Transcript Drugs of Abuse Detection - Trident Labs

Drugs of Abuse Detection
By Jovana Zuccala
Trident Laboratories, Inc.
DRUG TESTING PROCESS
Sample
collection
Sample
accession
Drug
screening
Sample
reporting
Drug
confirmation
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AMPHETAMINES
• Adderall, Benzedrine, Dexedrine, Vyvanase
• Potent stimulant of central nervous system (CNS)
• Induces euphoria, alertness, reduced appetite
and the sense of increased power and energy
• Reported positive on the urine screen panel if
concentration exceeds 1000 ng/mL
• Confirmation metabolites: amphetamines and
metamphetamines
• Window of detection 3-5 days
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BARBITURATES
• Fioricet, Luminal, Nembutal, Seconal
• CNS depressants
• Induces effects similar to those of alcohol
intoxication
• Reported positive on the urine screen panel if
concentration exceeds 200 ng/mL
• Confirmation metabolites: phenobarbital and
butalbital
• Window of detection 4-6 days to 1-3 weeks
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BENZODIAZEPINES
• Xanax, Klonopin, Valium, Ativan, Rohypnol,
Tamazepam
• Less potent CNS depressants than barbiturates
• Reported positive on the urine screen panel if
concentration exceeds 200 ng/mL
• Confirmation metabolites: nordiazepam,
oxazepam, alpha-hydroxy-alprazolam
• Window of detection up to 7 days (chronic
users even longer)
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BUPRENORPHINE
• Buprenex, Suboxone, Subutex
• is a semi-synthetic opioid that is used to treat
opioid addiction and moderate acute and
chronic pain
• Reported positive on the urine screen panel if
concentration exceeds 5 ng/mL
• Confirmation metabolites: buprenorphine and
norbuprenorphine
• Window of detection 2-3 days
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COCAINE
• Potent CNS stimulant and local anesthetic
• Brings about extreme energy and restlessness,
continuous use causes tremors, spasms, fever
unresponsiveness and difficulties in breathing
• Reported positive on the urine screen panel if
concentration exceeds 300 ng/mL
• Confirmation metabolites: benzoylecgonine
(BE)
• Window of detection 1-5 days
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CANABINOIDS (THC)
• Typically detected in urine in after 1-6 days
after single use, 3-10 days after chronic
weekly use and up to 45 days after daily use
• CNS depressant causing euphoria and anxiety,
followed by crashing depression feeling
• Reported positive on the urine screen panel if
concentration exceeds 50 ng/mL
• Confirmation metabolites: THC-COOH
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METHADONE
• Synthetic opioid used to treat opioid dependence
(Dolophine, Methadose)
• Easy to overdose on: low levels can cause
difficulties in breathing and swallowing, low
pressure, coma even death
• Reported positive on the urine screen panel if
concentration exceeds 300 ng/mL
• Confirmation metabolites: methadone and EEDP
• Detection window 1-4 days
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OPIATES/OPIOIDS
• Avinza, Kadian, MS Contin, MSIR, Norco, Dilaudid,
Vicodin
• CNS depressants prescribed for chronic pain, sports
injuries, and cancer pain
• Number one abused prescription medication and
number one cause of death from overdose
• Reported positive on the urine screen panel if
concentration exceeds 300 ng/mL
• Confirmation metabolites: morphine, codeine,
dihydrocodeine, hydrocodone, hydromorphone
• Window of detection 2-3 days
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6-AM
• Heroin-specific metabolite
• Extremely addictive
• Can cause respiratory and cardiac arrest, coma
and death
• Reported positive on the urine screen panel if
concentration exceeds 10 ng/mL
• Semi-qualitative assay
• Window of detection 10 hours to 10 days
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ALCOHOL
•
•
•
•
CNS depressant
Ethanol and EtG tests
EtG has longer window of detection
After a single drink, ethanol can be detected for 4-6
hours; EtG in 24 hrs
• After binge drinking ethanol usually shows positive for
a day or two, while EtG for up to 80 hrs
• Reported positive on the urine screen panel if
concentration exceeds 500 ng/mL for EtG and 100
ng/mL for ethanol
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OXYCODONE/OXYMORPHONE
• Opioid class, but there is a separate assay to
screen
• Opana, Endocet, Oxycontin, Percocet,
Roxicodone, Roxicet
• Secondary metabolites of morphine and
hydromorphone
• Reported positive on the urine screen panel if
concentration exceeds 300 ng/mL
• Window of detection 1-4 days
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PCP
• Phencyclidine
• Potent hallucinogen (similar to LSD)
• Reported positive on the urine screen panel if
concentration exceeds 25 ng/mL
• Window of detection 1-7 days in occasional
users, while in chronic users up to 4 weeks
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PPX
• Propoxyphene (Darvocet, Darvon)
• Opioid class (pain management, cancer pain)
• Reported positive on the urine screen panel if
concentration exceeds 300 ng/mL
• Confirmation metabolites: Propoxyphene and
Norpoxyphene
• Window of detection 6 hours-2days
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ECSTASY
• Ecstasy can induce euphoria, a sense of
intimacy with others, and diminished anxiety
• CNS stimulant illegal in United States
• Reported positive on the urine screen panel if
concentration exceeds 500 ng/mL
• Confirmation metabolites: MDA and MDMA
• Window of detection 1-3 days
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CARISOPRODOL (SOMA)
• Muscle relaxant
• Used to treat injuries and painful muscle
conditions
• Habit-forming and often abused drug
• Reported positive on the urine screen panel if
concentration exceeds 100 ng/mL
• Window of detection 1-2 days
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Ketamine
• Ketanest, Ketaset, Ketalar (street name
“Special K”)
• Use in veterinary and human medicine for
anesthesia, analgesia and sedation
• Similar to PCP, it induces “dissociative
anesthesia” and therefore used as recreational
drug
• Window of detection 1-2 days
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TRAMADOL
• Ultram, Tramal, Ryzolt
• Used as centrally acting synthetic analgesic
and in opioid dependency treatments
• Reported positive on the urine screen panel if
concentration exceeds 200 ng/mL
• Window of detection 2-4 days
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FENTANYL
• Actiq, Duragesic, Fentora, Sublimaze
• Extremely strong synthetic opioid, often
prescribed in pain management clinics
• Reported positive on the urine screen panel if
concentration exceeds 2 ng/mL
• Exist as a transdermal patch and lozenges
(lollipop)
• Window of detection 1-3 days
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MEPERIDINE
• Meperitab, Demerol, Mepergen
• Meperidine is an opioid and a controlled
substance with an abuse liability similar to
morphine.
• Reported positive on the urine screen panel if
concentration exceeds 200 ng/mL
• Window of detection 1-2 days
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Methylphenidate
• Ritalin, Concerta, Daytrana
• Psychostimulant drug approved for treatment of
ADHD, lethargy, narcolepsy, depression and
obesity
• Methylphenidate is sometimes used by students
to enhance their mental abilities, improving their
concentration and helping them to study
• Confirmation of methylphenidate in urine serves
to monitor compliance in those receiving the
drug therapeutically
• Window of detection 1-2 days
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TRICYCLIC ANTIDEPRESSANTS (TCA)
• Pamelor, Elavil, Sinequan, Trofanil
• Generally low abuse potential
• Used as antidepressants, in ADHD therapy and
for chronic pain
• Reported positive on the urine screen panel if
concentration exceeds 300 ng/mL
• Window of detection 2-19 days
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Synthetic Cannabinoids
• K2, Spice, Black Mamba, Fake Weed, Genie, Bombai
Blue…
• Psychoactive designer drug derived of natural herbs
sprayed with synthetic chemicals
• Illegal to posses or use in the U.S.
• Synthetic cannabinoid intoxication is associated with
acute psychosis, worsening of previously stable
psychotic disorders, and also may have the ability to
trigger a chronic (long-term) psychotic disorder among
vulnerable individuals such as those with a family
history of mental illness.
• Window of detection up to 72 hours
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Bath Salts
• Ivory Dove, Vanilla Sky, Blue Silk, Cloud Nine,
Hurricane Charlie, Drones…
• “Street name” for the family of designer drugs
containing substituted cathinones
• Produce effects similar to amphetamines and
cocaine
• Banned in at least 41 states
• Window of detection 2-3 days
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Cotinine
• Metabolite of nicotine, also found in tobacco
• Cotinine is used as a biomarker for exposure to tobacco
smoke and has also been sold as an antidepressant under
the brand name Scotine.
• Cotinine levels <10 ng/mL are considered to be consistent
with no active smoking. Values of 10 ng/mL to 100 ng/mL
are associated with light smoking or moderate passive
exposure, and levels above 300 ng/mL are seen in heavy
smokers - more than 20 cigarettes a day. In urine, values
between 11 ng/mL and 30 ng/mL may be associated with
light smoking or passive exposure, and levels in active
smokers typically reach 500 ng/mL or more.
• Window of detection in urine is up to 7 days
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VALIDITY TESTING-pH
• pH test measuring acidity of urine (normal
values between 4.5 and 8.9). If pH found to be
lower than 4.5 or higher than 8.9, the
specimen is considered adulterated
• Adulterants that change pH of urine- any acid
or base (lemon juice, soap, house cleaning
products, etc)
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VALIDITY TESTING-OXIDANTS
• Oxidants test for the presence of oxidizing agents
such as bleach and hydrogen peroxide. Normal
human urine should not contain oxidants or PCC
• Cutoff of the assay on instrument is 50 µg/mL
• Adulterants that change oxidant levels of urine
are Pyridinium chlorochromate (sold under the
brand name UrineLuck), bleach, etc.
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VALIDITY TESTING-NITRITES
• Nitrites test is testing for the presence of
nitrite salts in urine sample (certain foods and
meats contain nitrites)
• Normal humane urine doesn’t contain any
nitrites
• Instrument cutoff is 500 µg/mL
• Adulterants containing nitrites are Klear,
Whizzies, etc.
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VALIDITY TESTING-SPECIFIC GRAVITY
• Specific gravity tests for sample dilution. The
normal range is from 1.003 to 1.020. Values
outside this range may be the result of specimen
dilution or adulteration.
• Factors affecting specific gravity are dehydration,
excessive sweating, increased water intake, etc.
• Trident lab is currently phasing specific gravity
out, due to the fact that this test can be easily
manipulated with.
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VALIDITY TESTING-CREATININE
• Creatinine is a waste product of creatine; an aminoacid contained in muscle tissue and found in urine. A
person may attempt to foil a test by drinking excessive
amounts of water or diuretics such as herbal teas to
“flush” the system. Creatinine and specific gravity are
two ways to check for dilution and flushing, which are
the most common mechanisms used in an attempt to
circumvent drug testing. Low creatinine and specific
gravity levels may indicate dilute urine.
• The absence of creatinine (<2mg/dl) is indicative of a
specimen not consistent with human urine and is
considered substituted (apple juice, etc.)
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