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Medicine Supporting Your Practice

Screening for Poly-Drug Usage: A New Tool

My guest is Dr. Philip Britz-McKibbin, Associate Professor of Bio-analytical Chemistry at McMaster University and co-author of the article recently published in Analytical Chemistry and which details the research that led to this new method: High Throughput Screening Method for Systematic Surveillance of Drugs of Abuse by Multisegment Injection−Capillary Electrophoresis−Mass Spectrometry.

In light of the epidemic of prescription drug abuse and its impact on public health, it has become imperative to develop new tools to detect and screen these abused substances. The biochemical tests that are available to our scientists today are prone to bias and are not applicable to determine a large number of psychoactive stimulants.

A team of researchers at McMaster University developed a new method that would reduce the time and steps currently employed to screen for drug use.

I hope you find the interview informative. Please share your feedback, thoughts and suggestions with us at oasisdiscussions@cda-adc.ca

Chiraz Guessaier, CDA Oasis Manager

Highlights

  • New technologies are urgently required for reliable drug screening given a worldwide epidemic of prescription drug abuse and its devastating socioeconomic impacts on public health.
  • Primary screening of drugs of abuse (DoA) currently relies on immuno-assays that are prone to bias and are not applicable to detect an alarming array of psychoactive stimulants, tranquilizers, and synthetic opioids.
  • These limitations impact patient safety when monitoring for medication compliance, drug substitution, or misuse/abuse, and require follow-up confirmatory testing by more specific yet lower throughput instrumental methods.
  • The authors introduce a high throughput platform for non-targeted screening of a broad spectrum of DoA and their metabolites based on multi-segment injection−capillary electrophoresis−mass spectrometry (MSI−CE−MS).
  • They demonstrate that MSI−CE−MS enables serial injections of 10 samples within a single run (<3 min/sample) where multiplexed electrophoretic separations are coupled to high resolution MS with full-scan data acquisition.
  • Unambiguous drug identification was achieved by four or more independent parameters, including co-migration with a deuterated internal standard or in silico prediction of electromigration behavior together with accurate mass, most likely molecular formula, as well as  MS/MS as required for confirmation testing.
  • Acceptable precision was demonstrated for over 50 DoA at 3 concentration levels over 4 days (median coefficient of variance = 13%, n = 117) with minimal ion suppression, isobaric interferences, and sample carry-over (<1%).
  • This approach offers a rapid yet accurate method for simultaneous detection and identification of DoA at their recommended screening cutoff levels in human urine while allowing for systematic surveillance, specimen verification, and retrospective testing of designer drugs that elude conventional drug tests.

Full Interview (8.21″)

 

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