Drug Testing & Relapse Protocol

The purpose of this Protocol is to maintain a sober environment for all Residents, to provide an objective measure of compliance with the zero-tolerance sobriety policy, to identify relapse early so that it can be addressed honestly and safely, and to keep the residence accountable to the standards set out in the Resident Admission Agreement.

Every Resident, by signing the Resident Admission Agreement, gives ongoing and irrevocable consent for the duration of his stay to drug and alcohol testing under this Protocol.

Consent extends to testing on admission, scheduled testing, random testing, reasonable-suspicion testing, return-from-leave testing and post-incident testing.

Tests may screen for any of the following substances, in any combination, and the panel may be amended from time to time:

• alcohol (via breathalyser and, where indicated, saliva or urine);
• tetrahydrocannabinol (THC) and cannabidiol (CBD) metabolites;
• cocaine and benzoylecgonine;
• methamphetamine and amphetamine;
• opiates, including morphine, codeine and heroin metabolites;
• benzodiazepines;
• barbiturates;
• methaqualone;
• methcathinone;
• synthetic cannabinoids;
• mandrax;
• MDMA / ecstasy;
• tramadol;
• ketamine;
• buprenorphine and methadone, where clinically relevant.

The Facility conducts the following categories of test:

• Admission test: every Resident is tested on the day of admission to record a baseline.
• Random test: random tests are conducted without notice, on dates and times determined by the Facility, on any Resident or group of Residents.
• Scheduled test: every Resident is tested on the day of return from any weekend leave.
• Reasonable-suspicion test: tests are conducted where a staff member reasonably suspects substance use, intoxication or relapse.
• Post-incident test: tests are conducted after any incident that may be related to substance use, including aggression, behavioural change, slurred speech, smell of alcohol, unsteady gait, sedation or paraphernalia found.
• Programmatic test: tests may be conducted at programmed milestones during the stay.

Tests are conducted using approved point-of-care test kits and, where appropriate, by accredited laboratory services. Methods may include:

• urine multi-panel immunoassay;
• oral fluid (saliva) testing;
• breath alcohol analysis using a calibrated breathalyser;
• laboratory confirmation by gas chromatography or mass spectrometry where a screening test is positive or contested.

Tests are conducted by a trained staff member, with a second staff member present where reasonably possible. Tests of female-presenting persons are not applicable at the Facility, which accommodates adult males only.

The Resident's identity is confirmed before the test. The Resident is informed of the substances tested for and the consequences of a positive result, refusal or tampering.

The Resident is observed during sample collection, in a manner that maintains the Resident's dignity, to confirm that the sample is fresh and not contaminated.

The temperature of any urine sample is checked immediately on collection. The kit's lot number and expiry are recorded.

Results are read in accordance with the kit manufacturer's instructions, within the time window specified.

Every sample sent for laboratory confirmation is sealed in the presence of the Resident, labelled with the Resident's name, the date and the time, and recorded on a chain-of-custody form.

The chain-of-custody form records every person who handles the sample from collection to laboratory delivery, and the date and time at which each handover occurs.

The Resident is offered the opportunity to initial the seal and the chain-of-custody form.

Every test, whether positive, negative or invalid, is recorded in the Drug Testing Logbook. The record includes:

• the Resident's name and identifying details;
• the date and time of the test;
• the category of test (admission, random, scheduled, suspicion, post-incident, programmatic);
• the kit lot number and expiry;
• the substances tested for and the result for each substance;
• the staff member conducting the test and the witness;
• the Resident's signature acknowledging the result;
• any laboratory confirmation reference where applicable.

A negative result is interpreted as no detectable substance above the cut-off threshold of the panel.

A positive result is interpreted as detection of a substance above the cut-off threshold.

An invalid result requires the test to be repeated.

Where the Resident contests a positive result, the sample (or a fresh sample) is sent for laboratory confirmation. Pending laboratory confirmation, the Resident is treated in accordance with the precautionary steps in the Relapse Response Procedure.

Refusal to test, evasion of testing, delay in providing a sample, failure to provide a sufficient sample, or any conduct intended to dilute, substitute, contaminate or otherwise tamper with a test or sample, is deemed a positive result.

Refusal and tampering are treated as serious breaches under the House Rules and are addressed under the Disciplinary Policy in parallel with the Relapse Response Procedure.

Residents must disclose all current and recent medication that may influence test results. The Facility cross-references positive screening results against the Medication Register before reaching any final conclusion.

A positive result that is explained by a disclosed, prescribed and approved medication, taken in accordance with the prescription, is not treated as a relapse. The result is recorded and the explanation noted.

Where a positive result is recorded, the Facility:

• informs the Resident of the result and the substance detected;
• removes the Resident from communal areas where this is necessary for safety;
• checks for signs of intoxication, withdrawal or medical risk and arranges appropriate care, including, where reasonable, calling the emergency doctor or an ambulance;
• notifies the Responsible Person as soon as reasonably possible and normally within two hours;
• initiates the Relapse Response Procedure and convenes a relapse review meeting;
• completes a Relapse Incident Report Form;
• considers further action under the Disciplinary Policy, taking into account the Resident's history, the substance involved, the circumstances and the safety of the residence.

If, at any time, a Resident shows signs of overdose, severe intoxication, withdrawal, psychiatric crisis or other medical risk, staff must act immediately to safeguard the Resident, including by calling an ambulance, contacting the emergency doctor or applying basic first aid.

Disciplinary process is paused while the Resident is medically unwell or at risk. The Resident's wellbeing comes first.

Test results are recorded in the Resident's file and are shared only with persons who require the information for the safe management of the Resident. This typically includes the Facility Manager, the Resident's counsellor or mentor, the emergency doctor, the pharmacist and the Responsible Person.

Test results are not shared with third parties without the Resident's consent, save where required by law or where the safety of any person reasonably requires.

Samples are not retained beyond the time required for laboratory confirmation, save where retention is required by an investigation. Records of test results are retained as part of the Resident's file in accordance with the Communication and POPIA Consent.

Test kits are stored in accordance with the manufacturer's instructions and within the temperature range specified.

Stock is rotated on a first-expiry first-out basis. Expired kits are removed from service and disposed of.

The breathalyser is calibrated in accordance with the manufacturer's instructions. Calibration records are kept.

Staff conducting tests receive initial training and annual refresher training. Training records are kept.

The Facility Manager, or delegate, audits the Drug Testing Logbook monthly. The audit reviews completeness, kit stock and expiry, calibration records, training records and chain-of-custody compliance. Findings are documented and corrective action taken where required.

On admission, a baseline test is recorded. A positive admission test is not automatically a basis for refusal of admission, but is considered together with the Resident's disclosure, the substance involved, the time since last use, and the Resident's clinical state.

Where a Resident returns from leave under the influence, the Resident is not permitted into communal areas, is safeguarded medically, the Responsible Person is contacted, and the Relapse Response Procedure is initiated.

The following records are maintained under this Protocol:

• the Drug Testing Logbook;
• Medication Register entries cross-referenced to any positive result explained by prescribed medication;
• Incident Report Forms and Relapse Incident Report Forms;
• chain-of-custody forms for samples sent for laboratory confirmation;
• calibration and training records;
• audit reports;
• Resident-specific correspondence relating to test outcomes.

DRUG TESTING LOGBOOK TEMPLATE

Reproduce the table below in the operational Drug Testing Logbook. One row per test.

RESIDENT ACKNOWLEDGEMENT

I, the undersigned Resident, acknowledge that:

• I consent to drug and alcohol testing under this Protocol for the duration of my stay.
• I will cooperate with every test and will not refuse, evade, delay, tamper with, dilute, substitute or otherwise interfere with any test or sample.
• I will disclose all current and recent medication that may influence a test result.
• I understand the consequences of a positive result, refusal and tampering.