Optimizing Toxicological Screening in Drug Endangered Children
Condition: Substance Abuse Detection
MeSH terms: Substance-Related Disorders
Study type: Observational

Summary: 
      Background:

        -  Children who enter the foster care system are all too often exposed to illicit drugs in
           the home. Children from these homes, known as drug endangered children, are not
           routinely tested for harmful substances. Any short- and long-term physical or
           developmental problems they may experience as a result of this exposure often go
           undetected and untreated.

        -  Children who are placed into protective custody are not always screened by physicians or
           nurse practitioners. Although drug-endangered children under 18 years of age
           automatically receive a urine toxicology screen to determine the types and levels of
           illicit drugs in their systems, this procedure has difficulties and limitations that may
           affect the quality of the data. Researchers are interested in developing more effective
           methods of analyzing the presence or absence of illicit environmental drug exposure in
           children.

      Objectives:

      - To determine the most effective method of identifying long-term illicit stimulant drug
      exposure in drug-endangered children.

      Eligibility:

      - Children under 18 years of age who are being placed into protective custody after having
      been found in a home where drugs are manufactured, used, or sold.

      Design:

        -  Researchers will gain verbal consent for the procedure for children who are 7 years of
           age or older. Children younger than 7 years of age will not be required to give verbal
           consent for sample collection.

        -  Researchers will collect standard urine samples for toxicological screening. Part of the
           sample will be sent to the National Institute on Drug Abuse for evaluation; the rest
           will remain with the local authority.

        -  In addition to this standard procedure, researchers will collect a hair sample by
           cutting a small amount of hair from the crown of the head as close to the root as
           possible (and not pulling any hair out of the child's head).

        -  Researchers will also use an oral swab to collect a saliva sample from the inside cheek
           of each child.

        -  No clinical care will be provided under this protocol....
    

Detailed description: 
      This is a single-center, investigator-initiated study to determine the best method for
      analyzing the presence or absence of illicit environmental drug exposure in children placed
      into protective custody in Sacramento County. In collaboration with the National Institutes
      of Health (NIH), National Institute of Drug Abuse (NIDA) we will use diagnostic procedures to
      determine the presence of illicit drugs in the following three samples: (1) hair; (2) oral
      swab; and (3) urine. These samples will be sent to a designated NIH lab site where 100
      de-identified samples will be analyzed for methamphetamine, amphetamine, Ecstasy (MDMA), and
      MDEA.
    

Time perspective: Prospective
Keywords: Toxicological Screening; Drugs; Alternative Matrices; Urine; Children