Analytical and technical aspects of testing for drug abuse: confirmatory procedures.

1988 ◽  
Vol 34 (3) ◽  
pp. 471-473 ◽  
Author(s):  
M A Peat
Keyword(s):  
Drug Testing ◽  
Analytical Procedure ◽  
Gas Chromatography Mass Spectrometry ◽  
Technical Aspects ◽  
Governmental Agencies ◽  
Accuracy And Precision ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Chemical Technique ◽  
Layer Chromatography

Abstract Many laboratories are now performing urine drug testing for employers, governmental agencies, and other institutions. It is now recognized that presumptive positive screening results have to be confirmed by an analytical procedure based on a different chemical technique with greater than or equal sensitivity to the screening test. Thin-layer chromatography has been widely used for this; however, it is relatively insensitive for certain drugs, and it cannot satisfy the accuracy and precision requirements needed to determine threshold concentrations reliably. Gas chromatography-mass spectrometry is able to satisfy these threshold requirements and has become the method of choice for confirming initial immunoassay results.

Lowering the federally mandated cannabinoid immunoassay cutoff increases true-positive results

1994 ◽  
Vol 40 (5) ◽  
pp. 729-733 ◽  
Author(s):  
M A Huestis ◽  
J M Mitchell ◽  
E J Cone
Keyword(s):  
Mass Spectrometry ◽  
Human Services ◽  
Drug Testing ◽  
Gas Chromatography Mass Spectrometry ◽  
True Positive ◽  
Health And Human Services ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Sensitivity Specificity ◽  
Positive Results

Abstract Proposed changes to the Health and Human Services Guidelines for forensic urine drug testing will lower the required cannabinoid immunoassay cutoff concentration from 100 to 50 micrograms/L. We investigated the effect of this change on the sensitivity, specificity, and efficiency of eight cannabinoid immunoassays: Syva Emit d.a.u. 100; Syva Emit II 100; Syva Emit d.a.u. 50; Syva Emit II 50; Roche Abuscreen Online; Roche Abuscreen radioimmunoassay; Diagnostic Reagents; and Abbott ADx. All specimens also were assayed by gas chromatography/mass spectrometry. Lowering the cutoff concentration from 100 to 50 micrograms/L increased efficiencies and sensitivities for all immunoassays, with minor decreases in specificity (1.0-2.6%). There was a 23.2-53.6% increase in the number of true-positive specimens identified. Thus, lowering the cannabinoid immunoassay cutoff concentration from 100 to 50 micrograms/L resulted in detection of a substantial number of additional true-positive specimens, with an accompanying small increase in unconfirmed positive results.

Forensic Testing for Drugs of Abuse

2000 ◽  
Vol 13 (3) ◽  
pp. 226-235 ◽  
Author(s):  
Peter D. Anderson ◽  
Kimmy Naik ◽  
Chenery Kinemond ◽  
Anne ImObersteg
Keyword(s):  
Drug Testing ◽  
Drugs Of Abuse ◽  
Drunk Driving ◽  
Gas Chromatography Mass Spectrometry ◽  
Confirmatory Test ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Chain Of Custody ◽  
Control Procedures ◽  
Forensic Testing

Forensic urine drug testing (FUDT) is a tool of many employers to assess drug use in employees. Collegiate and professional sports test for banned substances. Immunoassays are often the screening test. Gas chromatography/mass spectrometry is the confirmatory test. Numerous foods and medications interfere with test results. Safeguards in FUDT include chain of custody procedures, certification of laboratories and personnel, cutoff values, quality assurance and quality control procedures, and medical review officers. Breath analysis is used in drunk-driving cases. Blood and hair can also be analyzed for substances of abuse. Pharmacists can be an asset in drug testing issues.

Buprenorphine not detected on urine drug screening in supervised treatment

2021 ◽  
Vol 17 (7) ◽  
pp. 69-76
Author(s):  
Nazila Jamshidi, MBBS, FRACP, FAChAM, BPharm (hons), PhD ◽  
Akshay Athavale, MBBS, FRACP, BPharm (hons), MMed ◽  
Bridin Murnion, MBChB, FRACP, FFPMANZCA, FAChAM
Keyword(s):  
Cytochrome P450 ◽  
Child Protection ◽  
Drug Testing ◽  
Addiction Treatment ◽  
Clinical Decision ◽  
Gas Chromatography Mass Spectrometry ◽  
Cytochrome P450 3A4 ◽  
Opioid Agonist ◽  
Detection Rates ◽  
Urine Drug

Introduction: Urine drug screens (UDS) assist in clinical planning and assessment of adherence in opioid agonist treatment (OAT). Urine drug screens may also be used in criminal justice and child protection settings. Buprenorphine (BPN) UDS testing is complex. Immunoassay often does not detect BPN and gas chromatography-mass spectrometry (GC-MS) is needed. A limited understanding of testing can negatively influence UDS interpretation and clinical decision making.Objectives: The primary aim was to determine detection rates of BPN in UDS in participants on BPN or buprenorphine/naloxone (BNX) treatment. The secondary aim was to identify if comorbidities, sex, co-prescribed medications, or dosing site and observation were associated with BPN detection.Setting: Public outpatient clinic in a specialist addiction treatment service.Design/participants: In this retrospective observational study, records of clients on supervised BPN/BNX treatment between September 2017 and 2018 were reviewed.Measures: Data extracted included UDS results, age, sex, indication for BPN, frequency of observed doses, dose of BPN, dosing site, co-morbid medical conditions, and medications.Results: One hundred and sixty-one medical records were reviewed. Ninety-seven (60 percent) underwent screening urine immunoassay. Of these 97, 51 (53 percent) had further GC-MS testing for BPN of which 22 (43 percent) did not detect BPN despite directly observed OAT. Co-prescription of medications known to interact with cytochrome P450 3A4 was associated with nondetection of BPN (p 0.05). No significant association between median dose, dosing site, and observed dosing and BPN detection was identified.Conclusion: Urine drug testing for BPN is complex. Failure to detect BPN does not betoken nonadherence to treatment and is associated with co-prescription of drugs interacting with cytochrome P450 3A4.

Use of LC-HRMS in full scan-XIC mode for multi-analyte urine drug testing - a step towards a ‘black-box’ solution?

2017 ◽  
Vol 52 (8) ◽  
pp. 497-506 ◽  
Author(s):  
N. N. Stephanson ◽  
P. Signell ◽  
A. Helander ◽  
O. Beck
Keyword(s):  
Drug Testing ◽  
Black Box ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Full Scan
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