidence Interval + and - 5 + and - 5 + and - 5 + and - 5 + and - 5

Rate of Homogeneity .02 .02 .02 0.8 0.8Design Effect 1.18 1.38 1.58 8.2 16.2

RANDOM DRUG TESTING FLOW CHARTPre- Specimen Collection Phase

Supervising Agency requires the creation of “Selection Board” at the

school/institution level and orients them on roles and responsibilities including

preparation of documents (eg.masterlist)

1st Year 2nd Year 3rd Year 4th YearSec A

Sec B

SecC

Sec A

Sec B

SecC

Sec A

Sec B

SecC

Sec A

Sec B

SecC

1 1 1 1 1 1 1 1 1 1 1 12 2 2 2 2 2 2 2 2 2 2 23 3 3 3 3 3 3 3 3 3 3 34 4 4 4 4 4 4 4 4 4

5 5 5 5 5 56 6 6

Total Enrollment = 55 Student

Example: School X

1st Year Sec A 1

2

3

4

Sec B 5

6

7

Sec C 8

9

10

11

12

13

2nd Year Sec A 14

15

16

17

18

Sec B 19

20

21

22

Sec C 23

24

25

26

27

3rd Year Sec A 28

29

30

31

Sec B 32

33

34

35

Sec C 36

37

38

39

40

41

4th Year Sec A 42

43

44

Sec B 45

46

47

48

49

Sec C 50

51

52

53

54

55

RANDOM DRUG TESTING FLOW CHARTPre- Specimen Collection Phase

Supervising Agency through the Selection Board, informs the parent/families of

students on the Conduct of Random Drug Testing (RDT) in writing

RANDOM DRUG TESTING FLOW CHARTPre- Specimen Collection Phase

Supervising Agency and the Department of Health prepares and plans the conduct of

RDT and convenes the Team

RANDOM DRUG TESTING FLOW CHARTSpecimen Collection Phase

RDT Team meets with the Selection Board of the School concerned, pays courtesy

call and does orientation, while simultaneously preparing the collection site

RANDOM DRUG TESTING FLOW CHARTSpecimen Collection Phase

RDT Team and Selection Board, following set procedures, randomly select the

students to be tested from the masterlist provided by the school

Randomization

• Open Excell program• Place cursor in the A1 field

A B

1

2

Randomization

• In the Function bar (look for the field-fx ) type

• =RAND()*(Total School Population-1)+1• Example: School enrollment Total=100

fx =RAND()*(100-1)+1

Randomization

• Press Enter• A random number between 0 and 101 will

appearA B

1 21.33368

2

Randomization

• Place the “cursor” at the edge of the cell

A B

1 21.33368

2

Randomization

• Drag the cursor to get 10 numbers

A B1 21.333682 91.270043 67.25274 92.378755 79.85116 18.864077 59.711768 88.859179 39.58524

10 59.514461112

Randomization• Remove the

decimal points

• Match Randomly Selected numbers to the masterlist of students arranged in numerical order

A B1 212 913 674 925 796 187 598 889 39

10 591112

RANDOM DRUG TESTING FLOW CHARTSpecimen Collection Phase

RDT Team orients the student on the process of drug testing and other

frequently asked topics

The students shall then be requested to accomplish a drug testing form

Preliminary procedures prior to collection :

• Verify identity of donor

• Explain basic collection procedure

• Answer questions regarding the procedure

Donor Identification

• Photo ID ( drivers license , employee ID , passport )

• Identification by authorized agency representative

• Any other ID allowed by agency’s workplace drug testing plan

Unacceptable forms of ID

• Identification by a co-worker

• Identification by another donor

• Use of a single , non photo ID (credit card, voter’s registration card, others )

RANDOM DRUG TESTING FLOW CHARTSpecimen Collection Phase

Students who are prepared to give urine specimens shall approach the analyst table

and select a specimen bottle

Steps in collection

• Asks donor to select specimen bottle from available supplies. Labels legibly

• Observes collection one at a time – Close attention to collection– Observe unusual behavior , if present

repeat under DIRECT OBSERVED COLLECTION

RANDOM DRUG TESTING FLOW CHARTSpecimen Collection Phase

To safeguard the integrity of the urine sample, the student will be accompanied

by a specimen collector of the same gender to the collection site

RANDOM DRUG TESTING FLOW CHARTSpecimen Collection Phase

The student will be asked to thoroughly wash and dry hands, empty pockets and remove outer garments (jackets, gowns etc) if any. A body search may also be

done when necessary.

RANDOM DRUG TESTING FLOW CHARTSpecimen Collection Phase

Observed collection will be then be done

RANDOM DRUG TESTING FLOW CHARTSpecimen Collection Phase

Student submits urine to specimen collector who then examines, in his/her

presence, if urine collected can be accepted for testing.

RANDOM DRUG TESTING FLOW CHARTSpecimen Collection Phase

Student and specimen collector goes back to the analyst table. The student affixes his signature, date and time of collection to the

“sealing tape”

Steps in collection

• Measure temp , volume , inspect foradulteration and substitution. Fills up Step 2 and initiates Step 3 of Chain and Custody Form (CCF)

• Closes , places and initials seal over thelid bottle in front of donor

• Asks donor to fill up and sign Step 5

RANDOM DRUG TESTING FLOW CHARTSpecimen Collection Phase

The specimen collector “seals” the specimen bottle in the presence of the

student.

RANDOM DRUG TESTING FLOW CHARTSpecimen Collection Phase

The specimen collector and student affix final signatures in the drug testing form

attesting to the validity of the procedures done.

*A drop-type, two-metabolite, drug-testing kits procured by the DOH will be used to test for two metabolites (Methamphetamine-shabu and tetrahydrocannabinol-marijuana).

*Results and demographics will be recorded in triplicate using the approved Chain and Custody Form prescribed by the DOH.

*Specimen analysis will be done in an accredited DOH Laboratory (usually a hospital laboratory) at the end of each day.

The specimen collection is considered the “ WEAKEST

LINK “ of the drug testing program.

Efforts must be taken to make the collection legally,

forensically and technically indefensible.

Tampering Specimen

• Dilution

• Substitution

• Adulteration

• Substitution methods

– Catherization

– Concealed container, e.g. condoms

– Injection into bladder

– Another liquid like juice, etc.

– Stealing the urine

“BEATING THE DRUG TEST”

RANDOM DRUG TESTING FLOW CHARTPost-Specimen Collection Phase

The analyst prepares the specimen for analysis in an accredited facility

RANDOM DRUG TESTING FLOW CHARTPost-Specimen Collection Phase

Results will be forwarded to the Supervising Agency who will coordinate with the School Drug Testing Coordinator * If confirmed positive, the laboratory shall forward a sealed copy to the Supervising Agency to ensure confidentiality

RANDOM DRUG TESTING FLOW CHARTPost-Specimen Collection Phase

The School Drug Testing Coordinator shall personally inform the parent

and the student about the result and appropriate intervention

NATIONAL LEVEL= 30 Analyst

DEP ED= 20 Analysts CHED= 10 Analysts

REGIONAL LEVEL= 3 Analysts

Analyst A

Analyst B

Analyst C

T T T T T T T T T T

1 Team can visit 3 schools per day =

30 Randomly Selected Student

Per Region = 30 schools per day =

300 Randomly Selected Student

DOH NATIONAL LEVEL= 30 Analyst

DEP ED= 20 AnalystsREGIONAL LEVEL= 3

Analysts

Analyst A

Analyst B

Analyst C

T T TT T T T T T T

T= Specimen Collection TeamsComposed of:2 Specimen Collectors (1 Male and 1 Female)1 Paramedical Supervisor

1 Team can visit 3 schools per day = 30 Randomly Selected Students

Per Region = 30 schools per day = 300 Randomly Selected Student

3 ANALYSTS WILL TEST 300 SPECIMENS PER NIGHT PER REGION

NATIONAL LEVELDEP ED= 20 Analysts

10 Analysts will be deployed at one time

Region A=3A

Region B=3A

Region C=4A

The other 10 Analysts will alternate with the Deployed teams every two week and is, at the

time, preparing logistics

900-1000 SPECIMENS PER NIGHT PER DAYNATIONAL

IMPORTANT CONCERNS

A. How many working days will it take to visit all schools in your particular division if the following conditions are present?

1) A maximum of three analysts can be deployed per region

2) Each analyst can only manage 3-4 expansion specimen collection teams

3) Each expansion team can visit a maximum of 3 schools a day

IMPORTANT CONCERNS

B. Is there any DOH-Accredited Drug Testing Laboratory in your Division?

1)DOH Accredited-Government Drug Testing Laboratory

2)Government Hospital with a Laboratory

* Kindly indicate the name of the facility

IMPORTANT CONCERNS

C. Do you foresee problematic schools considering the following indicators:

1)Peace and Order Situation

2)Accessibilitya) Remote locationb) Expensive transportation cost

* Kindly specify the school, location and specific concern

Specimen retention

• Negative result = 5 days

• Positive result = minimum of 15 days

• Adulterated, substituted, invalid result = 15 days

• Judicial proceedings or upon request = up to a year

• 8670 students tested, 287 schools selected at random nationwide

• Nationwide Prevalence – 67 students out of 8,670 students is 0.8%

Student Random Drug TestingConfirmed Positive per Age Group and Sex

AgeYears old

Males Females Not Recorded

Total Number of Students Tested Positive

Percentage

12 1 0 0 1 1.5

13 0 0 0 0 0.0

14 2 0 0 2 3.0

15 7 0 0 7 10.4

16 9 1 0 10 14.9

17 14 0 1 15 24.4

18 8 0 0 8 11.9

19 12 0 0 12 17.9

20 5 0 0 5 7.5

21 2 0 0 2 3.0

22 3 0 0 3 4.5

23 2 0 0 2 3.0

TOTAL 65 1 1 67 100.0

Student Random Drug TestingConfirmed Positive Per Region

Region Positive Cases per Type

Total Number of Students

Tested Positive

Percentage

THC

Met

Both

1 0 0 0 0 0.0

2 0 0 0 0 0.0

3 1 1 0 2 3.0

4-A 4 2 0 6 9.0

5 1 0 0 1 1.5

6 2 0 0 2 3.0

7 3 3 4 10 14.9

8 2 0 0 2 3.0

9 1 0 0 1 1.5

10 13 0 0 13 19.4

11 10 0 0 10 14.9

12 7 0 0 7 10.4

CARAGA 9 0 0 9 13.4

ARMM 0 1 0 1 1.5

4-B 0 0 0 0 0.0

CAR 1 0 0 1 1.5

NCR 0 2 0 2 3.0

TOTAL 54 9 4 67 100.0

Thank You!!