Marketing 2013 A Year in Review

Fingernail Drug Testing For Alcohol & Substances of Abuse (SOA)

5 Factors to Consider When Choosing a Drug TestDesired window of detectionSpecimen typeLevel of adulteration potentialNotice required before collectionSubstances being tested

When choosing a drug test, there are 5 factors that should be considered.

Desired window of detection, specimen type, the substances being tested, the level of adulteration potential and the notice required before collection2

Specimen Windows of DetectionNAILMATRIXNAIL BED

Narration:

When selecting a drug testing option, it is helpful to know that each specimen type is most suitable for a particular timeframe or window of detection.

Note: The next 5 slides are to briefly review the specimen widow of detection options. It can be brief, as the point is to position fingernail as the front runner to long-term drug testing compared to all other specimen types available. The specimens are starred in each slide with regard to the note that the slide covers.3

NAILMATRIXNAIL BED

Urine, oral fluid and whole blood are the options most suitable for testing recent use because their window of detection ranges between 1-3 days

Narrative:

Urine, oral fluid and whole blood are the options most suitable for testing recent use because their window of detection ranges between 1-3 days.

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NAILMATRIXNAIL BED

Dried blood spot testing using PEth, a direct alcohol biomarker, is most suitable for testing heavy use of alcohol in the last 2-3 weeks.

Narrative:

Dried Blood Spot testing for PEth, an alcohol biomarker, is most suitable for testing heavy use of alcohol in the last 2-3 weeks.

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NAILMATRIXNAIL BED

Hair testing is most suitable for testing heavy use of alcohol or substances of abuse (SOA) in the past 3 months.

Narrative:

Hair testing is most suitable for testing heavy use of alcohol or SOA in the past 3 months.

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NAILMATRIXNAIL BED

Fingernail testing is most suitable for testing heavy use of alcohol in the past 3 months or heavy use of other SOA in the past 6 months.

Narrative:

Fingernail testing is most suitable for testing heavy use of alcohol in the past 3 months or heavy use of other SOA in the past 6 months.

Understanding the time frame that you want to test for will help you be able to better choose the most suitable test for your needs

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So, why does fingernail work so well for testing long-term biomarkers compared to other specimen types?

Narrative:

So, why does fingernail work so well for testing long-term biomarkers compared to other specimen types?

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Fingernails Are Made of KeratinKeratin: fibrous structuralproteinofhair, nails,horn, hoofs,wool, feathers, and of the epithelial cells in the outermost layers of theskin. The polypeptide chains of keratin are arranged in parallel sheets held together byhydrogen bonding. ~Encyclopedia Britannica

Narrative:

The answer lies within the nature of the fingernail.

Fingernails are made of keratin, the fibrous structuralproteinofhair, nails,horn, hoofs,wool, feathers, and of the epithelial cells in the outermost layers of theskin.

The polypeptide chains of keratin are arranged in parallel sheets held together byhydrogen bonding.

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Fingernails Are Made of KeratinThese keratin sheets stack on top of each other, giving the nail thickness and length, making adulteration of the specimen difficult.

Narrative:

These keratin sheets stack on to of each other giving the nail thickness and length, making adulteration of the specimen difficult.10

Incorporation of Alcohol & SOABiomarker: a measurable substance whose presence is indicative of ingestion or exposure to substances of abuse (SOA).

Narrative:

As the nail grows in thickness and length, biomarkers from alcohol and other substances of abuse build up in the nail at the germinal matrix and along the nail bed.

A biomarker is a measurable substance whose presence is indicative of ingestion or exposure to substances of abuse (SOA).

Biomarkers become trapped in the keratin fibers.

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NAILMATRIXNAIL BED

Biomarkers can be found in nails as early as 1-2 weeks after alcohol or other substances of abuse are ingested.

The time period during which drug or alcohol ingestion can be detected depends on the substance used, the amount used, and personal metabolism.

Biomarker Absorption

Narrative:

Biomarkers can be found in nails as early as 1-2 weeks after alcohol or other substances of abuse are ingested.

The time period during which drug or alcohol ingestion can be detected depends on the substance used, the amount used, and personal metabolism.

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NAILMATRIXNAIL BED

What is heavy use of alcohol (binge drinking) and how can honest self report be deceiving?

Expanding on Heavy Use of Alcohol

Narrative:

What are we talking about with heavy alcohol use and how can self report be deceiving?

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How Many Drinks Are in That Drink?

Narrative:

A standard drink is any beverage that contains 14 grams of pure alcohol.

Amounts vary depending on the percentage of Alcohol By Volume or ABV.

So, 12 ounces of beer, 8 to 9 ounces of malt liquor, 5 ounces of table wine, and 1.5 ounces of hard liquor are all equivalent to 1 standard drink.

Note: see shot glasses at the bottom of the image if you want to point out the numbers14

Alcohol By The NumbersIt is easy to see how someone can report 1 or 2 drinks a night, but actually be drinking 8-10 standard drinks.

Narrative:

But, these days, having a drink can be deceiving.The alcohol content can vary drastically from one drink to the next.

It is easy to see how someone can report 1 or 2 drinks a night, but actually be drinking 8-10 standard drinks.

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A binge is a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 gram percent or above.

For a typical adult, this pattern corresponds to consuming 5 or more drinks for a male, or 4 or more drinks for a female, in about 2 hours.

National Institute on Alcohol Abuse and Alcoholism. NIAAA Council approves definition of binge drinking. NIAAA Newsletter. 2004 Winter;:3.

Binge Drinking Defined

Multiple Binges And Keratin TestingMultiple binges raises alcohol biomarker levels.

These levels are what we are measuring in keratin based tests (fingernail/hair).

Negative Test = Few to no binges during 3 months

Positive Test = Multiple binges during 3 months

This is a test for dangerous drinking

This is NOT a test for social drinking

Fingernail Testing vs. Hair TestingAdditionally, hair growth is relatively slow compared to fingernails, which can be grown in as little as 1-2 weeks. Some notice may be needed for the donor to refrain from clipping their nails in preparation for a test.

Narrative:

Nail keratin is 4 times thicker than hair and often captures more of a biomarker

Additionally, hair growth is relatively slow compared to fingernails, which can be grown in as little as 1-2 weeks.

Some notice may be needed for the donor to refrain from clipping their nails in preparation for a test.18

Fingernail Testing vs. Hair TestingHair is not always available

Hair disadvantagesPigmentation (color) has a large influence on biomarker absorption in hair: dark hair vs. blonde & red hair

Chemical treatments can washout biomarkers more rapidly: bleaching, perming, straightening, dying, etc.

Narrative:

Hair is not always available

Hair is a great specimen type, but there are some disadvantages:

Pigmentation, or color of the hair, has a large influence on biomarker absorption.Dark hair absorbs more substances than blonde or red hair.

Chemical treatments, such as bleaching, perming, straightening, and dying can washout biomarkers more rapidly.

Hair growth is relatively slow compared to fingernails, which can be grown in as little as 1-2 weeks.

Some notice may be needed for the donor to not clip their nails in preparation for a test.

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Fingernail CollectionNAILMATRIXNAIL BED

Fingernail samples are clipped and collected by the donor in front of a trained collection staff member.

A clipping of 2-3 mm long (about the width of a quarter) from all ten fingernails will provide about 100 mg of sample, the ideal amount for screening and confirmation.

Narrative:

Fingernail is simple to collect, ship and store.

Samples are clipped and collected by the donor in front of a trained collection staff member.

A clipping of 2-3 mm long (about the width of a quarter) from all ten fingernails will provide about 100 mg of sample, the ideal amount for screening and confirmation.

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*Drug class details are available online and in our catalog. Substances DetectedSince hair and fingernail are both created from keratin protein, the drug testing panels available for each test are identical.

EtG for alcohol is ordered either as a standalone or an add-on test.

Narrative:

Since hair and fingernail are both created from keratin protein, the drug testing panels available for each test are identical.

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Common Reasons For Using Fingernail Drug TestingHeavy alcohol use in the previous 3 monthsHeavy SOA use in the previous 6 monthsHair is not a viable option (buzzed, bleached, etc.)Supporting evidence for donors wishing to prove lack of heavy alcohol or SOA use within the time frame of window of detection

ConclusionLit packExpert WitnessExamples for use in court cases? We understand that forensic drug testing has the potential for numerous outcomes, that can sometimes be difficult to navigate. We offer support services to give users a better understanding of what their drug testing options are.

Services include but are not limited to:Discussion of Tests and CutoffsLitigation SupportExpert Witness TestimonyExamples for use in court cases

Narrative:

We understand that forensic drug testing has the potential for numerous outcomes, that can sometimes be difficult to navigate. We offer support services to give users a better understanding of what their drug testing options are.

Discussion of tests and cutoffs, litigation support, expert witness testimony, and examples for use in court cases.

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Questions?Poster Available Online

Please view or order at http://www.usdtl.com/media/infographics# under the Posters tab

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Questions?Questions?Contact Our RepresentativeMeghan BurkeMeghan.Burke@usdtl.com847.830.7998

All Rights Reserved. Copyright 2014 United States Drug Testing Laboratories, Inc.

Note: feel free to include your number. I thought it might be easier if they called Client Services first, and not your direct line.25