ࡱ> y bjbj 7{{1 | | 8lFDZ|^$^$^$CCCCCCC$NGJZDQ^$#N^$^$^$D|fDp*p*p*^$<|Cp*^$Cp*p*>|?|]q kZ&g?C|D0D}?ZJ&ZJ,??ZJ@^$^$p*^$^$^$^$^$DDp*^$^$^$D^$^$^$^$ZJ^$^$^$^$^$^$^$^$^$| : The goal of parental assessment in child welfare cases is the identification and provision of services that are specifically targeted to address the parent(s) needs and ensure permanency is reached. If you need to know:Order:Potential Providers:Holistic view of parent (physical, mental, environmental, spiritual, behavioral and social assessment) Psychosocial Assessment Community Mental Health Centers (Comp Care), Targeted Assessment Program (TAP), Private Outpatient ProviderEffects of head injury, stroke, damage from substance abuse Neuropsychological AssessmentNeuropsychologist @ Medical or Outpatient Private ProviderMental status, development in social, educational and vocational areas, history of psychological adjustment, review of physical health, review of psychosis or need for psychotropic medicationPsychiatric EvaluationPsychiatrist @ Community Mental Health Center or Private Outpatient ProviderPsychological history, diagnosis of individuals thinking, feelings and behavior, learning disabilities, IQ testing or diagnosis clarification. Psychological EvaluationPsychologist @ Community Mental Health Center or Private Outpatient Provider Whether someone is likely to have a substance use disorder and/or is in need of further assessmentSubstance Abuse ScreeningDCBS, Community Mental Health Center, or any Health and Human Service AgencyEstablishes the presence or absence of a substance use disorderSubstance Abuse AssessmentCommunity Mental Health Center, TAP, Private Outpatient ProviderWhether someone is a victim of domestic violenceDomestic Violence Victimization Risk AssessmentKY Domestic Violence ProgramsWhether someone is a batterer and/or would benefit from a batterer programDomestic Violence Batterers Intervention Program Assessment KY Batterers Intervention Program (BIP)A parents ability to care for a child (strengths and weaknesses) Parenting Assessment Local Parenting Program such as Community Action or may be offered @ Community Mental Health Center Family strengths and vulnerabilities in five areas: 1) family/social 2) emotional/behavioral/psychological/physiological 3) attachment 4) life history/traumatic events 5) development/cognitive/academic CATS Assessment (Comprehensive Assessment and Treatment Service) University of Kentucky, Center on Trauma and ChildrenInformation regarding mental illness, personality disorder, bonding, parenting capacity and prognosis for caregivers in alleged maltreatment cases. This is an extraordinary assessment and should be ordered sparingly due to availability and costs. Forensic Mental Health Evaluation Hospitals including Kosair Division of Pediatric Forensic Medicine and University of Kentucky; some Community Mental Health Centers and Private Outpatient Settings Drug use is one of multiple factors which must be considered collectively to gauge risk of harm. Drug testing is one option to identify possible substance use, however other behaviors should be considered in addition to drug testing results to effectively measure progress. An effective drug testing program should be random, monitored to protect against tampering, and results should include laboratory confirmation in key decision making points.  Types of TestingUrine is the most widely used and researched biological specimen for the detection of drugs in the human body. Most illicit drugs are excreted through urine within approximately 72 hours. The exception is alcohol which is excreted usually within 12 hours. However, EtG testing which detects the Ethyl glucuronide metabolite (chemical byproduct) of alcohol and can allow detection for up to 48 hours. Urine specimens can easily be tampered with, replaced or adulterated, therefore observed collection and creatinine analysis is required for a test to be considered valid. Urine testing is the preferred and authorized testing method for the Family Law Drug Testing Initiative.Breath specimens are collected using a device that estimates a persons blood alcohol content. For forensically valid use, breath testing devices, commonly known as breathalyzers must be calibrated according to the U.S. Department of Transportation standards and State statutes or regulations (U.S. Department of Transportation, 2007). The major advantages of this specimen collection method include that it is inexpensive, noninvasive, and reliable for detecting the presence and concentration of alcohol. A limitation of breath specimen testing is that it only provides information about recent alcohol use but not drug use.Hair is an increasingly common method of drug detection. An advantage of hair analysis is that it has the widest window of detection and detects drug exposure for a period of several months. Disadvantages include an inability to detect recent use (within 5-7 days), the expense of testing, and some concerns about the accuracy of results because of different types of hair and other factors.Sweat patch testing has also become a popular form of drug testing. Among the advantages of the sweat patch is that they have a detection window is 10-14 days and are relatively non-invasive and difficult to tamper with. The disadvantages are that the patch does not detect alcohol and there are some concerns about accuracy due to contamination. Oral fluid is also used for drug testing. The strengths of oral testing are that it is noninvasive and easy to administer. However, the window of detection is shorter than urine testing and concerns have been raised about the accuracy of on-site commercial products.Blood specimens are collected to detect use of both alcohol and drugs. However, the process for obtaining blood specimens is invasive and qualified personnel must collect these specimens.  Addressing a Positive Drug Test: A positive drug test can serve as a means to talk about recovery needs and positive tests should be viewed as an indicator of the need to adjust the parents treatment planning. Some suggested responses are: Provide an opportunity for the parent to explain the results Consult with the treatment provider about the parents relapse prevention plan Reassess the array of services offered to the parent Consider a modification in the frequency of the current drug testing schedule  Detection: Timing is a critical factor in drug and alcohol testing. The amount of time a drug remains in the body is dependent on a variety of factors including the amount of drug taken and the metabolism of the individual. A negative test indicates that no drugs or metabolites were detected in the sample tested above the cutoff level. There is no form of testing that can absolutely guarantee that an individual is not using drugs.  SUBSTANCEBLOODSALIVAURINEHAIR HYPERLINK "http://www.erowid.org/chemicals/alcohol/alcohol_testing.shtml" Alcohol12 hrs4-12 hrs6-24 hrs (5 days with EtG)n/a HYPERLINK "http://www.erowid.org/chemicals/amphetamines/amphetamines_testing.shtml" Amphetamine12 hrs3 days1-4 daysup to 90 days HYPERLINK "http://www.erowid.org/chemicals/barbiturates/barbiturates_testing.shtml" Barbituratesunknownunknown2-10 daysup to 90 daysBenzodiazepinesunknown6-48 hrs 1-42 daysup to 90 days HYPERLINK "http://www.erowid.org/plants/cannabis/cannabis_testing.shtml" Cannabis (single use)2-3 days12-24 hrs2-3 daysup to 90 days HYPERLINK "http://www.erowid.org/plants/cannabis/cannabis_testing.shtml" Cannabis (habitual use)2 weeks12-24 hrs15-30 daysup to 90 days HYPERLINK "http://www.erowid.org/chemicals/cocaine/cocaine_testing.shtml" Cocaineunknown1 day1-3 daysup to 90 daysOpioidsunknown1-36 hrs2-4 daysup to 90 days HYPERLINK "http://www.erowid.org/chemicals/heroin/heroin_testing.shtml" Heroinunknown1-36 hrs2-4 daysup to 90 days HYPERLINK "http://www.erowid.org/chemicals/meth/meth_testing.shtml" Methamphetamine1-3 days1-48 hrs3-5 daysup to 90 days HYPERLINK "http://www.erowid.org/chemicals/pcp/pcp_testing.shtml" PCP1-3 days3 days3-7 daysup to 90 daysBuprenorphineunknown6-12 hrs1-6 daysunknownMethadoneunknown6-12 hrs6-12 daysunknown Randomized Drug Testing: Recovery from substance abuse disorders is a long term process and it may take time for parents to begin to integrate recovery into their lives. A random drug testing program can be beneficial in reducing safety concerns and lowering the risk of future maltreatment. This table can assist in determining the frequency of drug testing and should be modified to meet individual needs as well.   Commonly Abused DrugsSubstanceCategory AdministeredCommercial or Street NamesEffectsMetabolites/Reactive CompoundsAlcoholDepressantSwallowedBooze, Chug, Brew, JuiceEuphoria, stimulation, relaxation, lowered inhibitions, visual distortions, sexual dysfunction, loss of consciousness, increased risk of injuriesEthyl sulfate; Ethyl glucuronideBarbiturates DepressantInjected, SwallowedAmytal, Nembutal, Seconal, Phenabarbital: barbs, red birds, yellows, tooiesEuphoria, unusual excitement, fever, sedation, drowsiness, reduced anxiety, feelings of well being, lowered inhibitions, slurred speech, poor concentrationAmobarbital, Butabarbital, Butalbital, Pentobarbital, Phenobarbital, SecobarbitalBenzodiazepine DepressantSwallowedAtivan, Halcion, Librium, Valium, Xanax, Klonopin: candy, downers, tranksSedation, drowsiness, reduced anxiety, feelings of well being, lowered inhibitions, slurred speech, poor concentrationAlprazolam, Clobazam, Clonazam, Diazepam, Lorazepam, OxazepamMarijuana HashishCannabinoidSmoked, SwallowedBlunt, dope, ganja, grass, boom, gangster, hash, skunkEuphoria, relaxation, slowed reaction time, distorted sensory perception, impaired balance and coordinationTetrahydrocannabinolCocaineStimulantInjected, snorted, smokedBlow, bump, C, candy, coke, crack, snow, rockNasal damage from snorting, feelings of exhilaration, increased energy, mental alertness, tremors, reduced appetite, irritability, anxiety, paranoiaBenzoylecgonineAmphetamineStimulantSwallowed, snorted, injected, smokedBiphetamine, Dexedrine: beenies, black beauties, crosses, heartsFeelings of exhilaration, increased energy, mental alertness, tremors, reduced appetite, irritability, anxiety, paranoiaI-Amphetamine, MDA, PhentermineMethamphetamineStimulantSwallowed, snorted, injected, smokedDesoxyn: meth, ice, crank, chalkSevere dental problems, feelings of exhilaration, increased energy, mental alertness, tremors, reduced appetite, irritability, anxiety, paranoiaEphedrine, Fenfluramine, I-Methamphetamine, Phenethylamine, ProcaineHeroin OpioidSmoked, injected, snortedSmack, horse, brown sugar, dope, skagEuphoria, drowsiness, impaired coordination, dizziness, confusion, nausea, sedationDiacetylmorphineOpiate Pain RelieversOpioidChewed, swallowed, snorted, injectedTylox, Oxycontin, Percodan, Percocet, Vicodin, Lortab, Lorcet, Diaudid, Demerol, Davon, DarvocetPain relief, euphoria, drowsiness, sedation, weakness, dizziness, nausea, impaired coordination, confusion, dry mouth, itching, sweating, severe constipationCodeine, Diacetylmorphine, Levorphanol, Oxycodone, Hydrocodone, Oxymorphone, Meperidine, Propoxyphene, MorphineLSD Mescaline PsilocybinHallucinogensAbsorbed, smoked, swallowedLSD: blotter, acid, yellow sunshine Mescaline: Buttons, cactus, mesc Psilocybin: Magic Mushrooms, shrooms, little smokeAltered states of perception and hallucinations. LSD can cause flashbacks. Psilocybin causes nervousness, paranoia and panicLysergic acid diethylamideKetamine PCP Salvia DXMDissociative DrugsInjected, snorted, smoked, swallowedKetamine: Cat valium, K, special K PCP: Angel dust, boat, hog Salvia: Sally-D, herb, magic mint DXM: Robo, Triple CFeel like there is a separation from the body and environment, impaired motor function, anxiety, numbness. Ketamine causes analgesia and delirium. PCP causes psychosis, aggression, violence and some hallucinations. DXM causes euphoria, slurred speech, confusion and dizziness.Ketalar SV Phencyclidine Salvinorin A DextromethorphanMDMA Flunitrazepam GHBClub DrugsSwallowed, snorted, injectedMDMA: Ecstacy, Adam, clarity, Eve Flunitrazepam: Rohypnol, R2, Roach, roofies GHB: G, soap, scoop, liquid XMDMA causes mild hallucination, increased tactile sensitivity, empathic feelings, anxiety, chills, sweats, teeth clenching. Flunitrazepam causes sedation, muscle relaxation, confusion and memory loss. GHB causes drowsiness, nausea, headache, disorientation, loss of coordination. Methylenedioxy-methamphetamine Gamma-hydroxybuyrate      Assessment & Drug Testing Practice Guidelines Kentucky Court of Justice 1 Remember: Screening and assessment are crucial factors in providing efficient services to parents. Screening and assessment also help in making decisions on whom to drug test. Drug tests are a tool to assist in this process but are not the sole indicator of recovery! 2 Inappropriate uses for drug and alcohol testing may include:  When a parent is already an active participant in a substance abuse treatment program in which frequent, random testing is a required component of the program  When used as punishment to a parent  When used as the sole indicator of a parent s progress   Appropriate uses for drug and alcohol testing may include: As component of a comprehensive family assessment to identify or treat substance abuse as a contributing factor to maltreatment when there are indicators of substance use. To assist a parent in their readiness for treatment interventions When substance abuse is a contributing factor in maltreatment and the parent is not participating in a substance abuse treatment program To provide positive reinforcement and to monitor parents, particularly in early recovery 3 Judges may give parents the opportunity to admit to recent drug or alcohol use at any time during a court proceeding, possibly eliminating the need for a drug test. 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