By Freepik© Studio

1) What is the difference between a clinical test and a forensic test?

• Forensic testing includes confirmation testing, which uses a second portion/aliquot of the original specimen run on different, more sophisticated instruments when possible to duplicate positive screening results. This is a fail-safe to prevent false positives.
  
  
• Forensic testing also includes a clearly documented chain of custody, which ensures the specimen collected is the specimen that was tested and, in turn, reported out. This is because forensic testing has processes to ensure that the evidence created is defensible in a court of law, potentially mitigating issues associated with the testing.

2) How do I know if a laboratory is a good option for forensic newborn drug testing?

You should seek a laboratory that has forensic accreditations. Forensic drug testing laboratories work with the oversight of forensic accrediting bodies. These accrediting bodies review the laboratory processes regularly for accuracy and compliance. Laboratories that don’t have proper oversight can put an organization’s reputation and integrity at risk if their processes are determined to be forensically indefensible. This can lead to extensive and costly reevaluation. USDTL holds one of the highest international accreditations for forensic toxicology as an ANSI-ASQ National Accreditation Board (ANAB) ISO 17025 forensic testing laboratory. This means that every test completed by USDTL is done under the highest standards available for a forensic drug testing laboratory.

3) What is the best way to reduce the chances of missing newborn drug exposure while reducing testing bias?

Standardized collection of umbilical cord tissue at every birth ensures equity in the newborn drug testing process. No newborn will be left without the documented exposure they need for their lifetime and no hospital is left without the data they need to make the best decisions. This process streamlines staff training and reduces issues of missed collection because every umbilical cord is collected even if it is not tested. Stored specimens can be sent out for testing based on hospital protocol or if the neonate starts showing unexpected symptoms of withdrawal hours or days after birth. Specimens that do not need testing are simply discarded. See our blog The Onset of Newborn Withdrawal Symptoms is Highly Variable, which shows the different times onset can occur. According to the study, some barbituates could take up to 14 days for withdrawal to present.