Afghanistan Treatment Center Study: Children’s Hair, Oral Fluid, and Urine Drug Testing

Executive Summary

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The Colombo Plan and U.S. Department of State, Bureau of International Narcotics and Law Enforcement Affairs (INL), sponsored a study of drug use or exposure in Afghan children receiving treatment in six INL-supported residential drug treatment centers in Afghanistan. Hair, oral fluid, and urine samples were obtained from children residing in treatment centers and tested for opioids and other drugs.

Samples were obtained from a total of 334 children, 47% male and 53% female, during five sampling periods over four years. On average, children tested had been in the treatment center for over 24 days. Several children included in the study were not in treatment but accompanying guardians who were in treatment at the center.

Hair samples were collected from 329 children and nearly half (159 or 48%) of the samples tested positive for opioid product. Oral fluid samples were collected from 321 children and 54 (17%) tested positive mostly for opioids. Urine samples were collected from 327 children and 55 (17%) tested positive for opioids. 

Positive oral fluid and/or urine drug tests suggest use or exposure to drugs within days. Of the 54 children who had positive opioid oral fluid and/or urine sample test results, 21 children were in treatment for 25 or more days.

Cannabis was detected in 26 children; 25 children were in the Sanga Amaj Center in Kabul. Nineteen of those children were positive in oral fluid, indicating recent exposure, and 5 of those children were in treatment for 25 days or longer.

Methamphetamine was found in 7 children; 4 of those children were in treatment for 19 days or longer.

These data strongly suggest that Afghan children in some treatment programs are continuing to be exposed to opioids and other drugs. Increased surveillance of this problem is needed to improve treatment efficacy and safety of the children.

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