Mission drug testing questioned

By Mary Garrigan, Journal Staff Writer | Thursday, January 04, 2007

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RAPID CITY -- Greg Madison claims he has been clean and sober for 26 years, so when he tested positive for illegal drugs after a urinalysis test this fall while living at Cornerstone Rescue Mission, he demanded a second opinion.

Madison's follow-up test was negative, and he was allowed back in the homeless shelter that same night.

Perhaps three or four times a year, someone disputes a positive drug test at the shelter, according to Jim Castleberry, executive director at Cornerstone.

When challenged, a positive drug test can be confirmed at Clinical Laboratory of the Black Hills, Castleberry said. Follow-up tests are supposed to be done at the individual's expense but, in practice, the mission often foots the bill. "We've covered the cost of that at times," Castleberry said. "We certainly don't claim 100 percent accuracy."

Drug and alcohol screening tests are administered routinely when someone stays at the local homeless shelter, which does not allow guests to use either.

Portable breath tests analyze the breath for alcohol levels and are used daily for some guests. Urine tests that screen for methamphetamine, cocaine and marijuana can be required on a random or as-needed basis after the initial entry test. If a mission resident leaves for one day, the screening test is performed again upon their return.

Madison wants to see urine tests replaced with a more sophisticated and accurate blood test. The 58-year-old Minneapolis man, who has lived at Cornerstone since August, also complains that random drug testing is sometimes administered in an arbitrary, punitive way at the mission, often against American Indians. Madison is Caucasian.

Al Touche, a National American University student who often eats meals at the mission and sometimes volunteers there, complains that Indians such as himself are targeted more often for breathalyzer tests. He has been given one three times in the past year, never for any reason he could determine. "I have no problem with drug testing, but I think it is used more often and more unfairly against Natives," Touche said.

Castleberry disagrees.

One confirmed false positive, in Madison's case, does not justify the additional cost of more expensive lab tests, he said. Cornerstone already spends between $5,000 and $7,000 per year on urinalysis tests, which it buys from Mid Direct, an Arkansas company, at a cost of about $2.50 each. The same screening tests are used for random drug testing of employees and guests alike at Cornerstone.

The cost of the screening tests insures that they are not used to harass or punish guests, Castleberry said. Employees do have discretion in administering them, however. "We reserve the right to do a urinalysis at any time," he said.

Urine tests are the industry standard for routine drug screening, according to Dr. Clinton A. Winslow, a certified medical-review officer. Winslow oversees the confirmation of positive drug screens for lab clients such as Clinical Laboratory of the Black Hills.

From a technical standpoint, the rapid drug tests used by homeless shelters and other institutions are essentially the same as a test performed in a laboratory setting, Winslow said. Inexpensive tests are highly sensitive for numerous drug compounds, which can then be further identified by a more sophisticated lab test. Employee drug tests are always confirmed in a laboratory, but confirmation procedures at homeless shelters and other sites where the screening is voluntary may be different, Winslow said.

Perfectly legal substances, such as Sudafed, poppyseeds in large amounts and certain hemp products can cause a positive result for methamphetamine, opiates or THC, respectively, Winslow said.

Numerous breathalyzer tests are administered daily at Cornerstone, for people whose parole conditions require it or for those with a known history of alcohol abuse. The machines are the same ones used by law-enforcement agencies. The mission has three portable breath-test machines, costing about $1,500 each. It goes through thousands of tubes yearly at a cost of about $2,000.

Cornerstone has had a formal drug-testing policy for about three years, Castleberry said.

A drug-free environment is required as a condition of the federal grants that the mission receives, so random drug screening is the most accurate, impartial way to manage substance abuse, Castleberry said. "We set that standard for the safety of the people who stay here," he said. "You can't have people who are using around vulnerable people who are trying to stay clean and sober."

At Cornerstone, when someone tests "hot" for meth, that person's only options are to leave or go to the county detox center, Castleberry said. Cocaine use is almost never detected at Cornerstone, probably for economic reasons, he said. If the test reveals marijuana use, the shelter will work with them since THC compounds can stay in the body for as long as 30 days. A second test administered after a two-week grace period must show diminishing THC levels for a guest to remain at the shelter, he said.

Contact Mary Garrigan at 394-8410 or mary.garrigan@rapidcityjournal.com