Positivity rates of drugs in patients treated for opioid dependence with buprenorphine: A comparison of oral fluid and urine using paired collections and LC-MS/MS

West, Robert; Mikel, Charles; Hofilena, Doriane; Guevara, Maria G.

doi:10.1016/j.drugalcdep.2018.07.023

Cited by 14 publications

(5 citation statements)

References 26 publications

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“…Urine is preferred for monitoring and compliance purposes owing to a longer detection period, non-invasiveness, and ease of collection in larger amounts. [20][21][22] However, the risk of adulteration and infection needs to be addressed. 23 Only 4% of samples were of gastric fluid, mainly sent from emergency/ITC settings.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Pattern of Drug Abuse from Different Clinical Settings in a Reference Laboratory of Pakistan During the COVID-19 Pandemic

Younas¹,

Aamir

Kirmani

et al. 2022

PAFMJ

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Objective: To determine the pattern of drug abuse from different clinical settings in a reference laboratory of Pakistan during the COVID-19 pandemic and assess any change from the previous trend. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan from Mar to Dec 2020.Methodology: Out of 6902 subjects tested for drug abuse, 672 subjects with positive results were included in the study. The study population was divided into three main Groups. i.e., Psychiatry, ITC/Emergency and Workplace testing. A pattern of drug abuse was compared in the pre (Mar-Dec 2019) and post-COVID (Mar-Dec 2020) periods. Results: Out of 672 study subjects, 338(50%) were psychiatry patients. Around 629(94%) subjects were males. Mainly young individuals (306, 46%) were affected. Cannabis was the most frequent drug of abuse detected (357, 53%), followed by Benzodiazepines (BZD) (236, 35%) individuals and Opiates (47, 7%). Compared with pre-COVID data, an overall increase of 3% in the total frequency of drug abuse from 392(7%) to 672(10%) was found in 2020. About 14% decrease, from the frequency of 81(21%) to 47(7%) in Opiates usage, while 8% increase in frequency, from 106(27%) to 236(35%) in Benzodiazepines, was observed. There was significant mean difference (p<0.001) between Psychiatric and ITC patients. Conclusion: Most frequent drug abuse in our settings is Cannabis, followed by Benzodiazepines and Opiates. An overall increase in drug abuse frequency while a decrease in the frequency of...........Keywords: COVID-19 pandemic, Pakistan, Substance abuse pattern.

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Section: Discussionmentioning

confidence: 99%

Assessment of Pattern of Drug Abuse from Different Clinical Settings in a Reference Laboratory of Pakistan During the COVID-19 Pandemic

Younas¹,

Aamir

Kirmani

et al. 2022

PAFMJ

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“…The matrix allows for easy collection, but attention to recovery, stability, and dilutions issues of some collection devices should be given consideration for pharmacokinetic studies [9,10]. Although ODT opioid assays that use dilute-andshoot methods with little sample manipulation have been developed and validated on AB SCIEX 4500 instruments with excellent calibration ranges (2.5-1,000 ng/mL) [11] robust ODT assays that also quantify the dextro (D-) and levo (L-) isomers of amphetamine and methamphetamine are less common. Furthermore, large ODT assays (50 drugs) have been successfully developed and validated on ultra-high performance triple quadrapole mass spectrometer (LC-MS/MS) [12], yet large ODT assay development on older LC-MS/MS technology and separation specificity are less common.…”

Section: Introductionmentioning

confidence: 99%

Quantifying 64 drugs, illicit substances, and D- and L- isomers in human oral fluid with liquid-liquid extraction

Robbins¹,

Carpenter

Long

et al. 2023

OJMS

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Although human oral fluid has become more routine for quantitative drug detection in pain management, detecting a large scope of medications and substances is costly and technically challenging for laboratories. This paper presents a quantitative assay for 64 pain medications, illicit substances, and drug metabolites in human oral fluid. The novelty of this assay is that it was developed on an older model AB SCIEX 4000 instrument and renders obscure the need for more technical and expensive laboratory equipment. This method includes addition of internal standard and a 2-step liquid-liquid extraction and dry-down step to concentrate and clean the samples. The samples were suspended in 50% MeOH in water and separation and detection was accomplished using triple quadrupole mass spectrometry (LC-MS/MS). Separation was achieved using reversephase liquid chromatography with detection by LC-MS/MS. A second injection was done in negative mode to determine THC-COOH concentration as an indicator of THC. An aliquot of the (already) extracted samples was analyzed for D-and L-isomers of amphetamine and methamphetamine using a chiral column. The standard curve spanned from 5 to 2000 ng/mL for most of the analytes (1 to 2000 ng/mL for fentanyl and THC-COOH) and up to 1000 ng/mL for 13 analytes. Pregabalin and gabapentin ranged from 25 to 2000 ng/mL. The result is a low-cost method for the sensitive detection of a wide-ranging oral fluid menu for pain management. This assay has a high sensitivity, and good precision and accuracy for all analytes with an older model mass spectrometer.

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“…Although ODT opioid assays that use dilute-and-shoot methods with little sample manipulation have been developed and validated on AB SCIEX 4500 instruments with excellent calibration ranges (2.5-1,000 ng/mL) [12] robust ODT assays that also quantify the D-and L-isomers of (meth)amphetamine are less common. Notably, there are several methods available for determining D-and L-(meth) amphetamine including immunoassays which have been designed to react with one or the other but often have problems with cross-reactivity.…”

Section: Introductionmentioning

confidence: 99%

A Human Oral Fluid Assay for D- and L- Isomer Detection of Amphetamine and Methamphetamine Using Liquid-Liquid Extraction

Robbins¹,

Carpenter

Long

et al. 2022

Journal of Analytical Methods in Chemistry

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Medical providers are increasingly confronted with clinical decision-making that involves (meth)amphetamines. And clinical laboratories need a sensitive, efficient assay for routine assessment of D- and L-isomers to determine the probable source of these potentially illicit analytes. This paper presents a validated method of D- and L-isomer detection in human oral fluid from an extract used for determination of a large oral fluid assay (63 analytes) on an older AB SCIEX 4000 instrument. Taken from the positive extract, D- and L-analytes were added. The method for extraction included addition of internal standard and a 2-step liquid-liquid extraction and dry-down step to concentrate and clean the samples. The samples were suspended in 50% MeOH in water, diluted with mobile phase, with separation and detection accomplished using LC-MS/MS to determine analyte concentration. Once samples were confirmed positive for (meth)amphetamine from the large oral fluid assay, they were further examined for the enantiomeric forms with 50 μl aliquots of the standards and samples of interest combined with 450 μl of D- and L-assay mobile phase, then analyzed using chiral column separation, and LC-MS/MS detection with standard curve spanning the range from 2.5 to 1000 ng/mL. The result is a sensitive and accurate detection of D- and L-isomers of amphetamine and methamphetamine in human oral fluid performed on an older model mass spectrometer (AB SCIEX 4000). The novelty of this assay is twofold (a) the 2-step liquid-liquid extraction and dry-down step to concentrate and clean the samples, and (b) its adoption characteristics as a reflex test from a large ODT panel without the need to invest in newer or expensive LC-MS/MS instruments. Finally, this assay also has potential to add a valuable option to high-throughput laboratories seeking a D- and L-testing alternative to urine drug testing methods.

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Positivity rates of drugs in patients treated for opioid dependence with buprenorphine: A comparison of oral fluid and urine using paired collections and LC-MS/MS

Cited by 14 publications

References 26 publications

Assessment of Pattern of Drug Abuse from Different Clinical Settings in a Reference Laboratory of Pakistan During the COVID-19 Pandemic

Assessment of Pattern of Drug Abuse from Different Clinical Settings in a Reference Laboratory of Pakistan During the COVID-19 Pandemic

Quantifying 64 drugs, illicit substances, and D- and L- isomers in human oral fluid with liquid-liquid extraction

A Human Oral Fluid Assay for D- and L- Isomer Detection of Amphetamine and Methamphetamine Using Liquid-Liquid Extraction

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