SEARCH · PubMed Health

Results for “Substance Abuse Detection”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources

PubMed1990

An evaluation of preemployment drug testing.

As part of a blind longitudinal study, 5,465 job applicants were tested for use of illicit drugs, and the relationships between these drug-test results and absenteeism, turnover, injuries, and accidents on the job were evaluated. After an average 1.3 years of employment, employees who had tested positive for illicit drugs had an absenteeism rate 59.3% higher than employees who had tested negative (6.63% vs. 4.16% of scheduled work hours, respectively). Employees who had tested positive also had a 47% higher rate of involuntary turnover than employees who had tested negative (15.41% vs. 10.51%, respectively). No significant associations were detected between drug-test results and measures of injury and accident occurrence. The practical implications of these results, in terms of economic utility and prediction errors, are discussed.

Adult↗

PubMed1994

A comparison of meconium, maternal urine and neonatal urine for detection of maternal drug use during pregnancy.

A large scale drug screening study was done to determine the prevalence of drug use in a large metropolitan, obstetric population. Meconium and first voided urine, as well as maternal urine were collected from 423 consecutive deliveries. Urine samples and methanolic extracts of meconium were initially screened by Enzyme Multiplied Immunoassay Technique (EMIT) and then confirmed by Gas Chromatography/Mass Spectrometry (GC/MS). Analysis of cocaine metabolite as benzoylecogonine, cannabinoid as carboxy-THC, codeine, morphine and methadone were included in the study. The positive rate for benzoylecgonine was virtually identical for meconium, maternal urine and neonatal urine (12%). Analysis of meconium was found to be more reliable than analysis of maternal or neonatal urine for the detection of benzoylecgonine. Meconium did not appear to offer an advantage over maternal or neonatal urine for detection of cannabinoid, codeine, morphine, or methadone.

Adult↗

PubMedDate not supplied

Cocaine metabolite (benzoylecgonine) in hair and urine of drug users.

Two methods of drug detection, urinalysis and hair analysis, were compared with respect to the efficiency of identification of drug use in a population of men living on the Arizona-Mexico border. The standard curve of cannabinoids in urine was linear to 20 ng/mL. The GC/MS levels for all cannabinoids combined in urine were very similar to that obtained by radioimmunoassay (RIA), 91% concordance. Similar results were obtained from samples analyzed dually for the cocaine metabolite benzoylecgonine (BE) after spiking. As determined by RIA of urine, 74% of the subjects were positive for cannabinoids. The majority were in the range of 100-1000 ng/mg creatinine. The pattern of excretion of THC metabolites with respect to the verbally reported time of first use was fairly normal, with the peak rate of elimination 13-24 hours following the last reported use. Washed hair samples were extracted by overnight acid hydrolysis. Urine samples and neutralized hair extracts were analyzed for cocaine and BE by RIA. Of the hair samples, 55% contained cocaine/BE, as compared with only 4.3% of the urine samples. Most hair samples contained cocaine/BE in the range of 25-100 ng/sample (100 mg hair). All hair samples testing negative for cocaine/BE by RIA also tested negative by GC/MS, and four samples containing the highest amounts of cocaine and BE by RIA were similarly found to contain the highest amounts by GC/MS. Hair analysis, therefore, gives a wider window of detection of drug use than does urinalysis and shows merit in the confirmation of cocaine use in small clinical research studies.

Adolescent↗

PubMed2006

Drugged driving in Hungary 2000-2004.

The authors analyzed the biological samples available in criminal cases that were started because of illicit and prescribed drug-impaired driving between 2000 and 2004. The result of the on-the-spot clinical test is not informative and cannot be evaluated as it is mainly affected by the simultaneous presence of alcohol. Licit or illicit drugs in the urine could be detected in 378 people out of 623 people (60.7%), whereas in 59 cases (9.5%) there was some substance present in the blood. The occurrence multiple drugs was high (36.8%). The joint use of alcohol and drugs has increased in the past few years.

Adolescent↗

PubMed1995

Screening for drugs of abuse. I: Opiates, amphetamines and cocaine.

(1) In order to provide an efficient and reliable service for drugs of abuse screening in urine, the laboratory should analyse 20-30 samples per week, and the staff should include a scientist with special expertise in the subject. (2) Turnaround times should be between 2-3 days of sample collection. To achieve this aim it may be necessary to make special arrangements for the delivery of samples to the laboratory. Results should preferably be transmitted by electronic mail or facsimile with the necessary precautions for security and confidentiality: hardcopy reports may also be required. (3) Good communications between the requesting clinician and the laboratory are essential. An advisory service should be provided by the laboratory and clinicians should be encouraged to discuss requests and results with laboratory staff. It is important that the laboratory inform doctors of the range of substances detected and the sensitivity and specificity of laboratory assays. (4) Assays should be performed according to the manufacturer's protocols, or by modified methods that have been rigorously validated. Quality control samples should be included in each analytical run and participation in an external quality assessment scheme, e.g. UKNEQAS, is essential to provide independent confirmation and confidence that results compare with those from other laboratories. Other requirements include adequate training and supervision of staff, and careful recording of samples and results. (5) Drugs to be tested will depend on the drug 'scene' in the area but should include those drugs regularly prescribed for maintenance therapy (e.g. methadone, dihydrocodeine, benzodiazepines), and drugs frequently misused (e.g. heroin, buprenorphine, amphetamines, cocaine). (6) Positive results obtained by preliminary screening methods e.g. EMIT, should be confirmed by another analytical technique, e.g. TLC, GC or GC-MS. If there are potentially serious or legal implications, and in employment and preemployment testing, confirmation of positive results is mandatory. In some cases, e.g. checking for methadone or benzodiazepine compliance, it may be considered unnecessary to confirm positive results although possible spiking of samples cannot be excluded without checking for the presence of metabolites by a chromatographic procedure.

Amphetamines↗

PubMed1992

Cigarette, alcohol, and other drug use by school-age pregnant adolescents: prevalence, detection, and associated risk factors.

Use of cigarettes, alcohol, and other drugs among pregnant adolescents is just beginning to be documented. This study sought to determine the prevalence and associated risk factors of cigarette, alcohol, and other drug use among school-age adolescents attending a comprehensive teenage pregnancy program. All enrollees completed a self-administered questionnaire and provided a breath sample for carbon monoxide analysis. Urine was obtained for quantitative determination of drug metabolites at the initial and one third-trimester visit. A chart review determined medical provider recognition of cigarette, alcohol, and other drug use. Results were analyzed for 93% of 229 eligible patients. Seventeen percent were positive for alcohol or other drug use by questionnaire self-report, provider report, or initial urine screen. Eleven percent were positive by urine screen alone at either the initial or third-trimester visit. Medical providers were successful in identifying nearly all of the cigarette smokers, but fewer than half of the alcohol drinkers and few of the other drug users. Forward stepwise multiple regression determined the most efficient model for predicting alcohol and other drug use. A report of having been high at school and personal or friends' use of cigarettes were the most significant risk factors. Results indicate a high prevalence of alcohol and other drug use and suggest a need for changes in current practice related to the detection and management of such drug use in pregnant adolescents.

Adolescent↗

PubMedDate not supplied

The detection and treatment of posttraumatic distress and substance intoxication in the acute care inpatient setting.

Each year, approximately 2.5 million Americans require inpatient admissions after sustaining traumatic physical injuries. Few investigations have assessed the routine detection and treatment of acute care inpatients with high levels of posttraumatic distress. A representative sample of 101 hospitalized patients with acute injuries was screened for posttraumatic stress disorder (PTSD) and depressive symptoms, as well as substance intoxication. Patients' medical records were reviewed for documentation of psychiatric symptoms and diagnoses and the initiation of early evaluation and treatment. High levels of PTSD and/or depressive symptoms were present in over 50% of patients. Although providers frequently noted symptomatic distress, few symptomatic patients received formal diagnoses, evaluations or treatment. Patients who had positive substance toxicology screens on admission infrequently received in-depth evaluation or treatment. A substantial number of injured trauma survivors have high levels of symptomatic distress that are inconsistently evaluated and treated in the acute care medical setting. Mental health interventions appear to be feasibly and effectively delivered from trauma centers. Therefore, ongoing investigation and policy initiatives informing the detection and treatment of patients with psychiatric disturbances in acute care could substantially enhance the quality of mental health care for injured survivors of individual and mass trauma.

Acute Disease↗

PubMed1995

[Intake of addictive drugs and traffic safety--a report of experiences of the Vienna federal police department].

Urine samples of 27 individuals with extremely conspicuous behaviour in road traffic were analysed by means of the Abbott ADx-analyser for cocaine metabolites, cannabinoids and opiates. Gas chromatography/mass spectrometry (GC/MS) confirmed positive results. 52% of those 26 positive samples confirmed the simultaneous consumption of two drugs. In 16% all three drugs tested could be found positive, exceeding the threshold values given for the tests hundred fold. Without exception, all 25 urine samples found positive in the ADx-analyser belonged to young people (22 males, 3 females) with 48% of them born between 1968 and 1970. 84% of tested people had previous convictions and 68% had drug addiction records. We also see this project as the beginning of continuing investigations of other drugs and pharmaceuticals. Given the fact that 25 out of 27 samples were found to be positive we most certainly detected nothing but the "tip of the iceberg". We should strive, in conjunction with other European countries, for a political solution to the problem of the illegal and legal consumption of drugs and pharmaceuticals and their effect on driving performance.

Accidents, Traffic↗

PubMed1997

Quantification of dextropropoxyphene and its metabolite by HPLC in hair of overdose cases.

Hair samples taken from 11 persons suspected to have died from an overdose of legal or illicit drugs were analysed. These hair samples were selected, because classical post-mortem toxicological investigations in blood revealed the presence of dextropropoxyphene (PPX) and its major metabolite norpropoxyphene (NPPX). For the hair analysis, hair strands were cut into segments of about 3 cm, washed with water and acetone, dried and pulverised. An aliquot of about 40 mg of those segments was incubated with acetate buffer pH 4.0 and beta-glucuronidase/arylsulfatase. After liquid-liquid extraction with hexane-3-methylbutanol (99:1), drugs were identified and measured by HPLC using piritramide as an internal standard. Preliminary assays showed that the limit of detection for PPX is below 1.0 ng/mg hair, the limit of detection for the metabolite NPPX being significantly higher (1.5 ng/mg). GC/MS, usually the method of choice for this kind of determination, was not chosen, because of the thermolability of PPX and its unspecific mass spectrum. From the hair of 11 persons, 24 segments were prepared and processed. Our results show that ten persons were found positive for PPX; moreover, when regarding the 24 segments, only three were found negative. PPX and NPPX concentrations were detected at maximal concentrations of 26.4 and 71.0 ng/mg hair respectively. Considering the ratio of PPX to NPPX for each person, we found more PPX than NPPX for three persons, whereas for seven persons we found more of the metabolite than its parent drug.

Chromatography, High Pressure Liquid↗

PubMed2000

Toxicological screening in trauma.

OBJECTIVES: To determine the prevalence and patterns of alcohol and drug use in patients with major trauma. METHODS: Consecutive trauma patient enrollment, 24 hours a day, was envisaged with anonymised patient data on gender, age band, and mechanism of injury collected. The study group had surplus plasma quantitatively analysed for ethanol concentration, and urine samples were initially screened, via immunoassay, for opiates, cannabinoids, amphetamines, benzodiazepines, cocaine, and methadone. Confirmation and specification of individual positive results was then performed using thin layer or gas-liquid chromatography. Drugs of treatment given in the resuscitation room, if subsequently detected in the urine samples, were excluded from the final results. RESULTS: There were 116 eligible trauma patients assessed and treated in the resuscitation room over a six month period, of which 93 (80%) were enrolled. Altogether 27% of this trauma population had plasma ethanol concentrations greater than 80 mg/dl. There was a significantly higher prevalence of alcohol intoxication in the group not involved in a road traffic accident (RTA) compared with the group who were involved in a RTA. Initial screening of urine for drugs revealed a prevalence of 51%. After 12 exclusions due to iatrogenic administration of opiates, the final confirmed prevalence was 35% in this trauma population. The individual drug prevalence was 13% for cannabinoids, 11% for codeine, 8% for morphine, 6% for amphetamine, 6% for benzodiazepines, 3% for cocaine, 1% for dihydrocodeine, and 1% for methadone. CONCLUSIONS: There is a notable prevalence of drug and alcohol use in this British accident and emergency trauma population. A significantly higher prevalence for alcohol intoxication was found in the non-RTA group compared with the RTA group. The patterns of drug usage detected reflect local influences and less cocaine use is seen compared with American studies. The association between alcohol, drugs, and trauma, together with ethically acceptable methods of screening, are discussed.

Accidental Falls↗

PubMedDate not supplied

[Determination of butane in respiratory gases by means of GC/MS and GC/MS-MS].

Butane is inhaled in order to achieve a pleasurable state of intoxication. An overdose can lead to death. In two deaths from our own investigation material the circumstances were suspicious for the inhalation of liquid gas, and the presence of butane should be demonstrated in the respiratory gases. For detection, a method of ion trap gas chromatography/mass spectrometry (GC/MS) and tandem-mass spectrometry (GC/MS-MS) was developed, whereby the gas samples from the lung tissue were directly injected into the GC. The GC/MS tests revealed the presence of butane. Moreover, it was found that during the MS-MS tests reaction products appeared which had formed in the ion trap. Systematic investigations of these reaction products showed that these appeared regularly and could be used as additional backup for the proof of butane. Thus phenomena in the ion trap were used which would not have been expected to occur in normal mass spectrometry or tandem-MS and had not been described in the forensic literature so far. The detected amount of butane could be quantified by means of serial dilutions with nitrogen and room air. The described method shows that small molecules or gases can be demonstrated with the ion trap mass spectrometer.

Adolescent↗

PubMed2005

Review: Pharmacokinetics of illicit drugs in oral fluid.

This article reviews studies that have measured drug concentrations in oral fluid following controlled dosing regimens. A total of 23 studies have been identified over the last 15 years. These show that the amphetamines including designer amphetamines, cocaine, cannabis and cocaine are quickly found in oral fluid following dosing and usually have similar time-courses to that in plasma. Following common doses peak oral fluid concentrations exceed 0.1 microg/mL and often even 1 microg/mL. The drug concentration will depend on whether a dilution step occurs with buffer as part of the sampling procedure. The uses of collectors that stimulate oral fluid usually reduce the drug concentration compared to a non-stimulated manner. This reduction will not disadvantage the recipient since it will potentially reduce the detectability of drug in oral fluid compared to non-stimulated collections. Only one recent study has been reported for a benzodiazepine. This showed nanogram per milliliter concentrations for flunitrazepam. More studies are required for benzodiazepines and indeed for other drugs, particularly in multiple drug situations and where disease may affect the pharmacokinetics of drugs.

Forensic Medicine↗

PubMed2004

An overview of the use of urine, hair, sweat and saliva to detect drug use.

This paper provides a brief overview of qualitative drug testing procedures using urine, hair, saliva and sweat specimens. Issues related to collection, analysis and interpretation of each specimen as well as their advantages and disadvantages are discussed. The biological detection of drug use involves a screening test which, if positive, is followed by a confirmatory test. Urine is the most widely used specimen in the detection of drugs. Urinalysis offers an intermediate window of detection (1-3 days). Hair analysis offers the largest window of detection (7-100+ days). Saliva analysis may be useful in determining very recent drug use (1-36 hours). The analysis of sweat may be useful for continuous monitoring of drug use (1-14 days). Drug testing has become a fast, convenient process with the development of point-of-collection drug testing devices.

Hair↗

PubMed2005

Date-rape drugs scene in Poland.

Since the beginnings of twenty-first century in Poland increasing number of reports about the drug-facilitated sexual assaults have been observed. Many drugs have been identified as so-called "date-rape drugs", because of their pharmacological properties, especially inducing amnesia. These drugs are used for the purpose of "drugging" unsuspected victims and than raping them. In a typical scenario, the perpetrator surreptitiously adds "date-rape drug" to the alcoholic or non-alcoholic beverage of an unsuspecting person, who is subsequently sexually assaulted while under the influence of this substance. Many victims do not report the incident until several days after the event or even do not report it at all. They report the incident so late after the events because they often have problems with remember the course of incident. It causes that victim is not reliable witness for justice. Detection of "date-rape drugs" in biological fluids is unequivocal evidence of perpetration. Analysis of biological fluids collected from victims of rapes for presence of drugs was rare in Poland up to now. The aim of this study is to show the use of "date-rape drugs" in Poland. Materials for this study were from the routine casework elaborated at the Institute of Forensic Research in Kraków. APCI-LC-MS methods were applied for screening of biological fluids (blood and/or urine) for amphetamine and its 6 analogues, for 12 substances from benzodiazepine group and for quantification of the detected drugs. HPLC-DAD was used as a screening method for wide range of medicinal drugs, and NCI-GC-MS methods for determination of ketamine and tetrahydrocannabinols (delta9-tetrahydrocannabinol, 9THC) and its metabolite (11-nor-carboxy-delta9-tetrahydrocannabinol, THCCOOH). In 2000-2004, the biological fluids taken from 33 persons, both sexually assaulted or perpetrators were analysed. In 2000 and 2002 not any case of this type was registered, in 2001 only two cases were recorded. After 2003 significant increase in the number of these cases was observed. Eleven and twenty cases involving "date-rape drugs" were submitted to the Institute in 2003 and 2004, respectively. The most common substances detected in analysed materials were amphetamine (in concentrations ranged from 10 to 85 ng/ml) and 9THC (0.36-1.4 ng/ml). Alcohol (0.27-2.3% per hundred), MDMA (8-201 ng/ml), benzodiazepines (oxazepam, nordazepam, estazolam), propranolol and lidocaine were also found in blood and urine specimens.

Amphetamine-Related Disorders↗

PubMedDate not supplied

[Comparison of the MTP immunoassay with EMIT in blood screening for drugs].

We compared the MTP immunoassay with EMIT for the screening of drugs of abuse (opiates, cannabinoids, cocaine metabolites and amphetamines) in whole blood samples. These blood samples were obtained from the German police, when driving under the influence of drugs of abuse was suspected. For screening with the MTP immunoassay 25 microliters of serum or blood (without any pretreatment) was pipetted into the wells of the microtiter plates and the procedure was followed as described. Prior to screening with a Cobas Mira and EMIT reagents, the samples were treated with acetone to precipitate serum proteins. The cutoff for all drugs of abuse was set at 10 ng per ml of serum or blood. In most cases there was a good agreement between the negative and positive results of the two screening assays. The agreement between the two assays in the detection of opiates and cocaine was 91% and 93%, respectively, and for cannabinoids and amphetamines approximately 80%. The MTP immunoassay was more sensitive than EMIT for the detection of cannabinoids--but at the same time the MTP immunoassay was less specific. Both screening assays have a sensitivity of 100% for the detection of opiates and cocaine, but the specificity of the EMIT--also for opiates--was substantially lower. The MTP immunoassay has in respect to amphetamines a very high sensitivity, whereas the sensitivity of EMIT for amphetamines is inacceptable due to losses during sample preparation. The specificity of MTP immunoassay for amphetamines is not optimal, because a relatively large amount of samples tested false-positive for amphetamines at the cutoff of 10 ng/ml. In summary the MTP immunoassay, although not automated, performs well in comparison with EMIT, especially if the sample preparation for EMIT testing ist considered.

Enzyme Multiplied Immunoassay Technique↗

PubMed2005

New designer drug, 2,5-dimethoxy-4-propylthio-beta-phenethylamine (2C-T-7): studies on its metabolism and toxicological detection in rat urine using gas chromatography/mass spectrometry.

Studies are described on the metabolism and toxicological analysis of the phenethylamine-derived designer drug 2,5-dimethoxy-4-propylthio-beta-phenethylamine (2C-T-7) in rat urine using gas chromatography/mass spectrometry (GC/MS). The identified metabolites indicated that 2C-T-7 was metabolized by hydroxylation of the propyl side chain followed by N-acetylation and sulfoxidation and also by deamination followed by oxidation to the corresponding acid or by reduction to the corresponding alcohol. To a minor extent, 2C-T-7 was also metabolized by S-dealkylation followed by N-acetylation, S-methylation and sulfoxidation. The authors' systematic toxicological analysis (STA) procedure using full-scan GC/MS after acid hydrolysis, liquid-liquid extraction microwave-assisted acetylation allowed the detection of an intake of a dose of 2C-T-7 in rat urine that corresponds to a common drug users' dose. Assuming similar metabolism, the described STA procedure should be suitable for proof of an intake of 2C-T-7 in human urine.

Administration, Oral↗

PubMedDate not supplied

Anabolic steroids and violent crime--an epidemiological study at a jail in Stockholm, Sweden.

Violent crime has been associated with the abuse of anabolic-androgenic steroids (AAS) in several reports. Speculations concerning such associations have been raised with regard to several recent crimes committed in Sweden. To test this hypothetical relationship, individuals in a Stockholm jail who had been arrested for violent crimes were screened for AAS in the urine. No AAS were detected in the urine samples of 50 prisoners who had volunteered for the study. However, 16 prisoners refused to participate. AAS abuse was admitted by two of the participating subjects. Although there is a great need for epidemiological studies to objectively confirm the association of AAS abuse and violence, it seems that such studies will be impossible to conduct as long as they, for legal reasons, depend on voluntary participation.

Adolescent↗

PubMed1999

The use of alcohol and other psychoactive substances by victims of traffic accidents in Greece.

Alcohol is one of the main causes of traffic accidents worldwide. Its use decreases significantly the driving ability of an individual as well as the reflexes of a pedestrian increasing in this way the possibilities of their involvement in motor-vehicle accidents. The above possibilities are increased when a psychoactive substance has been taken in combination with alcohol due to their synergistic effect. The Laboratory of Forensic Medicine and Toxicology of the University of Athens is authorized to perform the toxicological investigation of traffic accidents that happen in the major part of Greece. The findings of the toxicological analyses that were performed in our laboratory during the years 1995 to 1997 are classified according to the alcohol concentration and the kind of psychoactive substance detected as well as to the gender and the age of the victims, drivers or pedestrians. The results of the above classification are evaluated and the conclusions regarding alcohol, drugs and traffic accidents in Greece are discussed thoroughly.

Accidents, Traffic↗