e t drug court u practitioner i - ndci.org is hoped that drug court practitioners will find that...

NA

TIO

NA

LD

RU

GC

OU

RT

INST

ITU

TE

KA

RE

NFR

EE

MA

N-W

ILS

ON

, EX

EC

UT

IVE

DIR

EC

TO

RA

PR

IL20

06

VO

L. IV

, NO

. 2

PREFACEThe duration of the urinary cannabinoid detection window is not settledscience. The number of days, following the cessation of marijuana smoking, necessary for cannabinoids to become non-detectable usingtraditional drug testing methods is the subject of debate among forensictoxicologists and a matter of on-going scientific research. This articlemakes no pretense to limit this important discussion, but rather, seeksto enhance it. It is hoped that drug court practitioners will find that thisinformation clarifies some of the complex issues associated with theelimination of marijuana from the human body.

Conventional wisdom has led to the common assumption that cannabinoidswill remain detectable in urine for 30 days or longer following the use of marijuana. These prolonged cannabinoid elimination projections havelikely resulted in the delay of therapeutic intervention, thwarted the timely use of judicial sanctioning, and fostered the denial of marijuanausage by drug court participants.

This review challenges some of the research upon which the 30-plus dayelimination assumption is based. Careful scrutiny of these studies shouldnot be interpreted as an effort to discredit the findings or the authors of this research. However, as our knowledge evolves, the relevancy ofpreviously published scientific data should be evaluated anew. One factis clear—more research is needed in the area cannabinoid elimination.

THE MARIJUANA DETECTION WINDOW: DETERMINING

THE LENGTH OF TIME CANNABINOIDS WILL REMAIN

DETECTABLE IN URINE FOLLOWING SMOKINGA CRITICAL REVIEW OF RELEVANT RESEARCH AND CANNABINOIDDETECTION GUIDANCE FOR DRUG COURTS

By Paul L. Cary, M.S.

DRUG COURTPRACTITIONERF A C T S H E E T

Merely attempting to formulate cannabinoiddetection guidance invites controversy. Somewill argue that the proposed detection windowdefined in this article is too short. Others willsuggest the opposite. Still others will insistthat the scientific evidence is insufficient toallow the establishment of such guidance. To some degree, each position has merit. Nodetection window guidance, regardless of theextent of scientific support, will encompassevery set of circumstances or all client situations.If nothing else, the research demonstrates thatthere is significant variability between individualsin the time required to eliminate drugs.

These facts, however, should not precludethe development of reasonable and pragmaticguidance, supported by scientific research, foruse in the majority of drug court adjudications.It is widely accepted that in order to instillsuccessful behavioral changes in a substanceabusing population, that consequences needto be applied soon after the identification ofrenewed or continued drug use. In a drug courtcontext, the application of judicial sanctionsand the initiation of therapeutic interventionshave been needlessly delayed due to a lack of coherent guidance regarding the length oftime cannabinoids will likely remain detectablein urine following the cessation of marijuanasmoking. The purpose of this article is to provide that much needed guidance.

INTRODUCTION

In a recent forensic publication, Dr. MarilynHuestis wrote: “Monitoring acute cannabisusage with a commercial cannabinoidimmunoassay with a 50-ng/mL cutoff concen-tration provides only a narrow window ofdetection of 1–2 days,” (2002). In a 1985 article by Ellis et. al., researchers concluded;“that under very strictly supervised absti-nence, chronic users can have positive resultsfor cannabinoids in urine at 20 ng/mL orabove on the EMIT-d.a.u. assay 1 for as manyas 46 consecutive days from admission, andcan take as many as 77 days to drop below

the cutoff calibrator for ten consecutive days.”Based upon these seemingly divergent findings,it is not difficult to comprehend why judges,attorneys and other drug court professionalsare in a quandary regarding the length of timemarijuana can remain detectable in urine following use. The dilemma—if the scientificresearch seems not to be able to achieve consensus on the urinary cannabinoid detectionwindow, how are those responsible for courtmandated drug supervision programs supposeto understand and resolve this issue?

Like many other scientific and technical topicsthat have been thrust into the judicial environ-ment, the detection window of marijuana is both complex and controversial, yet theunderstanding of the pharmacology of thispopular substance is crucial to the adjudicationof cases in which marijuana usage is involved.While the difficulties associated with estab-lishing the length of time a drug will continueto test positive in urine after use are not uniqueto marijuana, the problem is exacerbated bythe extended elimination characteristics ofcannabinoids relative to other drugs of abuse,most notably after chronic use.

The questions posed by drug court professionalsrelated to cannabinoid detection in urine include:

• How many days is it likely to take for a chronicmarijuana user to reach a negative urine drugtest result?

• How long can cannabinoids be excreted anddetected in urine after a single exposure tomarijuana?

• How many days of positive urine drug tests for cannabinoids constitutes continued marijuana usage?

• How often should a client’s urine be tested to monitor for continued abstinence frommarijuana?

• How many days should the court wait beforeretesting a client after a positive urine drugtest for cannabinoids has been obtained?

• How should the court interpret a positiveurine drug test for cannabinoids after a clienthas completed an initial 30-day detoxificationperiod designed to “clean out” their system?

NATIONAL DRUG COURT INSTITUTE

2

To one degree or another, answering thesequestions depends upon the ability of the courtto estimate the length of time cannabinoidswill likely remain detectable in urine followingthe use of marijuana by a drug court client.Thus, the cannabinoid detection windowbecomes a determinative factor in the appro-priate interpretation of urine drug testingresults for marijuana. The lack of adequateguidance has hindered the development ofthese standards for use in drug court.

It is important to note that while courts may be seeking absolute answers (an exactcannabinoid detection window), the scienceof drug detection in urine can only providereasonable best estimates. The law is notalways black and white; neither is science.Therefore, precise “yes/no” answers or exact detection windows are generally notattainable. Sensible guidance for the interpre-tation of urine cannabinoid results by drugcourts, however, is achievable.

FRAMING THE QUESTION

Simply put, the detection window is the lengthof time in days following the last substanceusage that sequentially collected urine sampleswill continue to produce positive drug testresults—in other words, the number of daysuntil last positive sample. This time period isnot the same as the length of time a drug willremain in someone’s system—that concept is, in reality, indeterminable (given that thereis no analytical method capable of detectingthe presence of a single molecule of drug in adonor’s body). The question being addressedherein is not how long minute traces of mari-juana will remain in a client’s tissues or fluidsafter smoking, but rather how long thoseresidual cannabinoid metabolites will continueto be excreted in urine in sufficient quantitiesto produce a positive drug test (by standardscreening and confirmation testing).

For those compounds with uncomplicatedmetabolic pathways or for those drugs thatare not significantly retained in body storagecompartments, detection times have beenestablished and generally accepted. Theseinclude urinary detection windows for drugssuch as cocaine (1-3 days), amphetaminesand opiates (1-4 days), and PCP (1-6 days)(Baselt, 2004). For marijuana, the urine elimi-nation profile used to establish the detectionwindow is more complex. It is well docu-mented and understood that cannabinoids arelipid-soluble compounds that preferentiallybind to fat-containing structures within thehuman body (Baselt, 2004). This and otherchemical characteristics can prolong the elimi-nation half-life of cannabinoids and extend thedetection window beyond that of other abusedsubstances. Chronic marijuana use, whichexpands body stores of drug metabolitesfaster than they can be eliminated, furtherincreases cannabinoid detection time in urine.

VARIABLES

Estimating the detection time of a drug in urineis a complex task because of the many factorsthat influence a compound’s elimination fromthe body. Additionally, technical aspects of thetesting methods themselves also affect howlong a drug will continue to be detected in urine.The pharmacological variables affecting theduration of detection include drug dose, routeof administration, duration of use (acute orchronic), and rate of metabolism. Detectiontime is also dependent upon analytical factorsincluding the sensitivity of the test (cutoffconcentration) and the method’s specificity(the actual drug and/or metabolite that isbeing detected).

DRUG COURT PRACTITIONER F A C T S H E E T

3

Study subjects with exceptionally longcannabinoid detection times (30-plusdays) were just that-exceptional.

Generally speaking, the following factorsaffect the marijuana detection windowaccordingly:

• Drug DoseThe higher the dose; the longer the detectionwindow. The percentage of psychologicallyactive delta-9 THC in marijuana plant materialvaries considerably, making dosage difficult to estimate.

• Route of EntryInhalation (smoking) is the only route ofadministration to be evaluated in this review.

• Duration/Frequency of UseThe longer the duration and the greater thefrequency of cannabinoid usage (chronic); the greater the body storage of fat-solublemetabolites; the longer the cannabinoiddetection window. Drug surveillance pro-grams may be able to define use patternsbased on client self-reporting, arrest reports,documentation of previous treatment, orother court records.

• Metabolism RateThe higher the metabolic functions of the client;the faster cannabinoids are broken down; the shorter the detection window. Monitoringprograms cannot determine this parameter.

• Test SensitivityThe lower the cutoff concentration; the moresensitivity the testing method toward cannabi-noids; the longer the detection window. Courtstaff can select between various cannabinoidtesting cutoffs.

• Test SpecificityThe less specific the testing method; thegreater number of cannabinoid metabolitesdetected; the longer the detection window.This is difficult for monitoring programs toassess without technical assistance.

Of these variables, drug courts are effectivelylimited to controlling only the sensitivity of the drug test itself (i.e., cutoff concentration).Initial screening test cutoffs for cannabinoidsin urine generally include thresholds at 20, 50,and 100 ng/mL. The choice of testing cutoffhas a profound effect on the cannabinoiddetection window. The only other factor thatcan assist the court in the interpretation ofcannabinoid testing results and the estimationof a client’s detection window is attemptingto define the duration and extent of a client’smarijuana use over time (acute or chronic).

The differentiation between acute (a singleuse event or occasional use) versus chronic(persistent, long-term, continued usage) isimportant to establishing reliable detectionbenchmarks. As a result, drug court practitionersshould attempt to gather as much informationas they can about client drug use behaviorand patterns.

Finally, the detection window by its verynature is subject to the timing of events outside the purview of the court. The last useof marijuana by a client prior to a positive testis often unknown to drug court staff. Thus,the real interval between drug usage and first detection can rarely be ascertained. For example, if a client smoked marijuana onMonday and a urine sample collected onFriday produced a positive result, the windowof detection is 4 days shorter than if that sameclient had smoked on Thursday and produced apositive cannabinoid test on Friday. Therefore,the actual detection window for marijuana willalmost always be longer than the analyticallyderived detection window as determined viapositive tests.

RESEARCH REVIEW

Research associated with the detection windowof cannabinoids in urine spans several decades.While these studies have produced a signifi-cant amount of valuable information aboutmarijuana elimination, older studies (primarilythose performed in the 1980’s) have alsoyielded some unintended consequences aspertains to the detection window. The tech-nologies of drug testing and the methodologiesused in drug detection have advanced rapidlyin recent years. Consequently, cannabinoiddetection studies performed twenty years ago (employing older immunoassays methods)utilized drug testing methods that are eitherno longer in widespread use or assays thathave been extensively reformulated.

As cannabinoid screening tests evolved, theseimproved assays became more selective inthe manner in which they detected marijuanametabolites (breakdown products). As detection


4


5

Table 1. Review of Cannabinoid Studies Reporting Long Detection Times

MaximumDetection TimesDetermined forCannabinoids

Factors Potentially Affecting the Relevance of Study Findings to Cannabinoid Detection Window Interpretation

Year Author

36 days Retrospective case study of a single patient; report on 6 similar cases included; no testing data provided in publication; no cannabinoid cutoff given

1982 Dackis et al.

37 days 27 subjects studied, no testing data provided in publication;cannabinoid cutoff not provided; “calculated” cannabinoidcutoff less than 10 ng/mL; 37 day detection derived from95% confidence interval for calculated elimination half-life;actual length of positivity averaged 9.7 days (5-20 days);authors acknowledge subjects may have been able toobtain marijuana during study; possibility supported bystaff monitoring subjects

1983 Cridland et al.

40 days 10 subjects studied; self-reported as chronic users; subjectshoused on unrestricted drug treatment ward; marijuanause during study suspected by authors and confirmed byseveral subjects

1984 Swatek

67 days 86 subjects studied; self-reported as chronic users; subjectstreated on “closely supervised” ward; single case of anindividual’s time to last positive urine (at or above 20 ng/mL) of 67 days (77 days to drop below the cutoff calibra-tor for ten consecutive days); spikes in urine cannabinoidlevels during the study are not explained by the authors

1985 Ellis et al.

25 days 11 subjects studied for cannabinoid elimination patterns(70 participants in entire study); only one subjectremained positive for 25 days; mean elimination for self-reported “heavy” users was 13 days; immunoassayused in study not commercially available since 1995.

1985 Schwartz et al.

25 days 13 subjects studied; self-reported as chronic users; subjectabstinence not supervised during study; subjects allowedto smoke marijuana before and on the day of test drugadministration; only one subject tested positive beyond 14 days

1989 Johansson& Halldin

25 days Subject detection times determined using methods with a 5 ng/mL cannabinoid cutoff concentration

1994 Iten

32 days 19 subjects studied - half withdrew from study prior tocompletion; subjects were prisoners housed in generalpopulation with no additional surveillance; participantsnot asked to report new drug use during study; marijuanause during study suspected by authors

1999 Smith-Kielland et al.

specificity increased, the length of timecannabinoids were being detected in urinedecreased. The greater the cannabinoid testingspecificity, the shorter the detection window.Studies have demonstrated that detectiontimes of cannabinoid metabolites in urinemonitored by immunoassay have decreasedover the past two decades (Huestis, 2002;Huestis, Mitchell, & Cone, 1994). Therefore,the results of cannabinoid elimination investigations performed in the 1980’s mayno longer be applicable to estimating thedetection window for marijuana in urine usingtoday’s testing methodologies. Not to men-tion that twenty years ago, the routine use ofon-site drug testing devices was nonexistent.

Studies of chronic marijuana users reportingprolonged cannabinoid excretion profiles haveprovided the basis for the common assump-tion that marijuana can be detected in urinefor weeks or even months following use. In general, cannabinoid elimination studies thathave manifested exceptionally long detectiontimes suffer from a variety of research designshortcomings that raise concerns about theirusefulness in establishing a reliable cannabi-noid detection window for use in the moderndrug court movement. Table I examines some of the potentially limiting factors fromstudies that produced prolonged cannabinoiddetection times.

The research studies presented in Table 1contain numerous design details that confoundthe use of the data presented in establishinga reasonable and pragmatic cannabinoiddetection window for drug court proceedings.The most serious of these obfuscating factorsis the inability to assure marijuana abstinenceof the subjects during the studies. The adverse

effect of this flaw on determining the truecannabinoid elimination time after marijuanacessation is significant. Drug use during anelimination study would extend the durationcannabinoids would be detected in the urineof subjects and would produce inaccuratelylong detection windows. In several cases, theauthors themselves in their own review ofresults raise this concern. Other study designissues that may limit their usefulness includethe use of detection methods with cannabinoidcutoff concentrations far below those tradi-tionally utilized in criminal justice programs, theuse of testing methods no longer commerciallyavailable and the use of immunoassay drugtests with reduced cannabinoid specificity (ascompared with current immunoassay testingmethods). It is not the intention of this articleto discredit these studies, but rather to illus-trate the degree to which their prolongedcannabinoid detection findings have influencedthe understanding of the length of timecannabinoids can be detected in urine.

This critical evaluation (Table 1) is not present-ed to imply that these peer-reviewed articlesare unscientific or contain no information ofprobative value. It is insufficient, however, tomerely read the abstract of a scientific paperor the findings of a research study and drawthe conclusion that a drug court client canremain positive for 30 days or longer, basedupon the longest cannabinoid detection timereported therein. The data from these studiesare often misused to make such claims.

Despite the potential limitations affecting theinterpretation of the data produced by thestudies in Table 1, the research does presentsome general cannabinoid elimination trendsworth further examination. A closer evaluationof the study by Smith-Kielland, Skuterud, &Morland indicates that even with the factorsidentified as limiting its relevance, the aver-age time to the first negative urine sample ata cannabinoid cutoff of 20 ng/mL was just 3.8days for infrequent users and only 11.3 daysfor frequent users (1999). In the Swatek study,eight out of ten chronic subjects tested belowthe 50 ng/mL cutoff after an average of only


6

The detection window for cannabinoidsin urine must be seen in the propercontext-as a reasonable estimate.

13 days (range 5-19 days) (1984). Johanssonand Halldin identified only one study subjectthat tested positive for longer than 14 dayswith all thirteen subjects having an averagelast day with detectable levels (using a 20ng/mL cutoff) of 9.8 days (1989). In otherwords, despite the potential factors restrictinginterpretation, those study subjects withexceptionally long cannabinoid detection times(30-plus days) were just that—exceptional. In several of the studies presented in Table 1,only a single subject was the source of themaximum cannabinoid detection time.Unfortunately, these rare occurrences havehad a disproportional influence on the overallcannabinoid detection window discussion in a manner that has led to the general assump-tion that 30-plus day detection times are routine in drug court clients—regardless ofuse patterns (chronic vs. acute). Moreover,this prolonged elimination assumption and its widespread use as exculpatory evidencehas most likely fostered client denial and hindered legitimate sanctioning efforts.

By contrast, the research associated with acutemarijuana usage and resulting cannabinoiddetection window is considerably morestraightforward and less contentious. In a 1995study using six healthy males (under continu-ous medical supervision), Huestis, Mitchell, & Cone determined that the mean detectiontimes following a low dose marijuana cigaretteranged from 1 to 5 days and after a high dosecigarette from 3 to 6 days at a 20 ng/mLimmunoassay cutoff concentration (average2.1 days and 3.8 days, respectively) (1995).They also concluded that immunoassays atthe 50 ng/mL cannabinoid cutoff provide onlya narrow window of detection of 1-2 days following single-event use. In 1996, Huestiset. al. published research focusing on carboxy-THC, the cannabinoid metabolite most oftenidentified by gas chromatography/mass spectrometry (GC/MS) confirmation methods.Using the 15 ng/mL GC/MS cutoff, the detec-tion time for the last positive urine sample(for six subjects following high dose smoking)was 122 hours—just over five days. In 2001,

Niedbala et. al. demonstrated similar resultswith 18 healthy male subjects following thesmoking of cigarettes containing an averageTHC content of 20-25 mg. Analyzing urinesamples at a 50 ng/mL immunoassay cutoffyielded an average cannabinoid detection time of 42 hours. These acute marijuana elimination studies conclude that after singleusage events cannabinoids are detected inurine for no more than a few days.

While studies of the cannabinoid detectionwindow in chronic substance users havebeen more difficult to accomplish, researchprotocols have been developed to overcomeconcerns about marijuana usage during thestudy. Using a well-crafted study design,Kouri, Pope, & Lukas in 1999 determined thecannabinoid elimination profiles of 17 chronicusers. Subjects were selected after reportinga history of at least 5000 separate “episodes”of marijuana use in their lifetime (the equiva-lent of smoking once per day for 13.7 years)plus continuing daily usage. Abstinence duringthe 28-day study was ensured by withdrawingthose subjects whose normalized urinecannabinoid levels (cannabinoid/creatinineratio) indicated evidence of new marijuana use.Kouri, et al, found that five of the 17 subjectsreached non-detectable levels (less than 20ng/mL) within the first week of abstinence,four during the second week, two during thethird week and the remaining six subjects still had detectable cannabinoid urinary levelsat the end of the 28-day abstinence period.Unfortunately, analytical results related to thecannabinoid testing in the article were scantas the primary objective of the study was toassess changes in aggressive behavior duringwithdrawal from long-term marijuana use.Even though this represents one of the beststudies of chronic marijuana users, interpreta-tion of this data for cannabinoid eliminationpurposes is limited because the actual drugtesting data is not available. Nonetheless,Kouri, et al, shows that after at least 5000marijuana smoking episodes, 30-day eliminationtimes are possible.


7

A 2001 research project by Reiter et al. alsoseemed to avoid many of the design issuescited as concerns in Table 1. Reiter’s casestudy involved 52 volunteer chronic substanceabusers drug tested on a detoxification ward.Daily urine and blood tests excluded illicitdrug consumption during the study. Using a20 ng/mL immunoassay cutoff, the maximumelimination time (last time urine tested abovethe cutoff) for cannabinoids in urine was433.5 hours (or just over 18 days); with amean elimination time of 117.5 hours (4.9days). When controlling for covert marijuanause by subjects during the study, chronicusers in this study did not exhibit detectableurine cannabinoid levels for even three weeks.

In aggregate, using the data from the fivestudies cited in this review that researchersdescribed as chronic marijuana users (evenincluding data from Table 1), the averagedetection window for cannabinoids in urine atthe lowest cutoff concentration of 20 ng/mLwas just 14 days (Ellis, et al, 2002; Iten, 1994;Niedbala, 2001; Schwartz, Hayden, & Riddile,1985; Swatek, 1984).

PERPETUATING THE 30-PLUSDAY ASSUMPTION

The assumption that cannabinoids can be rou-tinely detected in urine following the smokingof marijuana for 30 days or longer appearswidespread and longstanding. Exacerbatingthis problem is the nearly constant proliferationof published material that continually reinforcesthe 30-plus day cannabinoid detection windowinto the criminal justice psyche. Examples ofthe enormous body of information/literaturethat propagates the 30-plus day cannabinoiddetection times abound:

• Substance abuse treatment literature pro-claiming that “some parts of the body stillretain THC even after a couple of months.” 2

• Drug abuse information targeted toward teensthat often presents unrealistic cannabinoiddetection times such as; “Traces of THC canbe detected by standard urine and blood testsfor about 2 days up to 11 weeks.” 3

• Criminal justice publications that list thecannabinoid detection limits of a “ChronicHeavy Smoker” as “21-27 days.” 4

• Drug testing manufacturers’ pamphlets that state the time to last cannabinoid positive urine sample as “Mean = 27.1 days;Range = 3-77 days.” 5

• General information websites that offer“expert” advice concluding, “The averagetime pot stays in your system is 30 days.” 6

• Urine tampering promotions in magazinessuch as High Times and on websites that offer urine drug cleansing supplements andadulterants intended to chemically mask thepresence of drugs in urine often exaggeratethe detection window in an effort to promotethe continued use of their products. Some oftheir claims include: drug detection times inurine [for] “Cannabinoids (THC, Marijuana)20-90 days,” 7 and detection times for smokerswho use “5-6x per week—33-48 days.” 8

• Health information websites that provide thefollowing guidance; “At the confirmation levelof 15 ng/ml, the frequent user will be positivefor perhaps as long as 15 weeks.” 9

• Dr. Drew Pinsky (a.k.a. Dr. Drew), who has co-hosted the popular call-in radio showLoveline for 17 years, states that “Pot stays in your body, stored in fat tissues, potentiallyyour whole life.” 10

Based upon these information sources thatclaim cannabinoids elimination profiles of 25days, 11 weeks, 90 days, up to 15 weeks afteruse, and for “your whole life,” is it any wonderthat drug court professionals cannot reachconsensus on this issue? Is there any doubtwhy drug court clients make outlandishcannabinoid elimination claims in court? Theserepresent but a sampling of the many dubioussources that perpetuate the prolonged cannabi-noid detection window. As a consequence,the 30-plus day cannabinoid elimination periodremains a commonly assumed “fact.”

ESTABLISHING THE CANNABINOIDDETECTION WINDOW IN URINE

The detection window for cannabinoids inurine must be seen in the proper context—as a reasonable estimate. Detection times for cannabinoids in urine following smoking vary considerably between subjects even in


8

controlled smoking studies using standardizeddosing techniques. Research studies have alsodemonstrated significant inter-subject differ-ences in cannabinoid elimination rates. Thetiming of marijuana elimination is further com-plicated by the uncertainty of the termination ofuse and continued abstinence. That said, gen-eral estimates for establishing a cannabinoiddetection window in urine can be advancedand accepted for use in drug courts. Basedupon the current state of cannabinoid elimina-tion knowledge and the drug testing methodsavailable in today’s market, the following practicalcannabinoid detection guidance is offered.

Based upon recent scientific evidence, atthe 50 ng/mL cutoff concentration for thedetection of cannabinoids in urine (usingthe currently available laboratory-basedscreening methods) it would be unlikely fora chronic user to produce a positive urinedrug test result for longer than 10 days afterthe last smoking episode. Although there areno scientific cannabinoid elimination studieson chronic users using non-instrumentedtesting devices, one would assume that ifthe on-site devices are properly calibratedat the 50 ng/mL cutoff level the detectionguidance would be the same.

At the 20 ng/mL cutoff concentration for thedetection of cannabinoids in urine (usingthe currently available laboratory-basedscreening methods) it would be uncommonfor a chronic marijuana smoker to producea positive urine drug test result longer than21 days after the last smoking episode.

For occasional marijuana use (or singleevent usage), at the 50 ng/mL cutoff level,it would be unusual for the detection ofcannabinoids in urine to extend beyond 3-4 days following the smoking episode(using the currently available laboratory-based screening methods or the currentlyavailable on-site THC detection devices). At the 20 ng/mL cutoff for cannabinoids,positive urine drug test results for the single event marijuana use would not beexpected to be longer than 7 days.

This cannabinoid detection guidance shouldbe applicable in the majority of drug courtcases. These parameters (acute vs. chronic),however, represent opposite ends of the marijuana usage spectrum. Clients will oftenexhibit marijuana-smoking patterns betweenthese two extremes resulting in an actualdetection window that lies within these limits.As noted in the Kouri, et al, study, researchsuggests that under extraordinary circum-stances of sustained, extended and on-goingchronic marijuana abuse (thousands of smoking episodes over multiple years) that 30-day urinary cannabinoid detection ispossible in some individuals at the 20 ng/mLcutoff (1999). However, the burden of prooffor documenting such aberrant and chronicmarijuana use patterns should fall on the drugcourt client or the client’s representatives. For a client to simply disclose “chronic” use isinsufficient corroboration.

Much has been made about marijuana researchthat has produced dramatically prolongedcannabinoid elimination times, particularly inthose subjects identified as chronic. This datahas often been used to explain continuingpositive cannabinoid test results in clients longafter their drug elimination threshold (resultingin negative urine drug tests) should have beenreached. The pertinent question: to whatextent does the scientific data (demonstrating30-plus day cannabinoid detection times inchronic users) influence the disposition ofdrug court cases? Put another way, do drugcourt practitioners need to be concernedabout the potential of extended cannabinoiddetection times impacting court decisions(i.e., sanctions)? In reality, the only timeframein which an individual’s chronic marijuana use(possibly leading to extended cannabinoidelimination) is relevant is during a client’sadmission into the drug court program. It isduring this initial phase that the court mayfind itself attempting to estimate the numberof days necessary for a client’s body to riditself of acquired cannabinoid stores and thetime required to produce negative drug testresults. In many programs, a detoxification


9

period is established for this purpose. Once inthe drug court program (following the initialdetoxification phase), the extent of a client’spast chronic marijuana usage does not influencethe cannabinoid detection window as long asappropriate supervision and drug monitoringfor abstinence continues on a regular basis. It would seem reasonable to assume thatchronic client marijuana usage of the extremelevels discussed here while within a properlyadministered drug court would be highlyunlikely. Therefore, the consequences ofchronic marijuana usage on the cannabinoiddetection window are effectively limited tothe initial entry phase of the program.

The cannabinoid detection window guidanceprovided herein relies upon the widely usedcutoff concentrations for the initial screeningtests—20 ng/mL and 50 ng/mL. For programsutilizing GC/MS confirmation for the validationof positive screening results, the confirmationcutoff has little influence on the length of the cannabinoid detection window in urine. A review of the potential result possibilitiesdemonstrates this point. If a drug court sampletests negative for cannabinoids on the initialscreen, the confirmation cutoff is obviouslyirrelevant because the sample is not submittedfor confirmation testing. If a sample bothscreens and confirms as positive for cannabi-noids (and is reported as positive), then thecutoff concentration of the confirmation analysis is also not relevant because the sam-ple would not have been sent for confirmationunless it produced a result greater than orequal to the cutoff level of the initial screeningtest. In other words, the confirmation proce-dure is merely validating the results (andtherefore the cutoff) of the original screening

test. The only scenario in which the confirma-tion cutoff could potentially impact the lengthof the cannabinoid detection window is if asample screened positive and the confirmationprocedure failed to confirm the presence ofcannabinoids (and the results of the drug testwere reported as negative). In this circum-stance, the cannabinoid detection windowmight be shorter than the estimate provided asguidance. This would be true on the conditionthat the confirmation cutoff concentration waslower than that of the screening procedure—which is nearly always the case. A shortercannabinoid detection window would not be seen as prejudicial to the client and mightactually be beneficial to the drug court.

Using this cannabinoid detection windowguidance, the drug court decision-making hierarchy should be able to establish reason-able and pragmatic cannabinoid detectionbenchmarks that both provide objective criteria for court decisions and protect clientsfrom inappropriate or unsupportable conse-quences. Some courts may choose to use thecannabinoid elimination information detailed in this paper exactly as presented to establisha marijuana detection window that will allowthe differentiation between abstinence andcontinued/renewed use. Other courts maydecide to build into the guidance an additionalsafety margin, granting clients further benefitof the doubt. Regardless of the approach,however, courts are urged to establish detec-tion benchmarks and utilize these scientificallysupportable criteria for case disposition.

Every day drug courts grapple with two seem-ingly disparate imperatives—the need for rapidtherapeutic intervention (sanctioning designedto produce behavioral change) and the need toensure that the evidentiary standards, craftedto protect client rights, are maintained. Whileadministrative decision-making in a drug court environment (or a probation revocationhearing) does not necessitate the same dueprocess requirements and protections thatexist in criminal cases, as professionals weare obliged to ensure that court decisionshave a strong evidentiary foundation.


10

Science is not black and white and the state of our knowledge

is continually evolving.

Courts establishing detection windows forcannabinoids need to be aware of the exis-tence of research studies indicating prolongedelimination times in urine. It is not recom-mended, however, that drug courts manipulatetheir detection windows to include theseexceptional findings. Sound judicial practicerequires that court decisions be based uponcase-specific information. In weighing the evidence, courts also acknowledge the realitythat a particular client’s individualities or theuniqueness of circumstances may not alwaysallow the strict application of cannabinoiddetection window parameters in a sentencingdecision. These uncommon events, however,should not preclude the development ofcannabinoid detection windows for the use in the majority of court determinations.

CLIENT DETOXIFICATION: THE “CLEAN OUT” PHASE

As a result of the extended elimination ofcannabinoids (as compared to other abuseddrugs), some drug courts have instituted adetoxification stage or “clean out” period inthe first phase of program participation. Thisgrace period allows new clients a definedtime frame for their bodies to eliminate storesof drugs that may have built up over years of substance abuse without the fear of courtsanctions associated with a positive drug test. In many cases this detoxification periodextends for 30 days, which corresponds to the commonly held assumption that this represents the time period required formarijuana metabolites to be eliminated from a client’s system.

Regardless of the origin of the 30-day marijuanadetection window and its influence on theduration of the detoxification period, 30 daysis certainly an equitable time period for clientdrug elimination purposes. Simply becausethe science may not support the necessity ofa detoxification period of this duration doesnot mean that a court cannot use the 30-dayparameter in order to establish programexpectations. However, based upon the

cannabinoid detection guidelines presented inthis review, it is unlikely (utilizing reasonablephysiological or technology criteria) that a drugcourt client would continue to remain cannabi-noid positive at the end of this designatedabstinence period. After 30 days, using eithera 20 or 50 ng/mL testing cutoff, continuedcannabinoid positive urine drug tests almostcertainly indicate marijuana usage at somepoint during the detoxification period andshould provoke a court response to reinforceprogram expectations.

ABSTINENCE BASELINE

The abstinence baseline can either be a pointat which a client has demonstrated their abstinence from drug use via sequentiallynegative testing results (actual baseline) or a court-established time limit after which aclient should not test positive if that client has abstained from marijuana use (scientificbaseline). Each baseline has importance in a court-mandated drug monitoring program.The later has been the focus of this review. It is exemplified by establishing the detectionwindow for marijuana and utilizing positiveurine drug testing results to guide court intervention. Individuals who continue to produce cannabinoid positive results beyond the established detection window maximums(the scientific baseline) are subject to sanctionfor failing to remain abstinence during pro-gram participation.

The alternative approach uses negative testresults in establishing the actual abstinencebaseline. This has been referred to as the“two negative test approach” and has been


11

Courts are urged to establish detection benchmarks and utilizethese scientifically supportable criteria for case disposition.

previously described in the literature (Cary,2002). A drug court participant is deemed tohave reached their abstinence baseline whentwo consecutive urine drug tests yielding negative results for cannabinoids have beenachieved, where the two tests are separatedby a several day interval. Any positive drugtest result following the establishment of thisbaseline indicates new drug exposure. Thistechnique can be used with assays that testfor marijuana at either the 20 or 50 ng/mL cutoff concentration.11

CANNABINOID TESTING FOLLOWINGPOSITIVE RESULTS

Due to the prolonged excretion profile ofcannabinoids in urine (especially after chronicuse) some drug court programs wrestle with the issue of whether to continue urinedrug testing during the expected marijuanaelimination period. Simply put, why continuethe expense and sample collection burden for clients who have already tested positivefor cannabinoids knowing that the client maycontinue to produce positive cannabinoidresults for many days? There are at leastthree principle reasons drug courts are notadvised to suspend urine drug testing followinga positive result for cannabinoids.

First, most court-mandated testing includesdrugs other than marijuana. Client surveillanceoften encompasses testing for many of the popularly abused substances such asamphetamines, cocaine, opiates, and alcohol.Programs that forego scheduled testing runthe very real risk of missing covert drug usefor substances other than marijuana. If a drugcourt client knows a positive cannabinoid test will result in a drug testing “vacation,”they may use that non-testing period to usesubstances with shorter detection windows (i.e. cocaine or alcohol). By continuing to test,the court maintains its abstinence monitoringfor drugs besides marijuana.

Second, from a programmatic standpoint thesuspension of scheduled client drug testingsends the wrong therapeutic message. If a

drug court's policies and procedures require a certain schedule of testing, suspending testing for even a short period may appear to other program participants that the court is“rewarding” a client who has tested positive.Eliminating scheduled drug tests in responseto a positive cannabinoid result degrades the program’s efforts at maintaining clientbehavioral expectations.

Lastly, depending upon the cutoff concentrationof the drug test being used and whether theclient’s marijuana usage was an isolated event(rather than a full relapse), it is entirely possiblethat a client who has previously tested positivefor cannabinoids may test negative sooner thanthe cannabinoid detection window estimate.As indicated earlier, acute marijuana useresults in cannabinoid positive urine samplesfor only several days following exposure.Curtailing drug testing for longer than threedays extends unnecessarily the period ofuncertainty about a client’s recent behavior andmay delay appropriate therapeutic strategiesor sanction decisions.

COURT EXPECTATIONSAND CLIENT BOUNDARIES

One of the most important prerogatives ofdrug court (or any therapeutic court) is toclearly define the behavioral expectations forclients by establishing compliance boundariesrequired for continued program participation.Drug testing used as a surveillance tool definesthose boundaries and monitors client behaviorin order that the court can direct either incen-tives or sanctions as needed to maintain participant compliance. To fulfill this importantresponsibility, drug courts teams must agreeupon specific drug testing benchmarks inorder to apply court intervention strategies in an equitable and consistent manner.

The primary focus of this article is to promotethe establishment of a drug testing benchmarkthat defines the expected detection windowof cannabinoids in urine following the cessa-tion of smoking. In order for drug courts todetermine their cannabinoid detection window,


12

the program will need to consider the cutoffconcentration of the urine cannabinoid testbeing utilized and develop criteria for definingchronic marijuana users. Drug courts shouldalso take into account how the cannabinoiddetection window will be incorporated intotheir current policies and procedures and howthe detection window will be used in caseadjudication. Once established, the courtshould apprise program participants of theexpectations associated with the cannabinoiddetection window. Clients should understandthat sanctions will result if continued cannabi-noid positive tests occur beyond the estab-lished detection window (the drug eliminationtime limit after which a client should not testpositive if that client has abstained from marijuana use). Courts are reminded that thecannabinoid detection window may requirerevision if there are modifications to the drugtesting methods or if there are significantchanges in marijuana usage patterns in thecourt’s target population (i.e., significantincreases in chronic use).

Practitioners are reminded that the goal inestablishing a cannabinoid detection windowis not to ensure that a monitored client isdrug free. Chronic marijuana users may carryundetectable traces of drug in their bodies for a significant time after the cessation ofuse. Rather, the goal is to establish a giventime period (detection window limit) afterwhich a client should not test positive forcannabinoids as a result of continued excretionfrom prior usage.

Finally, the cannabinoid detection window is a scientifically supportable, evidence-basedeffort to establish a reasonable and practicalstandard for determining the length of timecannabinoids will remain detectable in urinefollowing the smoking of marijuana. Drug courtsare reminded that science is not black andwhite and that the state of our knowledge iscontinually evolving. While detection windowbenchmarks will and should guide the sanc-tioning process for violations of abstinent

behavior, courts are urged to judge a client’slevel of compliance on a case by case basisusing all of the behavioral data available to thecourt in conjunction with drug testing results.In unconventional situations that confound the court, qualified toxicological assistanceshould be sought.

Paul L. Cary, M.S. is the Director of the Toxicology & Drug Monitoring Laboratory, University of MissouriHealth Care, Columbia, Missouri; and NDCI FacultyResident Expert on drug testing issues. Mr. Cary can be reached at [email protected].

This document was published with support from theOffice of National Drug Control Policy, Executive Office of the President and the Bureau of Justice Assistance,U.S. Department of Justice.

References Baselt, R.C. (2004). In Disposition of Toxic Drugs

and Chemicals in Man, (7th ed.). Foster City,CA: Biomedical Publications.

Cary, P.L. (2002). The use creatinine-normalizedcannabinoid results to determine continuedabstinence or to differentiate between newmarijuana use and continuing drug excretionfrom previous exposure. Drug Court Review,4(1), 83-103.

Cridland, J.S., Rottanburg, D., & Robins, A.H. (1983).Apparent half-life of excretion of cannabinoidsin man. Human Toxicology 2(4), 641-644.

Dackis, C.A., Pottash, A.L.C., Annitto, W., & Gold,M.S. (1982). Persistence of urinary marijuanalevels after supervised abstinence. AmericanJournal of Psychiatry, 139(9), 1196-1198.

Ellis, G.M., Mann, M.A., Judson, B.A., Schramm,N.T., & Tashchian, A. (1985). Excretion patternsof cannabinoid metabolites after last use in agroup of chronic users. Clinical Pharmacologyand Therapeutics, 38(5), 572-578.

Huestis, M.A. (2002). Cannabis (marijuana): Effectson human behavior and performance. ForensicScience Review, 14(1/2), 15-60.

Huestis, M.A., Mitchell, J.M., & Cone, E.J. (1994).Lowering the federally mandated cannabinoidimmunoassay cutoff increases true-positiveresults. Clinical Chemistry, 40(5), 729-733.

Huestis, M.A., Mitchell, J.M., & Cone, E.J. (1995).Detection times of marijuana metabolites inurine by immunoassay and gc-ms. Journal ofAnalytical Toxicology, 19(10), 443-449.


13

Huestis, M.A., Mitchell, J.M., & Cone, E.J. (1996).Urinary excretion profiles of 11-nor-9-carboxy-∆9-tetrahydrocannabinol in humans after singlesmoked does of marijuana. Journal of AnalyticalToxicology, 20(10), 441-452.

Iten, P.X. (1994). In Fahren untrer Drogen-o-derMedikamenteneinfluss. ForensischeInterpretation und Begutachtung. Zürich: Institutfür Rechtsmedizin der Universtät Zürich.

Johansson, E. & Halldin, M.M. (1989). Urinaryexcretion half-life of ∆1-tetrahydrocannabinol-7-oic acid in heavy marijuana users after smoking.Journal of Analytical Toxicology, 13(7/8), 218-223.

Kouri, E. M., Pope, H. G. Jr., & Lukas, S. E. (1999).Changes in aggressive behavior during with-drawal form long-term marijuana use.Psychopharmacology, 143(3), 302-308.

Niedbala, R.S., Kardos, K.W., Fritch, D.F., Kardos,T.F., & Waga, J. (2001). Detection of marijuanause by oral fluid and urine analysis followingsingle-dose administration of smoked and oral marijuana. Journal of Analytical Toxicology,25(7/8), 289-303.

Reiter, A., Hake, J., Meissner, C., Rohwer, J.,Friedrich, H.J., & Ochmichen, M. (2001). Timeof drug elimination in chronic drug abusers: Casestudy of 52 patients in a “low-step” detoxifica-tion ward. Forensic Science International, 119,248-253.

Schwartz, R.H., Hayden, G. F., & Riddile, M. (1985).Laboratory detection of marijuana use.American Journal of Diseases of Children,139(11), 1093-1096.

Smith-Kielland, A., Skuterud, B., & Morland J.(1999). Urinary excretion of 11-nor-9-carboxy-∆9-tetrahydrocannabinol and cannabinoids infrequent and infrequent drug users. Journal ofAnalytical Toxicology, 23(9), 323-332.

Swatek, R. (1984). Marijuana use: Persistence andurinary elimination. Journal of Substance AbuseTreatment 1(4), 265-270.

Endnotes1. EMIT is a registered trademark of the Dade

Behring/SYVA Company and stands for (EnzymeMultiplied Immunoassay Technique). EMIT is a commercial drug testing product for the analysis of drugs of abuse in urine (d.a.u.).

2. Detoxing from Marijuana (pamphlet). (1992).Marijuana Anonymous: 12-Step Program forMarijuana Addicts, 4. The entire text reads asfollows: “Why do some effects last so long?”“Unlike most other drugs, including alcohol,THC (the active chemical in marijuana) is stored

in the fat cells and therefore takes longer tofully clear the body than with any other commondrug. This means that some parts of the bodystill retain THC even after a couple of months,rather than just the couple of days or weeks forwater soluble drugs.”

3. Website: TeenHealthFX. URL: http://www.teenhealthfx.com/answers/12.html.TeenHealthFX.com is a project funded byAtlantic Health System, a New Jersey hospitalconsortium. The website states that “the professional staff who answer questions fromour vast audience and provide oversight includeclinical social workers, health educators, adolescent medicine physicians, pediatriciansand pediatric subspecialists, psychiatrists, psychologists, nurses, nutritionists, and manyother health professionals.”

QUESTION: “Dear TeenHealthFX,Smoking marijuana can be detected how long?I’ve heard a couple of weeks in urine, a coupleof days in blood, and a couple of years in hair…please clarify! Also, during a routine physical atthe doctor, will they check for marijuana in theblood or urine sample?Signed: Longevity Of Marijuana - How LongDoes It Stay In Your System”

ANSWER: “Dear Longevity Of Marijuana - HowLong Does It Stay In Your System, The chemicalin marijuana, THC, is absorbed by fatty tissues invarious organs. Traces of THC can be detectedby standard urine and blood tests for about 2 days up to 11 weeks depending on the per-son’s metabolism, how much they smoked andhow long they smoked. THC can be detectedfor the life of the hair. Again, the sensitivity ofthe test ranges from person to person dependingon many factors including the amount of bodyfat, differences in metabolism, and how longand how much they smoked.”

Presumably, the 11 week estimate comes fromthe research finding of Ellis, et. al. (1985) whichhas been described earlier.

4. Bureau of Justice Assistance Monograph entitled:Integrating Drug Testing into a Pretrial ServicesSystem: 1999 Update, July 1999, NCJ # 176340.On page 48, Exhibit 5-3 titled; ApproximateDuration of Detectability of Selected Drugs inUrine lists Cannabinoids (marijuana) Chronicheavy use as 21 to 27 days. Source: Adaptedfrom the Journal of the American MedicalAssociation’s Council on Scientific Affairs (1987,p. 3112).

The source material citation is the Journal ofthe American Medical Association. (1987, June)


14

12;257(22):3110-4. The article is titled;“Scientific Issues in Drug Testing—Council onScientific Affairs.” On page 3112, Table 2. titled“Approximate Duration of Detectability ofSelected Drugs in Urine” lists chronic heavysmoker as 21-27 days. The references cited forthis data are Dackis, et. al (1982), and Ellis, et.al. (1985), the potential shortcomings of bothhave been discussed in this article. It is note-worthy and illustrative that this 1999 “updated”publication still relies on research performed in1982 and 1985.

5. Cannabinoid Issues: Passive Inhalation,Excretion Patterns and Retention Times(pamphlet). (1991). Dade Behring, SYVACompany, S-10036. On page 25 in a table titled: “Emit d.a.u. Cannabinoid Assay (20ng/mL)” is listed the following:

All Subjects (n = 86):

First Negative: Mean = 16.0 days Range = 3-46 days

Last Positive:Mean = 27.1 days Range = 3-77 days

Examination of the references associated withthis data indicates the following sources; Ellis,et. al. (1985), Schwartz, Hayden, & Riddile (1985),and Johansson& Halldin (1989). All of these references and their potential study design issueshave been reviewed in this article. This pam-phlet also contains cannabinoid elimination datausing the Emit-st Cannabinoid Assay testingmethod. Given that this assay is no longerbeing manufactured, the data was not included.

6. Website: What You Need to Know. About.comURL: http://experts.about.com/q/1319/718935.htm.This is a popular website for general informationinquiries about almost any subject matter. In asection entitled “About Our Service” the web-site states, “Allexperts, created in early 1998,was the very first large-scale question andanswer service on the net! We have thousandsof volunteers, including top lawyers, doctors,engineers, and scientists, waiting to answeryour questions. All answers are free and mostcome within a day!”

The question submitted to the site was, “Howlong does marijuana stay in your system?” Theexpert response was: “The average time potstays in your system is 30 days. The time maydiffer depending on your metabolism. If youhave a fast metabolism it may be shorter than30 days, if you have a slow metabolism it maybe more. The average though is about 30 days.”Note that in this answer, 30 days is given as anaverage cannabinoid elimination time.

7. Website: Health Choice of New York. URL: http://www.clearchoiceofny.com/drugtestinfo.htm. This website states: “It's One Stop ShoppingFor All Of Your Detoxifying Needs. We Have AllThe Products You Need To Pass A Urine DrugTest.” In a section entitled “Drug ApproximateDetection Time in Urine,” the site provides thefollowing information: “Cannabinoids (THC,Marijuana) 20-90 days.”

8. Website: IPassedMyDrugTest.Com. URL:http://www.ipassedmydrugtest.com/drug_test_faq.asp#detect_time

The following table is provided:

Cannabinoids (THC, Marijuana) Detection Time:1 time only 5-8 days2-4x per month 11-18 days2-4x per week 23-35 days5-6x per week 33-48 daysDaily 49-63 days

9. Website: HealthWorld Online. URL:http://www.healthy.net/clinic/lab/labtest/004.asp.Site’s mission statement; “HealthWorld Onlineis your 24-hour health resource center—a virtualhealth village where you can access informa-tion, products, and services to help create yourwellness-based lifestyle.” In the section called“Detection of Cannabinoids in Urine,” the fol-lowing information is provided: “Cutoff andDetection Post Dose: The initial screening cut-off level is 50 ng/ml. The GC/MS cutoff level is15 ng/ml. The elimination half-life of marijuanaranges from 14-38 hours. At the initial cutoff of50 ng/ml, the daily user will remain positive forperhaps 7 to 30 days after cessation. At theconfirmation level of 15 ng/ml, the frequentuser will be positive for perhaps as long as 15weeks.”

10.Website: Dr. Drew. URL: http://drdrew.com/Office/faq.asp?id=1083&sec-tion=5002

QUESTION: How long does pot (or other drugs)stay in your body? Is there any way to detect it?

ANSWER: Most readily available drug screensare tests of the urine. Blood tests and breathanalyzers are another way substances can bedetected. Pot stays in your body, stored in fattissues, potentially your whole life. However, it is very unusual to be released in sufficientquantities to have an intoxicating effect or bemeasurable in urine screens. Heavy pot smokers,people who have smoked for years on a dailybasis, very commonly have detectable amountsin their urine for at least two weeks.


15

4900 Seminary Road, Suite 320Alexandria, VA 22311

(703) 575-94001-877-507-3229

(703) 575-9402 Faxwww.ndci.org

NATIONALDRUG COURTINSTITUTE

11.Research data indicates that in the terminalphase of cannabinoid elimination, subjects canproduce urine samples with levels below thecutoff concentration (negative results), followedsubsequently by samples with levels slightlyabove the cutoff (positive results) (Huestis, 2002).This fluctuation between positive and negativedid not occur in all subjects and in those thatdid exhibit this pattern, the fluctuation was generally transitory. Based on this eliminationpattern, it is recommended that programs using a cannabinoid cutoff of 50 ng/mL allow an interval of at least three days between thetwo negative result samples to establish theabstinence baseline. It is further recommendedthat programs using the 20 ng/mL cannabinoidcutoff allow an interval of at least five daysbetween the two negative result samples toestablish the abstinence baseline. If a program’stesting frequency is greater than every five days(using the 20 ng/mL cutoff), a total of three ormore negative tests may be required before the five-day interval is achieved.

PublisherC. West Huddleston, IIIDirector, National Drug Court Institute

National Drug Court Institute4900 Seminary Road, Suite 320Alexandria, VA 22311703.575.9400 ext. 13703.575.9402 [email protected]

Test your new knowledge. Answerthese true and false questions basedon the Fact Sheet text.

1. The “detection window” meansthe length of time a drug willremain in someone’s system.

2. The choice of testing cutoffhas a profound effect on thecannabinoid detection window.

3. Despite changes in testingmethodologies, detection timesof cannabinoid metabolites inurine monitored by immunoas-say have remained the sameover the past two decades.

4. Chronic users of marijuanacommonly produce a positiveurine drug test result 30 daysafter the last smoking episode.

5. Any positive drug test resultfollowing two successive negative urine drug tests several days apart indicatesnew or recent drug exposure.

6. Since marijuana has such aprolonged elimination period,temporarily suspending drugtesting of a client who testspositive for marijuana is agood money-saving strategy.

FT

FT

FT

FT

FT

FT

FACT SHEET QUIZ: WHAT DID YOU LEARN?

Answers:1. False; 2. True; 3. False; 4. False; 5. True; 6. False

e t drug court u practitioner i - ndci.org is hoped that drug court practitioners will find that...

Documents