[Urine Screening for Narcotics under Court-Imposed Abstinence Requirements: Comparative Validity of Forensic-Toxicological Analyses with Involvement of Public Health Services]. / Urinscreenings auf Betäubungsmittel unter gerichtlichen Abstinenzauflagen ­ Vergleichsvalidität von forensischtoxikologischen Analysen unter Mitwirkung des Öffentlichen Gesundheitsdienstes.

AIM OF THE STUDY: Assessment of the comparative validity between qualitative and quantitative analyses of urine screenings for defined narcotics residues under court-imposed abstinence restrictions. METHODS: Following the introduction of a valid marker system which, based on the application of a defined sugar substance and its detection in the urine of person under probation in 2006, urine samples were assayed in administrative cooperation by a Bavarian public health office for probationary services for evidence of narcotics. The urine samples were sent to an external laboratory in order to carry out forensic toxicological analyses for defined narcotics. The qualitative and quantitative laboratory results were reported back to the public health department so that a digital-based data set of a total of 380 persons with more than 27,000 individual analyses from a total of 14 consecutive calendar years could be established and retrospectively evaluated in an anonymised form. RESULTS: The overall prevalences of findings positive for narcotics were 2.7% (n=366 of 13,531) for the qualitative and 2.6% (n=348 of 13,525) for the subsequent quantitative result categorisations, with cannabis and opiates being detected most frequently in both test methods. Using the kappa coefficient as a quantitative measure for the comparative validity of both test methods, the test results showed the highest agreement (1.000) for buprenorphine and lowest agreement for PCP (0.880). No age- and gender-specific stratifications could be recorded for a total of ten different narcotic substances; substance-specific case numbers differed among the analyses. CONCLUSION: Based on the strong to very strong correspondences between qualitative and quantitative narcotics analysis results, it could be assumed that both analysis methods accurately recorded violations of abstinence requirements and were to be classified as sufficiently substantiating for judicial decisions under the Narcotics Act (Betäubungsmittelgesetz, BtMG). According to these results, the content of urine screenings for narcotics controlling abstinence should be discussed.

[Narcotic Use under Probation and Parole Supervision - A longitudinal Study of Risk-group-specific Recidivism under Abstinence Conditions]. / Betäubungsmittelkonsum unter Bewährungs- und Führungsaufsicht ­ Eine Langzeituntersuchung zum risikogruppenspezifischen Rückfallgeschehen unter Abstinenzauflagen.

STUDY OBJECTIVE: The aim of this long-term study was to record substance-specific prevalences of illegal use of narcotics despite court-imposed abstinence requirements. METHODS: Urine assays were obtained by a public health department on the basis of administrative assistance for the probation department of a district court. The individual and valid allocation of these urine samples was ensured using a proven marker system. After postal dispatch, laboratory chemical analyses for narcotics residues were carried out in an external laboratory via enzyme immunoassay and validation by mass spectrography in the case of positive narcotics results. On the basis of all available routine data, a pooled data set covering a total of fourteen consecutive calendar years (2006-2019) was generated digitally and evaluated anonymously. RESULTS: From a total of 380 subjects (female: 13% versus male: 87%; average age: 30.4 years), 13,500 individual narcotic substance analyses from 2,941 urine samples were available. In 2.7% of all individual analyses, at least one of eight potential narcotic substances was detected, whereby the highest overall prevalences in the sense of a relapse were found for cannabis with 3.7% and for opiates with 2.4%. In contrast, there were almost no residues for barbiturates and LSD and no positive evidence for buprenorphine and PCP. As expected, most relapses in all narcotics groups were found in the age groups from 18 to 35 years. Strikingly, more women than men violated the court abstinence order with amphetamines, while relapses with the other seven narcotics groups occurred predominantly among men. In the course of the entire observation period, the most marked fluctuations in relapse rates were found for cannabis, opiates and cocaine. CONCLUSION: The use of narcotic substances during probation and parole supervision does not appear to be a rare occurrence and has received little professional attention. Increased attention to this group-specific recidivism and more studies on this topic should help reduce this deficit.