Legal, workplace, and treatment drug testing with alternate biological matrices on a global scale

Global trends in drug trafficking and drug usage patterns indicate a contin uing pattern of escalation throughout the world. Over the last two decades, urinalysis has evolved into a highly accurate means for determining whethe r individuals have been exposed to illicit drugs of abuse. Advances have al so been made in the use of alternate biological matrices such as hair, oral fluids and sweat for drug testing. Often, these new matrices demonstrate s ome distinct advantages over urinalysis, e.g. less invasive procedures, dif ferent time course of drug detection. They may even indicate impairment. Na tional and local laws of each country provide the underpinnings of drug-tes ting programs, but most countries have not addressed use of these alternate matrices. Currently, only a few countries have statutes that specifically mention use of alternate biological matrices, e.g. United States (Florida s tate law), Germany, Ireland, Poland and the Czech Republic. Conversely, few countries have prohibited collection of alternate biological specimens or drug test devices that utilize such specimens. In addition, guidelines for implementing drug testing pro-rains have been slow to emerge and most deal primarily with workplace drug testing programs, e.g. United States. Current ly, scientific technology utilized in drug testing is advancing rapidly, bu t there is a clear need for parallel development of guidelines governing th e use of alternate matrices for drug testing. This article provides an over view of global drug trafficking patterns and drug use, and results from a s urvey of legal statutes in 20 countries covering use of alternate matrices for drug testing. In addition, elements needed for the development of guide lines for alternate matrices testing for drugs of abuse are discussed, and specific examples of use of alternate matrices in treatment monitoring are provided. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.