This Isn’t Pass-Fail

[00:00:00] [Jaunty Guitar Music]

[00:00:12] Mike: Welcome everyone to Avoiding the Addiction Affliction, a series brought to you by the Kenosha County Substance Abuse Coalition. I'm Mike McGowan. We're gonna have a conversation today about drug testing. I'm pleased to have our guest, Guida Brown. Guida is a community relations consultant with the United States Drug Testing Laboratories. She's also an adjunct faculty member with Concordia University, Wisconsin. We're gonna talk about some of the many questions I hear all the time from therapists, social workers, department of corrections workers, and parents. Welcome, Guida. Glad you're with us.

[00:00:47] Guida: Hey Mike. Thanks for having me.

[00:00:48] Mike: Okay, so I wanted to start here if it's okay. So my voice is a little bit hoarse cause I just visited the doctor right. She ordered a whole bunch of [00:01:00] tests, blood tests and samples, I was a pin cushion. So that she could know what's going on.

[00:01:05] Guida: Did you fail any of them?

[00:01:07] Mike: Well, I look away, so there you go. But that's kind of standard operating procedure, right? You go into the doctor, right? So why don't we do the same thing when we're treating substance use disorder?

[00:01:23] Guida: I think it has to do with the stigma and with the idea that peeing into a cup is not really, you know, it - I can take your blood, there's not a easy way for me to take your urine, and so many people think, "Oh, if I'm gonna have a test, it's gonna be a urine test." And that's really kind of old school. And just the stigma that goes with that. And then, I mean, the whole punitive aspect, right? We take a test for substance use, substance abuse, and it's very often thought of as a pass fail and the [00:02:00] idea that you are going to have a consequence if you fail it. So that was my joke, did you fail any of your blood tests? You know, you don't ever fail a test from the doctor, right? But with a substance use test, community perception, society perception is if it's positive, then you failed. And if it's negative, then you passed. And that stigma that goes with that doesn't address the disease aspect, it just addresses the failure aspect, the badness of having a positive test.

[00:02:32] Mike: Well, that's a good point. If she gets my test results back, she doesn't say, "Oh, guess what You failed for diabetes," or, "Oh, what you failed for this." She said it shows the presence of, or this is what it indicates. Okay, so that gets us to the professionals, even professionals, the attitude among professionals is different when it comes to testing.

[00:02:52] Guida: Yeah. I think we give lip service to the idea that addiction is a disease, but when we have the tools to [00:03:00] treat it as such, we don't. And I think testing is one of those tools that we have that would help us understand the trajectory of the disease. My sister has diabetes, and I use her as an example all the time. When she goes to the doctor, she doesn't get yelled at because she had bad sugar levels or, insulin levels or she gets so mad at me cause I don't understand. But that's the thing, so when you have ongoing testing, you shouldn't get yelled at because you had bad levels.

Now, I think the other thing, especially with addiction, the disease of addiction, is there's this idea that we don't have consequences if we recognize the disease. And I find that ridiculous. Right? I knew somebody who had diabetes, was not taking care of his health and wrapped his car around a tree during a diabetic incident. He had consequences for wrapping his car around the tree, right? I mean, aside from his health consequences, he [00:04:00] got a ticket. He had to pay a fine, he had to do that stuff. So there is not a reason why people who do things that are illegal, because they have a substance use disorder, should not be held accountable for their behavior. You know, we, we don't not give people tickets for OWIs or charge them with OWIs, we do recognize it's a disease. Same with the person who has diabetes, who wraps themself around a tree. We don't not ticket him, but we also say, "Hey, here are the means to get your diabetes in order." And that's the piece that we're missing. There's like this idea that if I recognize the disease aspect, then I can't hold this person accountable for doing things illegally. And yeah, you can. I mean, you know, you absolutely can. Those two things are not mutually exclusive, and so I think that's part of it as well. And so the professionals feel like, "Well, yeah, it's a disease," and [00:05:00] so we somehow consequent the disease behavior specifically with Department of Corrections. They love to lock people up if they have a " dirty", and I'm putting quote marks around that cause I would never use that language, have a "dirty" UA, so we lock 'em up for a few days. And my contention is, you already knew he was gonna be using, You already knew he had a positive test. So let's look at the behaviors and let's look at the disease aspect of that and help him overcome that.

[00:05:32] Mike: Let's get back to the behaviors in a minute. But testing, when we do test, it lets us look not only at what's going on, right, the present, but the recent pass depending on the test you use. So what kind of, we did a one a while back on, you know, the sweat patch, but what kind of testing does the US drug testing labs use? What do you guys do?

[00:05:52] Guida: So we actually do, we do everything but that sweat patch. We do urine, we do blood spots for alcohol, [00:06:00] and then we do fingernail or hair testing, and fingernails are just a little more reliable across races and genders because of what you can do to your hair and that hair follicle's not the same. But so it's sort of a three day, three week, three month look back. I think that's specifically for alcohol, for the three month look back, it's about six months for other drugs of abuse will stay in your fingernails.

And so that's what's so great about our tests is that they're not time constrained. So if somebody comes along and says, "Oh God, oh goodness, I just clipped my nails." Oh, lucky for you, we can take your nails in two weeks and we're still gonna have that same six-month look back for drugs of abuse. It's not gonna alter anything. And so the tests are really good, they're not invasive, there's no collection as the, the provider, as the customer of the lab. The agency doesn't have to do anything except stay in there [00:07:00] and watch and fill out a form, a chain of custody form. But the, the donor who's providing the sample is a person who does everything. And so it's really kind of cool. Urine tests, of course, you know, they're not always very reliable because they have to be witnessed. And even when they're witnessed, they're not tamper proof. The others, the blood spot for alcohol testing and the fingernails are completely tamper proof.

[00:07:26] Mike: What is the blood spot?

[00:07:27] Guida: So the blood spot is actually a lancet, like a diabetic lancet, you just poke your finger, you drip it onto a little card that has little circles, you fill up those circles, it gets dried and sent to the lab and they test it for alcohol, and it's about a three week look back period.

[00:07:42] Mike: So the blood is three weeks, the urine is depending the drug, maybe 72 hours?

[00:07:47] Guida: Yeah, about three days.

[00:07:49] Mike: But the fingernail, it goes back six months, including alcohol?

[00:07:54] Guida: Three months for alcohol, six months for other drugs of abuse.

[00:07:57] Mike: Is there a floor? Like what if I had one [00:08:00] margarita? Would that fill up?

[00:08:01] Guida: So that's what I was gonna say. Yep, there's a floor. And the idea behind this is there is no test, Mike, we know that there is no test that will test for abstinence, right? There's no test out there. Unless you're following somebody with a breathalyzer one hundred percent of the time, there is no test that's gonna prove abstinence.

These tests are not for your social user. These tests are specifically for people who have substance use disorders to help them in their recovery. So we used them when I was at the Hope Council, they still use them, but at the Hope Council, they used them for the intoxicated driver population. And I can't tell you how many people would be like, "Oh, I hardly drink at all." And then they test positive, and it might be a pretty high positive. And we're like, talk about your drinking. "Well, you know, I only have two, three drinks... every six hours," like some ridiculous amount that you're like, oh, that's a lot of [00:09:00] drinking.

I had a personal experience. Somebody got put on naltrexone, the pill form of Vivitrol. So the pill form of Vivitrol, and she was really sick, and I said, "You're sick because you're going through withdrawal." And she said, "Oh, no, I was hardly drinking. I was only having like one or two drinks a day." And I'm like, well hmm. You know, first off, any more than one drink for a woman in a day is unhealthy drinking. Secondly, my pores and your pores are likely not the same. So your margarita example, if you have one margarita, is that gonna show up in this three month window? No. If you have an over poured margarita every Friday, might it? It might. Long Islands, we're, we're really known for our Long Island iced teas. And people seriously think that that's one drink. And I'm like, it's at least four. That's at least four drinks. And so [00:10:00] again, people don't understand how much they're drinking.

So these tests are not for your average user, they're for people who we already know you've got a problem and we wanna help you address it.

[00:10:12] Mike: Is there a substantial difference in the cost between testing a urine sample and fingernail? How do agencies then decide which of those to use?

[00:10:20] Guida: Well, so again, my thinking is a urine test goes back three days. A drug test, a nail test, goes back for drugs six months. How effective is your urine test if you're only doing it once every six months, or how much information are you getting looking back six months? So our clients at the Hope Council would complain that we charged $200 for alcohol and other drugs in a nail panel, and they would say, $200! And I say It's $200 every five months. I don't care how rot gut, the alcohol you're drinking [00:11:00] is, it still costs more than $200 every five months. And that's just alcohol, right? And cocaine, heroin, you're driving those costs up. So it's a lot cheaper than using, that's kind of the bottom line. And over the course of time, the nail tests are so much more effective and efficient than a urine test is. So I would argue that they're much more cost effective as well.

[00:11:26] Mike: Well and going back to what we first started talking about, if I'm a worker, having that accurate information is not unsimilar to a doctor having great information in the tests that you would do for any other medical problem.

[00:11:39] Guida: Yep, absolutely. And that is my quest to get us to recognize these tests as a means to help with treatment, not as a means to punish people.

[00:11:51] Mike: On your website it said you also do something called NeoTox, testing newborns.

[00:11:57] Guida: Yeah, so USDTL is the [00:12:00] forerunner in umbilical cord testing. A lot of people know meconium testing, that babies first poop that comes out, and they do test that and the lab will process that. The problem with that is that it's hard to gather a proper amount over the baby's first poop. You know, I don't wanna be too graphic, but babies can poop anywhere, including in utero. And so they don't necessarily get that whole thing, and if they don't get that whole thing, it's not as reliable, the information's not as reliable and the amount isn't there, so oftentimes there's a quantity not sufficient, a QNS, saying we couldn't even test it. Umbilical cord, obviously every baby has it, and they take six inches of it. They pull out the blood and it can be stored, so they freeze it, it can be stored for up to a year, so if they collect on every single baby, they don't have to send it in, but they have it [00:13:00] there so that if the baby starts showing some signs of anything, they can then test it and see what's going on.

[00:13:08] Mike: Is that now standard for hospitals to do, do you know?

[00:13:11] Guida: It's not. Too many hospitals are still doing meconium, just because it's sort of like the urine test of babies. And there actually is a urine test of babies that I'm like, oh my God, I can't even imagine doing that. And a hair test of babies. But, so, no, it's not standard. There are expectations if a person presents with certain - no prenatal care, you know, looking, whatever the standards are, they are supposed to test the mother or the baby. There's a difference between testing mom and baby. So if you do a urine test on Mom, that's gonna tell you what she did three days ago within the, the last three days. If you do that umbilical cord on the baby, it looks back, I wanna say, a full trimester. I think, I could be wrong about that, but, so it's much greater information for that baby. But [00:14:00] the problem ends up being the cost is one, and the idea that, well, now that I have this information, so what? What do I do with this information? Particularly for alcohol, particularly in Wisconsin. So I know that the baby had alcohol in its system, now what? And because of our lack of services for fetal alcohol spectrum disorders we're not doing a great job there.

[00:14:26] Mike: I'm thinking about my friends who we've had on this podcast who do the neonatal work and you know, that's a really, really tough job. And that would be information that would be great for them to have. If it was standard for them to do.

[00:14:38] Guida: Yep.

[00:14:38] Mike: You mentioned that meconium before, I gotta tell you, I don't wanna get off the topic, but they clearly didn't measure my kids cuz they had plenty of it. I gotta tell you, Guida, the first one, I had no idea what it was. I had no idea. I called my mom and she said, better call the hospital. I thought she was kidding me afterwards, she said she didn't change a diaper for five days, so she wouldn't know.

[00:14:57] Guida: Oh my God.

[00:14:58] Mike: And when I called back to the hospital, the [00:15:00] woman goes, "Yeah, I thought you'd be calling." That's not what you really wanna hear as a dad. You know, like, what about me told you I'd be calling within 20 minutes of my leaving the hospital? Anyway. So how do those biomarker tests help with those who have substance use?

[00:15:17] Guida: They're so good. Let me give you an example from the Hope Council. We had a woman who came in. We started testing in 2011, she was literally our second client. So it was early July, second client, she came in, she had three OWIs because that's all we tested for at the time, now we test everyone who goes to treatment, but she had three OWIs, she came in and she told me your story, you know, okay. So I sent her to the back, I did not do her initial test because we were all learning and we were taking turns and so she went back. It was July, and I only know that because we started our testing in July. She had said, "I haven't had a drink. Oh my gosh. Like since October." I'm like, oh okay. So her test comes back positive and at the time we were doing both blood spot and fingernail, and her [00:16:00] test comes back positive for alcohol. And I called her on the phone and I said, "Hey we're gonna have to have you come back in and do another blood spot, because I was a little surprised, you told me you hadn't had a drink since October, but your test came back positive. And she said, "Yeah, okay."

So she comes in and we're in the front of the building and she says, "We gotta talk," and I said, "Well, we're going back into the bathroom we can talk back there." And so we go back there, we're doing her blood spot, and I said, "So, you know, tell me what happened."

She said, "Yeah, I drank, you know, whenever," and I said, "Oh, okay, well, you know, now you're on an abstinence order, you can't drink anymore, blah, blah, blah," and she said, "Yeah, when they told me I had to go to the Hope Council, I thought, "Hope Council, what a joke. Last time you guys sent me to education," and I said, "Yeah, you know, we're trying to get better, you know, blah, blah, blah," and she says, "Yeah. And then I come back here and it's like, CSI," and I just love that conversation because I was like, yeah it's like CSI, like [00:17:00] we're trying to figure out how to help you.

And so she had a negative test. She went through, now it's right after Christmas. And we would always time things like, oh you know, oh, you're due for your test on December 27th, I'm like, no no, no, no, no, you're due for your test on January 7th. Like, we wanna make sure we're getting all the information in there. And so she comes back and she has a positive test after Christmas and I remember calling her, talking to her and saying, "Hey, you a positive test. You know, remember our goal is abstinence."

And she said, "Your goal is abstinence. My goal is to keep my driving privileges." And I was like, "Yep, you're right." She says, "I don't care how many times you test me, when you test me after Christmas, it's gonna be positive because it's a terrible time in my life." And I was like, fair enough. Right? I'm not trying to punish you. I'm not trying to take away your driving privileges. I'm trying to help you understand that you are drinking a heck of a lot more than you think you are. And it works. [00:18:00] They come, you know, oh I'm, I'm not drinking, I'm not drinking. Yeah, you are. And the stories and the just, the, the pushback.

And then when they start getting a more clear head and recognizing that "Oh, I was drinking way more than I thought I was," or, "Oh,, I, I, you know, I am having these positive tests." Just all the stories that go into it, not so much alcohol with the positive test. Like, "Oh, I must have been around somebody, I must have been around somebody who was using cocaine." And we can actually differentiate in our test if it's environmental or if it's used.

[00:18:36] Mike: How do you do that? That's one of the questions I was gonna ask you anyway.

[00:18:38] Guida: It's, it's actually from the test result. You get three different metabolites, and if one of the metabolites is missing, then there's a percentage of the others that you have to figure out. And so, I know that seems confusing to some degree, but when you have a person who uses cocaine or when you have a person who uses, and it's any airborne drug, so pretty much [00:19:00] every drug, right? You can tell the difference, and the beauty of those tests is that we can also now test children to determine if children are in an environment where somebody is misusing substances. So it's called child guard and it tests their fingernails or their hair. Generally hair, because children don't have the level of fingernails to do it. And it tells us, yeah, somebody's using cocaine around this child. Somebody's using heroin around this child. Somebody's using marijuana consistently around this child. So they're really good for both. But again, our sense, they're not false positives. They're positives based on the environment that you're in. And we can discern is it ingested or is it environmental?

[00:19:46] Mike: I used to have people say all the time, "Well, I must have been around it." I'm like, yeah if you're in a Volkswagen Beetle with four people and the windows are closed and they're all huffing it out and you're inhaling, yeah. Other than that, the levels, you know, aren't high enough.

[00:19:58] Guida: It's so funny because [00:20:00] now that you know the tests are at a point, even for a urine test, we have never observed our urine test we just tell 'em, go in there, don't run the water, and I know there have been a few where I'm like, you know, gosh, there aren't any bathroom noises coming outta here, it seems odd that all of a sudden you have a full cup, but yeah, okay. But for the most part, they'll be pretty honest. And that's the only reason we do our urine test. We say it's just to test the veracity of your statements. I wanna know, were you honest with me? And they're honest, but their stories are really kind of off the wall. Like I had one guy who he admitted to using marijuana and we, you know, we go and test him. It's like, well, did you also use cocaine? Cause you're positive for cocaine? No, no, no, I didn't use cocaine. And we're like, "Okay, well, you know, go sit down, we're gonna do your paperwork." And then we go back in the room and he is like, "Oh, my God. I just called my buddy. They laced that marijuana with [00:21:00] cocaine!"

[00:21:01] Mike: But you know, that's an interesting point because nowadays I can see where somebody thinks they're taking one thing, and it comes back positive for an opiate or fentanyl that is actually - I mean, we've had people here thinking they're taking Percocet and it -

[00:21:16] Guida: Oh, that, yes, absolutely, absolutely. But the other piece of that is, did you have a prescription for this Percocet you were taking? So we don't, it doesn't matter, and then that's the other thing, we don't ask for your prescriptions until after your test results come back and then we wanna know what you were prescribed and we can figure out through a medical review officer, you can't figure out if it's a therapeutic level, you know, because people, again, just because I'm prescribed it doesn't mean I'm taking it properly or just cuz I'm prescribed it doesn't mean I'm only taking mine.

[00:21:47] Mike: So all those, all those people that wanna say, "Oh, they're test results, say, you know, they're, they're so much better than they used to be." All the old stories we used to hear.

[00:21:56] Guida: Oh gosh. Yeah, absolutely. And I know [00:22:00] when you had the person from PharmChek I think whatever, she talked about - they're confirmed. So no results come out that aren't confirmed. So they aren't, again, they aren't false positives. They don't, you get a presumptive positive. And that's even, that's what drives me nuts about cups. Like, "Oh, he said I was positive for whatever. And I'm like, "Well, where do you read the cup?" "Well, in the office." "Well, it's not confirmed."

I had a brand new staff person who had a presumptive positive for, I think it was cocaine, and you can Google this, I mean, not about my staff person, but you can Google this, ibuprofen shows a positive for something, I think it's cocaine on a urine cup. And so I was like, oh shoot. You know, we can't hire this guy, send it to the lab. No, they confirm it, it's negative, right? So we use those tests really poorly again. We don't confirm every urine test, but if you're going to use the [00:23:00] information you need to confirm every single positive test. And otherwise you're being irresponsible if you're gonna use that information for anything except information.

[00:23:10] Mike: I would think that the fingernail and hair are less scam likely than urine. I mean, I had time drop an earring into a urine cup, started to fish it out with her fingers, I assume she put bleach on her fingers, right?

[00:23:23] Guida: That's the best. Yeah. No, and that's what's so wonderful about fingernails. So here you can adulterate not even as a deliberate attempt to adulterate it, but I dye my hair, I perm my hair. Hair across races is not identical, so some of them are more porous and hold the drugs better.

Fingernails are identical across everybody, a hundred percent. So if you have a proper amount of sample and the sample is, if you can lay a quarter flat on the top of all 10 fingers and clip off the white, that's a proper sample. And that has to do with, again, that [00:24:00] confirmation. We can get a presumptive positive, but I don't wanna, I can't act on a presumptive positive. So it's really not that much of a sample. It's about 150 milligrams.

[00:24:09] Mike: Do you have to wipe the polish off?

[00:24:12] Guida: No polish is allowed, no polish, of course no acrylic nails, and so that's the one thing people will like, "Oh, I just got my nails done," and I'm like, "Well, just get your nails undone and we'll do this in two weeks." Or we can use toenails. Toenails have not been as tested or as researched, and so we don't know exactly how far back they'll go, so they can go back a lot farther.

[00:24:37] Mike: I wonder what acrylic nails would show up as, you're not alive?

[00:24:41] Guida: Well, you know, it's pretty funny because the machinations that people will go through, you know. They'll chew off all their fingernails and toenails. They'll shave, they'll shave every body part. You could actually, for hair, you can actually take arm hair, you can take body hair. [00:25:00] But they will, they'll shave every body part. And I'm like, I'm gonna assume you're positive! Like what are you going through this for? So, fingernails cannot be adulterated. They're, I mean, again, as a collector, I stand in there, I watch you clip your fingernails into a bag, I cut off the bottom of the bag, I weigh it to make sure we have enough and I send it off to the lab. That can't be adulterated. I did hear a story where - sorry, go ahead.

[00:25:26] Mike: One more question about that. Not to elaborate too much, so you said it can go back three months to six months depending on the drug. Does it tell you when?

[00:25:35] Guida: No. And there isn't a test out there that does.

[00:25:38] Mike: Okay.

[00:25:38] Guida: Nope. We don't know dosage and we don't know time. So I can't tell you how much you drank or used and I don't know when you used or drank.

[00:25:45] Mike: So how so? How do you get around the, "Well, okay yeah, I had something to drink three months ago, but I haven't had anything since then."

[00:25:53] Guida: Okay, then we'll have you come back in a month and we'll do a blood spot with you.

[00:25:56] Mike: Okay. Right. Got it.

Or we'll have you come back in 5, 4, [00:26:00] 3, months and do another nail test with you.

[00:26:02] Guida: And again, our population are not people who can white knuckle for too long. And so that was really a great learning process for us, we were doing blood spot and fingernails and we would see, they'd come in with a positive, we used to do five, now we only do three, but they would go through and that that last one they would have another positive or the blood, they would have another positive because they could white knuckle it for 11 months, but they couldn't do it for 12. Or they could white knuckle it for nine months, but not for 10. And that's the population we're working with. Those are the ones who need the help. Right? It's not the social drinker who can stop social socially drinking. It's the population of people who think they're doing okay and they're not. And so we help them through that process and say, "Okay, you know, we wanna make sure that your recovery is sticking," and how do we do that? Well, we test you because you're telling us it's not gonna - again, Mike, we wanna make sure your antibiotic is working. [00:27:00] How do we do that? We test you, right? We don't say, Mike, how do you feel? Oh, I feel good cause I don't wanna be sick to my stomach anymore, so I'm gonna lie because, whatever. And then you go off and you're still sick, you still have a disease, but we're none the wiser because you know, who cares? Mike said he was fine.

[00:27:18] Mike: Who buys your products? I would assume counties do? Clinics?

[00:27:23] Guida: We have two assessment agencies in Wisconsin who do it. Hospitals, counties can, clinics can, I mean, anyone can use it. And again, the collection process is so easy that I really wish more people would. I had done a presentation years ago at an addiction conference in Denver and with a bunch of doctors, and they came up to me afterwards, I was like, just partner with a non-profit in your area, anyone can be a collector. So partner with somebody, it's a funding stream for the nonprofit, you don't have to do the work, you can refer 'em over there. Our tests are so good. They're so helpful. The [00:28:00] information that's available is so valuable and I just wish more people knew about it and were using it.

[00:28:08] Mike: Can parents do it?

[00:28:11] Guida: I have Collected a sample from a child with a parent there. Parents have asked me, "Can I just bring in a hair sample?" Absolutely not! Like, no, no. You can't cut your kid's hair while he is sleeping and then bring a sample in me. No, you can't. And you know, Mike, my thing about testing is if you are at the point where you wanna test your kids, you've already got a problem, right? So I always say, here's what parents should do. They should buy a urine cup and leave it on the refrigerator and never test the kid, but always threaten to test the kid. And then the kid has an excuse to never use because they can always tell the friends, "Oh my gosh, my mom's gonna test me. There's no way I'm gonna use that."

And I think that's sort of the same our, guys who get arrested, [00:29:00] people who get arrested, they oftentimes get the SCRAM bracelet. And so many of them say that's what helped me. I wore a SCRAM bracelet for 30 days and I had an excuse not to drink with my buddies. So to me that's a great way. But once you think you need to test your kids, you probably do, but there's got a lot of other issues going on there.

[00:29:17] Mike: I used to tell parents that all the time, if we're at that point, we need to have a different kind of discussion. Cause you're wanting to prove something to your kid that everybody already knows.

[00:29:26] Guida: Yeah. So we did, we had a person who brought her child in. Her child was willing to do the test and she actually tested negative, so that was fine, and mom was relieved, and, you know, I don't know what their conversation was. Obviously, the girl said, yeah I'll toss, so it's fine. But I was gonna tell you, I talked to another person, another provider, and she said somebody once brought in a bag of fingernails. And said, "Here I saved my fingernails over the course" - Yeah it doesn't work like that. Yeah. Wow. We haven't had anybody do that. We've haven't had somebody [00:30:00] ask. No, no, you can't do that. But, and that's it. Again, the collection is so easy. You just stand there and watch 'em clip their nails. It's, it's awesome. All you do is stand there and watch 'em clip their nails. They're really reliable, valuable tests. And my husband just went through a lot of health issues recently, and we joke that Froedert has more of his blood than he does now. And I feel like, I don't know how much those blood tests cost, but I know they're not inexpensive. And I just think if we could do these tests, especially the neonate stuff, if we could do these tests to really help address a problem, we would be so much farther ahead. We're like, you know, we're, we're making it way harder for ourselves, I think.

[00:30:45] Mike: That's just such a great place to leave it. For those listening, we always put the contact information at the bottom of the podcast for the guest and that will include the United States Drug Testing Lab information on this one. So, Guida, thank you [00:31:00] so much for also not just doing this topic, but going a little further afield. I really appreciate it today.

[00:31:07] Guida: Oh, it's always my pleasure.

[00:31:08] Mike: And for those of you listening, we'll see you next time, or actually hear you next time. Until then stay safe and keep your fingernails just a little bit long.

[END AUDIO]