What goes on inside a pathology laboratory?

Here at NSW Health Pathology we spend a lot of time analysing samples and producing results. Recently we got to see how our work is making a difference on the other side of a very high fence.

Inside a secure facil­i­ty on the grounds of Sydney’s Parklea Cor­rec­tion­al Cen­tre, two young men dressed in prison greens kick a foot­ball across a grassed court­yard. Anoth­er is busy in a kitchen prepar­ing chick­ens for roast­ing, and in a near­by art room a group of men are cre­at­ing extra­or­di­nary paintings.

But despite the razor wire on the fences, they’re not in prison; they’re part of a spe­cial drug treat­ment pro­gram over­seen by the NSW Drug Court.

Denise Con­stan­ti­nou is the Senior Psy­chol­o­gist at the Parklea Com­pul­so­ry Drug Treat­ment Cor­rec­tion­al Cen­tre and explains how par­tic­i­pants go through three stages of recov­ery after they arrive at the facility.

“The pro­gram runs for a min­i­mum 18 months, with six months spent in each of the three stages,” she said.

“Stage one requires them to par­tic­i­pate in ther­a­peu­tic pro­grams to address their past drug use and offend­ing behaviour.

“We devel­op their treat­ment plan in col­lab­o­ra­tion with them and their adher­ence to that treat­ment plan is mon­i­tored on a week­ly basis.”

Ms Con­stan­ti­nou says par­tic­i­pants are required to pro­vide super­vised urine sam­ples reg­u­lar­ly through­out their treat­ment to ensure they remain drug free.

Cus­to­di­al offi­cers col­lect a urine sam­ple from par­tic­i­pants at least twice a week dur­ing stage one of the program.

“When they move to stage two the week­ly urine analy­sis actu­al­ly increas­es to three times a week because they’re able to access the com­mu­ni­ty,” she explains.

“Then in stage three when they are liv­ing out in the com­mu­ni­ty, but still part of the pro­gram, the urine analy­sis con­tin­ues at a rate of three times a week.

“All those tests hap­pen at the cen­tre so staff can see the par­tic­i­pants, assess their behav­iour, and ensure they’re not try­ing to evade detec­tion of drug use.”

Ms Con­stan­ti­nou says staff watch while the men give their urine sam­ple in a spe­cial­ly designed bathroom.

“Some will com­plain about hav­ing to par­tic­i­pate – there are some strin­gent pro­to­cols,” she said.

“We’re also very aware that some of our clients have expe­ri­enced a his­to­ry of trau­ma so uri­nat­ing in front of some­body can be very trig­ger­ing. So there needs to be some sen­si­tiv­i­ties around that process.

“But par­tic­i­pants also recog­nise that it does hold them account­able and ‘keeps them on track’. They know that if their drug use is detect­ed there will be con­se­quences in terms of the priv­i­leges and rewards that are afford­ed with­in the program.”

Ms Con­stan­ti­nou says some of the par­tic­i­pants are also work­ing on par­ent­ing plans to have con­tact with their chil­dren, so pro­vid­ing urine sam­ples means they can prove they’re stay­ing drug-free.

Sam­ples tak­en at the cen­tre are checked imme­di­ate­ly for drug mark­ers and if there’s a pos­i­tive indi­ca­tion, the urine is sent to NSW Health Pathology’s Drug Tox­i­col­o­gy Unit (DTU) for fur­ther test­ing and analy­sis to deter­mine what the drug is.

NSW Health Pathology’s Foren­sic & Ana­lyt­i­cal Sci­ence Ser­vice Direc­tor of Foren­sic and Envi­ron­men­tal Tox­i­col­o­gy San­ti­a­go Vazquez says the lat­est tech­nol­o­gy at the DTU lab­o­ra­to­ry ensures results are received by the Parklea cen­tre with­in days.

“We work with staff at the Com­pul­so­ry Drug Treat­ment Cor­rec­tion­al Cen­tre to ensure they know how to inter­pret the results of the urine tests and the reports that we pro­vide,” Dr Vazquez said.

“Our lab­o­ra­to­ry uses world-lead­ing tech­nol­o­gy to analyse a wide range of drugs and their metabolites.

“We’re proud to be sup­port­ing the work of the NSW Drug Courts and help­ing to man­age the recov­ery of participants.”

Since the drug treat­ment pro­gram began in 2006, the Parklea CDTCC has col­lect­ed more than 80,000 urine sam­ples for testing.