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Results for “Substance Abuse Detection”

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At least 271 records · Page 15Linked to original sources
PubMed1992

Presumption of a history of methamphetamine abuse by postmortem analyses of hair and nails: a case report.

By sectional analyses of hair, pubic hair, fingernail and toenail of the descendent who had been a habitual abuser of methamphetamine, the drug was detected in each specimen and the drug concentration in the section containing root was higher than that in the other sections. However, no methamphetamine was detected in the other body fluids and tissues. It was considered that the decedent had used methamphetamine for about 18 months and that the dosage of the drug used for the last 10 days or so was relatively large though he had discontinued injecting the drug for 3-5 days.

Adult↗
PubMedDate not supplied

Determination of chronic flunitrazepam abuse by hair analysis using GC-MS-NCI.

A 38-year-old male was found comatose at home with an empty package of Rohypnol (2-mg tablets, 10 per package) near the body. Many other drugs, which had recently been stolen from a pharmacy, were also found. The judge in charge of the investigation of the stolen pharmaceuticals asked our laboratory to determine if the subject was a chronic user of flunitrazepam, leading our laboratory to develop a procedure for the detection of this benzodiazepine in human hair. The method involved decontamination of hair samples with dichloromethane, incubation in Sorenson buffer (pH 7.6) in the presence of diazepam-d5 used as internal standard, direct liquid-liquid extraction with diethylether-chloroform (80:20, v/v), derivatization with heptafluorobutyric anhydride and analysis by gas chromatography coupled to mass spectrometry in the negative chemical ionization mode of detection. Flunitrazepam and its major metabolite, 7-amino-flunitrazepam, were both detected. The concentrations determined in the proximal hair segment were 89.5 and 24.0 pg/mg for flunitrazepam and 7-amino-flunitrazepam, respectively.

Adult↗
PubMed2000

The use of supercritical fluid extraction for the determination of amphetamines in hair.

A laboratory study interested in the analysis of human hair for drugs-of-abuse was conducted to determine if drugs could be detected and quantified from hair. Supercritical fluid extraction (SFE) techniques followed by GC-MS analysis were applied to extract amphetamines from hair. The group of amphetamines included methylenedioxyamphetamine (MDA), methylenedioxymetamphetamine (MDMA), methylenedioxyethylamphetamine (MDEA) and internal standard mephentermine (MP). To validate information on amphetamine use in hair, powdered hair samples free from drugs were collected and soaked in a known amphetamine standard solution. Authentic fortified case hair samples taken from known drug users known to have consumed amphetamines were also analyzed for amphetamine. Results from this study show that amphetamine use can be detected in spiked and authentic fortified human hair using SFE techniques for qualitative and quantitative reproducible results.

3,4-Methylenedioxyamphetamine↗
PubMedDate not supplied

Concordance between urinalysis results and self-reported drug use by applicants for methadone maintenance in Australia.

This study examined concordance between self-reported drug use and urinalysis data among 341 applicants for methadone treatment in Sydney, Australia. Rates of under-reporting of use of specific drugs were low (0% to 10%). Irregular drug use, short half-life of some abused drugs, and relatively low sensitivity of the TLC assay procedure led to most detected drugs being found in only one of two urine samples collected. Subjects reported having recently used nearly twice as many drugs as were detected in their urine. Agreement (kappa) between self-report and urinalysis results was in the fair to good range for most drugs. None of the six predictors of misreporting examined were found to be of practical value.

Adult↗
PubMed1993

The prevalence of substance abuse among pregnant women in Utah.

OBJECTIVE: To determine the rate of substance use among Utah's pregnant women, who are primarily white and middle class, for comparison to rates reported in studies of inner-city populations. METHODS: Urine specimens and demographic data were obtained anonymously from women who delivered infants at ten hospitals in urban and suburban Utah. Urine samples were screened by enzyme immunoassay for amphetamines, marijuana, cocaine, methadone, opiates, benzodiazepines, and ethanol. RESULTS: Among 792 women screened, the mean age was 26.2 years, 86.1% were white, 62.9% were multigravidas, and 66.3% had private insurance. Cocaine was detected in nine samples (1.1%), illicit amphetamines in five (0.6%), marijuana in 23 (2.9%), ethanol in 32 (4.0%), over-the-counter amphetamines in 51 (6.4%), and benzodiazepines in seven (0.9%). The prevalence rate for women positive for illicit drugs and alcohol combined was 7.8%. Cocaine-positive and marijuana-positive women were more likely to be non-white or Hispanic and to have Medicaid or no insurance than were women negative for either substance. Women with Medicaid or no insurance were four times more likely to be positive for illicit substances (10.7%) than were those with private insurance (2.3%) (P = .0001). CONCLUSION: The rates and patterns of substance use differ between Utah's pregnant women and inner-city populations. The patterns in Utah may be more representative of many communities in the United States that have a predominantly middle-class, white population.

Adult↗
PubMed1990

Drug testing effectiveness in identifying and preventing drug use.

The effectiveness of drug testing in identifying and preventing drug use was assessed by a study of intercollegiate athletes required to participate in a urine testing program. Five hundred athletes who underwent testing were contrasted with a comparison group of 124 athletes not tested. Results show that some drug-using athletes avoided detection. Although many reduced their drug usage, some continued in the same pattern as before; a few actually increased drug usage.

Adult↗
PubMed1996

Drug detection in a suburban psychiatric emergency room.

This study evaluated the yield and utility of urine toxicological screening (UTS) in psychiatric emergency room patients. We also assessed the effect of race, gender, and cocaine and/or alcohol detection on clinical symptoms and diagnoses. The study's null hypothesis is that recent use of cocaine and/or alcohol in psychiatric emergency patients does not change rates of psychiatric symptoms at evaluation. We did a retrospective chart review of 325 consecutive psychiatric emergency room patients and of 112 consecutive patients with benzoylecgonine (BE; major metabolite of cocaine) on UTS. At assessment clinicians were blind to the results of UTS in most cases. UTS was positive in about one-fourth of cases who submitted urine for toxicological testing. Alcohol, cocaine, and cannabis accounted for the majority of positive cases, and simultaneous detection of these drugs was common. Very few patients with BE on UTS were younger than 18 and none was older than 45. In patients with BE on UTS, substance use was missed in about one out of seven cases, and cocaine use in about one out of four cases. Patients with BE on UTS showed decreased rates of aggressive and bizarre behavior. Cocaine use increased rates of suicidality in males and rates of paranoia in black male patients. Black patients had more hallucinatory experiences than white patients, regardless of cocaine use. Principal diagnoses of psychotic disorders were frequently assigned to black patients with cocaine use, and principal diagnoses of affective disorders rarely. Patients with both BE and alcohol on UTS and patients with only BE on UTS had low rates of aggression, but patients with only alcohol on UTS were frequently aggressive. This study's findings show distinct clinical effects of cocaine and/or alcohol use on psychiatric emergency room patients, contrary to the null hypothesis. These effects differed according to race and gender. We conclude that there is little support to advocate routine toxicological testing in the psychiatric emergency room. Instead, selective testing based on empirical evaluation of risk factors might be more profitable to improve detection rates of cocaine and alcohol.

Adjustment Disorders↗
PubMed1998

Evidence of polydrug use using hair analysis: a fatal case involving heroin, cocaine, cannabis, chloroform, thiopental and ketamine.

A case is presented involving a young woman on several illicit drugs (heroin, cocaine and cannabis) as well as two medications and a solvent used for their anesthetic and narcotic properties: thiopental, ketamine and chloroform. This complex drug use was supported by hair analysis over a 10.5 cm segment of the hair taken at autopsy. The average measured concentrations in hair were: thiopental = 5.3 ng/mg, pentobarbital = 10.0 ng/mg, ketamine = 11.3 ng/mg norketamine = 1.0 ng/mg, diazepam = 1.2 ng/mg, nordiazepam = 0.1 ng/mg, 6-acetylmorphine = 4.4 ng/mg, morphine = 3.4 ng/mg, codeine = 1.2 ng/mg, cocaine = 5.5 ng/mg, benzoylecgonine = 1.5 ng/mg and methylecgonine ester = 1.0 ng/mg. While the ketamine/norketamine ratio is consistent with that already reported on drug detection in hair, the thiopental/pentobarbital ratio seems to be inverted.

Adult↗
PubMed2006

A third generation approach to detect erythropoietin abuse in athletes.

BACKGROUND AND OBJECTIVES: Information derived from blood analyses can assist in the detection and/or deterrence of blood doping in sport. We investigated whether comparing an athlete's hematologic values against his or her own historical baseline rather than population-derived thresholds enhanced the ability to detect blood doping. DESIGN AND METHODS: We developed an approach whereby an athlete's true baseline value could be estimated with just one prior blood test. We also estimated a universal value for within-subject variability for key hematologic parameters using the highest value obtained among four separate cohorts of male athletes including 80 elite rowers, 124 endurance-trained or team-sport subjects, 288 professional football players and 630 athletes competing at national or international level. The (individual) baseline and (universal) variability were then incorporated so as to define expected thresholds for subsequent blood tests. The sensitivity of our approach was obtained by analyzing data from 49 recreational athletes administered either recombinant human erythropoietin (n=37) or placebo (n=12). RESULTS: We found that removing within-subject variability by comparing new results against an historical baseline heightened the capacity to detect blood doping. It was possible to delineate the longitudinal changes in either hemoglobin (Hb) or the OFF-hr model score (an algorithm using both Hb and percent reticulocytes) caused by recombinant human erythropoietin treatment from the natural biological fluctuations found in subjects treated with placebo. INTERPRETATION AND CONCLUSIONS: Our objective data supported the intuitive belief that longitudinal monitoring of athletes' blood profiles will help detect blood doping. This information could be used to instigate target-testing of suspicious athletes, or even warrant the exclusion from competition of athletes with aberrant variations in key hematologic values.

Cohort Studies↗
PubMed1993

Antibodies to drugs as indicators of chronic drug use. An alternative to toxicological hair analysis.

An ELISA method for detection of specific antibodies to morphine-protein conjugate (MPC) in humans and animals was elaborated. In humans, antibodies could be detected predominantly as the IgM class of immunoglobulins. Elevated levels of such antibodies were found in about 50% of opiate addicts and morphine-treated rats. In the case of prolonged and regular drug use with the time since the last drug intake not exceeding 2 months, elevated levels of antibodies to MPC were detected more frequently (up to 75%). Antibodies to MPC, detected in opiate addicts, were specific to MPC, morphine and beta-endorphin. A similar approach was applied to the detection of antibodies to ephedrone (amphetamine-like derivative of ephedrine) in case of its chronic use.

Alcoholism↗
PubMed2005

Modeling drug detection and diagnosis with the 'drug evaluation and classification program'.

In this study, we propose formal models and algorithms to detect drug impairment and identify the impairing drug type, on the basis of data obtained by a Drug Evaluation and Classification (DEC) investigation. The DEC program relies on measurements of vital signs and observable signs and symptoms. A formal model, based on data collected by police officers trained to detect and identify drug impairments, yielded sensitivity levels greater than 60% and specificity levels greater than 90% for impairments caused by cannabis, alprazolam, and amphetamine. For codeine, with a specificity of nearly 90% the sensitivity was only 20%. Using logistic regression, the formal model was much more accurate than the trained officers in identifying impairments from cannabis, alprazolam, and amphetamine. Both the formal model and the officers were quite poor in identifying codeine impairment. In conclusion, the joint application of the DECP procedures with the formal model is useful for drug detection and identification.

Accidents, Traffic↗
PubMed2004

Value of hair analysis in postmortem toxicology.

It is generally accepted that chemical testing of biological fluids is the most objective means of diagnosis of drug use. The presence of a drug analyte in a biological specimen can be used to document exposure. The standard in postmortem drug testing is a general unknown screening, followed by the gas chromatographic/mass spectrometric confirmation conducted on a whole blood sample. In recent years, remarkable advances in sensitive analytical techniques have enabled the analysis of drugs in unconventional biological specimens such as hair. The advantages of this sample over traditional media, like urine and blood, are obvious: collection is almost non-invasive, relatively easy to perform, and in forensic situations it may be achieved under close supervision of law enforcement officers to prevent adulteration or substitution. Moreover, the window of drug detection is dramatically extended to weeks, months or even years. The aim of this review is to document the current status of hair analysis in postmortem toxicology.

Forensic Medicine↗
PubMed2006

Investigation into the suitability of a portable psychometric device to be used in the field: an illicit drugs field investigation.

RATIONALE: Driving performance is easily disrupted as a direct consequence of the use of alcohol, licit and illicit drugs. The use of such drugs has a high degree of correlation with increased accident risk. Europe wide research projects into drugged driving have called for the development of a portable objective device capable of screening those impaired through drug use which can be used at the roadside. OBJECTIVE: This study investigated the cognitive and psychomotor performance of a cohort of polydrug drug users in field conditions. Volunteers completed a psychometric test battery on a hand held device in music festival conditions. The test battery comprised a critical tracking task (CTT) and a sustained attention to response task (SART). Volunteers also took a breathanalyser and provided a saliva sample for a DOA screen. RESULTS: On the CTT significance was observed for tracking error following response to a peripheral stimulus in the high alcohol (>80 mg/100 ml) illicit drug group (p=0.0090) and approached significance for the low alcohol (<80 mg/100 ml) illicit drug group (p=0.088). For the SART, incorrect presses to the target stimulus was impaired for volunteers in both the low (<80 mg/100 ml) alcohol illicit drug group (p=0.0080) and the high alcohol (>80 mg/100 ml) illicit drug group (p=0.0415). Discrimination analysis demonstrated that the impairment device was able to discriminate between those individuals who had consumed neither alcohol nor drugs (94.12%), those in the low alcohol drug group (46.67%) and those in the high alcohol drug group (60.00%). CONCLUSION: It is possible to derive an impairment ratio. Further research will demonstrate whether this device could significantly contribute to drug driving detection and road traffic safety.

Adolescent↗
PubMed2004

Comprehensive two-dimensional gas chromatography with time-of-flight mass spectrometry (GC x GC-TOFMS) for drug screening and confirmation.

Comprehensive two-dimensional gas chromatography (GC x GC) is applied to analysis of drug standard mixtures containing 78 drugs of interest in forensic samples. For this study, underivatised drugs were employed. While several of the drugs were not detected at the low concentrations employed in the samples, most could be satisfactorily assigned their first and second dimension retentions in the GC x GC retention plane. For this study, time-of-flight mass spectrometry (TOFMS) detection was used. The enhanced separation possible in GC x GC is demonstrated, and typical linearity and apparatus precision are shown for tramadol, diazepam, olanzapine and desipramine using selected qualifier ions. Mass spectral library search quality for the detection of drugs in a selection of authentic forensic cases, along with retention position in the 2D retention plane, is used to support positive identification of the presence of the drugs. The analysis of 'difficult' drugs paracetamol and phenytoin is shown to produce anomalous chromatographic peak shape in the 2D plane, whereas most drugs gave acceptable peak shapes. The GC x GC technique was applied to screening drugs in forensic samples, with either flame ionisation (FID) or TOFMS detection, and compared favourably with conventional single column GC-MS analysis when tested for diazepam in an authentic forensic study.

Forensic Medicine↗
PubMed1996

Doping control in sports medicine.

Doping control has become one of the strongest measures to reduce the impact of doping in sports. The rationale for doping control is based on the need to maintain both ethical and medical principles. Among the banned pharmacological substances, the most relevant to sports medicine are anabolic agents, stimulants, narcotic, peptide hormones, diuretics, masking agents, and adrenergic beta-blockers. Optimized use of state-of-the-art analytical methodology and suitable quality control mechanisms warrant reliability in the laboratory. Adequate interpretation of results requires knowledge of pharmacology, toxicology, drug metabolism, and pharmacokinetics. The detection and confirmation of doping using endogenous substances are especially difficult for urine testing. The alteration caused in indirect markers in other biological materials, such as blood, will be the focus of further developments in the field.

Doping in Sports↗
PubMed2000

Substance dependence. A hospital based survey.

OBJECTIVE: To collect basic data on multiple and diverse issues such as drugs of dependence, smoking, initiation age, injection related harm, nutritional status, trauma, accidents, abnormal laboratory parameters and co-morbid conditions. METHOD: Seven hundred and ninety nine subjects from a voluntary detoxification unit were studied. Four hundred and ninety seven charts from June 1995 to December 1995 were reviewed retrospectively. For the other 302 subjects admitted between September 1996 to December 1996, information regarding drug use, smoking, trauma, accidents and co-morbid conditions was recorded during the admission interview while the remaining data was later obtained from the charts. RESULTS: Sixty eight percent were under 35. Ninety seven percent were smokers and 55% started smoking before the age of 15. Sixty four percent initiated drugs before the age of 25 while 34% had been on drugs for less than 5 years. Eighty seven percent were using heroin or alcohol. Fourteen percent were dependent on more than one drug. Among heroin users 91% were injecting, 21% had injection related complications, 69% had Hepatitis C Virus and 0.40% died. Forty four percent had at least one current medical disorder, 59% had one abnormal laboratory parameter and 21% below normal Body Mass Index. Nine percent had mental disorders and 1% presented with overdose. Twenty nine percent reported unintentional injuries and 12% reported of road traffic accidents. Seventeen point five percent had family history of drug use, 4.5% had mental disorders and 87% physical disorders. CONCLUSION: More accurate and reliable data is required. Current services need to be improved. Preventative measures should focus on early detection and intervention and a central body for information collection should be established.

Accidents↗