Refer to Requesting a drug screen - procedure for tasks that must be undertaken.
Child protection practitioners are sometimes required to assess the effects of substance use by a parent on their parenting capacity. A drug and alcohol screen is one of a number of ways that can identify and monitor drug and alcohol usage. This is only one tool and should never be used in isolation. Drug and alcohol screen results provide one piece of information that can contribute to a comprehensive assessment of the impact of parental drug and alcohol use on their capacity to parent their child. Screens should be used in conjunction with feedback regarding the parent's drug and alcohol treatment from service providers, parent’s self-report, information from the child and family members or other professionals, and observations of the parents’ behaviour.
Child protection practitioners should consult with specialist Aboriginal drug and alcohol services when working with Aboriginal parents who need to address drug and alcohol issues. See advice Drug and alcohol assessments and service description Drug and alcohol assessment and treatment services.
Regular monitoring through drug and alcohol screens can be one method of assessing a parent's level and type of substance use and their commitment and capacity to change. The child protection practitioner should not rely solely on drug and alcohol testing as evidence of a parent’s substance use, for a number of reasons:
- screens do not detect all substances
- the testing process may be open to manipulation by parents
- the substance identified in the screen may be a product of the substance used rather than the substance itself, due to how the substance metabolises in the body of an individual
- the level of substance detected is not a reliable indicator of the amount of substance that has been actually been used
- the time frame for substances to be detected in screens varies according to the substance taken and individual’s metabolism, and may be relatively short in some situations
- if prescription drugs are being misused this is difficult to identify from a screen alone.
Drug and alcohol screens are a form of testing for monitoring substance use. There are several screens that may be used when testing for drugs and alcohol:
- urine screen
- blood test
- breathalyser test
- hair test
- oral swabs
For the detection of drugs, a urine drug screen is usually requested and is the preferred method of the child protection program. For the detection of alcohol, whilst a urine screen can be requested, it only detects alcohol for up to 24 hours.
A blood test is a more reliable test of alcohol consumption, though this is a more intrusive measure and will bear additional costs. In some areas a pathology provider may offer a service where the parent can attend to undergo a breathalyser test. Hair testing is another method although would rarely be used and research on this method continues. Oral swabs are not currently used by the child protection program due to their lack of accuracy.
Careful consideration must be given to when drug screens are requested, and what level of frequency is required. This will vary depending on whether the screen is a condition of a Children’s Court order and therefore must be complied with, or agreed by the parent as part of the child protection investigation or case planning process. For example, if a child is living at home and there is concern regarding parental capacity due to substance misuse, or the result will help inform a significant decision such as commencing overnight contact, regular drug screens may be required for a period.
However, if the child is safe in an out-of-home care placement, less frequent drug screens are likely more appropriate.
If a drug screen is required during an investigation or in the absence of a court order requiring screens to inform the assessment by child protection, and a parent refuses, practitioners should consider whether an application for a temporary assessment order may be appropriate (s232(1)(h) Children, Youth and Families Act 2005), and discuss this with the Child Protection Litigation Office (CPLO).
Understanding drug screen results
Reading and interpreting drug screen results can be complex. To assist child protection practitioners, a powerpoint presentation with a voiceover explanation for each slide has been prepared. The ‘Understanding and interpreting drug screen results’ can be located on the department's e-learning portal (as known as the learning management system).
The powerpoint will assist practitioners to understand the complexity of screen results whilst providing them an evidence base to inform assessments, interventions and include in court reports. It will highlight important information, for example:
- where results show similar creatinine levels that can suggest a singular sample has been used for multiple tests
- if a drug, such as Diazepam, has not metabolized and is present in the screen results, this suggests an individual has not consumed the drug but has directly added it to the sample.
These type of situations can occur when an individual is trying to subvert the test results.
What is being requested?
Drug screens are first processed through an immunoassay, which is also known as a ‘screening test’. This will indicate whether a class of drug was detected by indicating positive or negative. This screening test has some limitations and therefore may require further testing (RFT). Further testing is achieved through Gas chromatography in combination with mass spectrometry (GC/MS), otherwise known as confirmation testing. This is a further test of the initial screen which provides a breakdown of the identified class of drug. Consideration must be given to whether a screening test is sufficient or whether the initial screen requires confirmation testing also. This decision should be based on the individual circumstances of the case. For example if a parent contests the drug use or attributes the positive reading to a legitimate source. If the results are to be relied upon in court proceedings it is recommended confirmation testing be undertaken to avoid doubt.
Child protection has a contract for pathology services. This provider must be used, except in exceptional circumstances where the decision to use an alternate provider has been endorsed by team manager or above. The drug and alcohol screen will usually be supervised by trained pathology staff at the collection centre. Refer to Drug screen collection sites for child protection for locations.
The child protection practitioner will need to provide a referral form specific to their team, to enable them to access the results.
Results are accessed using the online e-viewer using details provided by the pathology provider. It is important the practitioner is familiar with the process of requesting drug and alcohol screens in their division. See procedure Requesting a drug screen for how to undertake this task.
- Drug screen collection sites for child protection
- Drug screens - information sheet for parents
- Drug and alcohol assessments
- Drug and alcohol assessment and treatment services
- Drug treatment services
- Temporary assessment orders (TAO) - advice
- Understanding and interpreting drug screen results - elearning module