Does ADAM Need a Haircut? A Pilot Study of Self-Reported Drug Use and Hair Analysis in an Arrestee Sample

• DOI: 10.1177/002204260203200105
• Published date: 01 January 2002
• Date: 01 January 2002
• Author: Tom Mieczkowski
• Subject Matter: Article

© 2002 BY THE JOURNAL OF DRUG ISSUES

JOURNAL OF DRUG ISSUES 0022-0426/02/01 97-118

DOES ADAM NEED A HAIRCUT? A PILOT STUDY OF

SELF-REPORTED DRUG USE AND HAIR ANALYSIS IN

AN ARRESTEE SAMPLE

TOM MIECZKOWSKI

This article evaluates the potential impact that the use of hair analysis may have

on the drug prevalence estimations derived from survey research that has relied

upon urinalysis as an indicator of the accuracy of self-reported drug use. The paper

reviews the history and nature of the DUF and ADAM programs, the relationship

between self-report drug use and urinalysis results for arrestee populations, and

the outcome of a pilot study employing hair assays in lieu of urinalysis. The author

concludes that hair analysis may have a significant impact on the estimations of

drug use for cocaine, heroin, and amphetamines and is less likely to have an effect

on estimations of marijuana use. The author recommends consideration of periodic

use of hair analysis within the ADAM system to more accurately and effectively

monitor drug use.

INTRODUCTION

The Arrestee Drug Abuse Monitoring [ADAM]1 Program has been the major

source of drug prevalence data on persons entering the criminal justice system

through arrest. The ADAM program, operated under the direction of the National

__________

Thomas Mieczkowski, Ph.D., is a Professor of Criminology at the University of South Florida. His

interests include drug smuggling, theories of syndicated crime organizations, drug distribution

organizations and methods, drug epidemiology, the validation of various drug detection technologies

with an emphasis on ion mobility spectrometry and radioimmunoassay of hair, and the estimation of

drug prevalence and incidence using bioassays and survey methods. Dr. Mieczkowski has published

numerous scholarly articles, book chapters, and two books. In 1993 he published Drugs, Crime, and

Social Policy (Allyn and Bacon) and in 1999 a book with CRC Press on bioassay technology titled Drug

Testing Methods: Assessment and Evaluation. Dr. Mieczkowski has lectured internationally, including

invited lectures at the Royal Society of Medicine in London, the National Youth Center in Tokyo, and a

consortium of police executives in the United Arab Emirates. He serves on the boards of the Stapleford

Charitable Trust in Great Britain and the Stapleford Foundation in the United States. He is an invited

member of the Substance Abuse and Mental Health Services Administration committee on standards

and practices for hair analysis.

MIECZKOWSKI

98 JOURNAL OF DRUG ISSUES

Institute of Justice (NIJ), monitors trends in the prevalence and types of drug use

among booked arrestees in urban areas. ADAM’s survey and bioassay data play an

important role in creating a national picture of drug abuse in the arrestee population

and they have been important sources of information for assessing the links between

drug use and crime. ADAM is the only national drug data program that permanently

utilizes drug testing in the form of urinalysis.

This article presents a sketch of the potential effects on ADAM data that might

be expected if the program were to utilize hair analysis as well as its current reliance

on urine testing. The major potential contribution that hair analysis would bring to

the ADAM system would be longer retrospective detection of rapidly excreted

drugs, notably cocaine, heroin, and amphetamines. The purpose of this article is to

evaluate the findings of a small pilot study using an ADAM-like protocol, but

collecting and assaying hair specimens in lieu of urine specimens. The “musings”

offered here are highly speculative and designed to stimulate thinking about the

possible utility of hair assays. Because of the constraints on the data from the size

and method of the pilot study one can only view the analysis as suggestive.

THE ADAM SYSTEM

The ADAM system is an enhancement and extension of the Drug Use Forecast

(DUF) system. The DUF was first instituted in 1986, initially at 8 sites nationwide,

and over the following years steadily added sites. In 1997 the program was retooled

and further expanded as the ADAM. Like its DUF progenitor, each ADAM site

deploys interviewers who collect voluntary and anonymous interview data and urine

specimens from arrestees. A random selection of arrestees are approached within

48 hours of their arrest and asked to participate in the study. In most sites, more

than 80% of the individuals approached agree to the interview and, of those, more

than 80% agree to give urine specimens. The urine specimen undergoes analysis

for 10 psychoactive drugs.2 The interviewer records basic demographic information

such as age, gender, living circumstances, employment, and educational status. As

well, the interviewer asks a series of specific questions on the nature and extent of

drug use by the arrestee. Data collection takes place four times a year, each calendar

quarter. Data collection periods for any single population are generally for two

consecutive weeks in a quarter. The ADAM program currently operates in 35 sites.

Since 1997 NIJ has been engaged in reassessment and redevelopment of the

interview questionnaire used in the ADAM. A revised ADAM interview instrument

is currently undergoing development, with the aim of enhancing the assessment of

the need for drug treatment by including several diagnostic questions to determine

substance dependency.