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PubMed2006

Validation of the "problematic use of narcotics" (PUN) screening test for drug using adolescents.

The aim of the study was to examine psychometric properties of the PUN screening test concerning illicit drug problem use by adolescents. The criterion standard for the test's validity was a diagnostic interview conducted by trained specialists. Respondents were reached by snowball sampling in 58 randomly chosen Polish local communities. A total of 1344 adolescent (37% female) aged 13 to 18 years, who used any illicit drug at least once in the past 12 months, participated. The majority (89%) had no contacts with any drug therapy facilities. 41% were diagnosed as occasional drug users and 59% as problematic users or dependents. Logistic regression analysis showed that 10 out of the basic set of 25 test items were most powerful in differentiating occasional and problematic users. A test score of 2 or higher was optimal for identifying problem drug use (sensitivity: 0.88, specificity: 0.79, PPV: 0.86, NPV: 0.81). Validity was not affected by age or sex. These results confirmed the PUN test potential as a brief screening tool.

Adolescent↗
PubMedDate not supplied

Using the drug abuse screening test (DAST-10) to analyze health services utilization and cost for substance users in a community-based setting.

The dual purpose of this study was to: (1) determine whether problematic drug users, defined through the Drug Abuse Screening Test (DAST-10), exhibited differences in health services utilization and cost relative to a combined group of non-problematic drug users and non-drug users; and (2) assess whether the findings were similar to those for chronic drug users (CDUs) and injecting drug users (IDUs). Results showed that health services utilization and total cost were very similar for problematic drug users defined through quantity-frequency (i.e., CDU, IDU) and diagnostic (i.e., DAST-10) criteria. Findings suggest that quantity/frequency criteria for problematic drug use were reasonable approximations for diagnostic-based measures.

Adult↗
PubMed2003

Comparison of the prevalence of substance use and psychiatric disorders between government- and self-employed commercial drivers.

Five hundred and five city government-employed bus drivers (GED) and 506 self-employed drivers (SED) who were primarily taxi drivers attending annual health check-ups were studied. A two-step survey was applied. Data on basic demographics were collected, the 12-item Chinese Health Questionnaire (CHQ), Michigan Alcoholism Screening Test (MAST), Drug Abuse Screen Test (DAST) questionnaires were administered and urine drug screening for amphetamine and benzodiazepines was performed in all subjects. Subjects with MAST scores > or =3, DAST > or =5 from both groups and CHQ > or =4 for the GED group and CHQ > or =7 for the SED group were regarded as a high-risk group; and subjects with normal MAST, DAST and CHQ results serving as the comparison group were invited for further interview by psychiatric specialists using the Mini International Neuropsychiatric Interview. The mean CHQ scores were 0.94 +/- 1.53 for the GED group and 2.08 +/- 2.42 for the SED group. The mean MAST scores for the GED and SED groups were 0.23 +/- 0.58 and 0.38 +/- 1.12; and the mean DAST scores were 1.03 +/- 0.85 and 1.41 +/- 1.89, respectively. The positive rate for benzodiazepines in urine screening by enzyme immunoassay was 8.3% for the GED group, and 8.5% for the SED group. After specification using liquid chromatography, this rate reduced to 4.6% and 3.7%, respectively. Only one subject in the SED group tested positive for urine amphetamine. The SED group had a higher rate of neurotic problems, psychiatric diagnosis and a higher frequency of substance use than the GED group. These findings suggest that different work style of commercial drivers may contribute to this phenomenon. The rate of psychiatric diagnosis was significantly higher in the high-risk subjects from both groups. Questionnaires such as CHQ, DAST and MAST are useful tools to screen out subjects at high risk of psychiatric disorders during routine health checks in labor workers.

Adult↗
PubMed2000

Performance evaluation of four on-site drug-testing devices for detection of drugs of abuse in urine.

On-site drug tests are becoming increasingly more popular because of their easy test protocols and instantaneous results. This study evaluates the performance of four on-site drug testing devices that use competitive binding immunoassays to qualitatively determine the presence of drugs in urine: Triage Panel for Drugs of Abuse plus TCA, QuickScreen Pro-Multi Drug Screening Tests, Syva Rapid Test d.a.u. 5 and d.a.u. 2, and Rapid Drug Screen. All devices simultaneously determine the presence of the following drugs of abuse: amphetamine (AMP), benzoylecgonine (BE), 11-nor-9-carboxy-delta9-tetrahydrocannabinol (THCA), opiates (OPI), and phencyclidine (PCP). Triage and Rapid Drug Screen also simultaneously test for benzodiazepines (BZB) and barbiturates (BRB), whereas QuickScreen and Rapid Test require separate devices for the BZB and BRB analyses. Urine specimens (222) containing drug concentrations around or above cutoff values were screened by ONLINE or EMIT II immunoassays. Of these, 199 yielded positive gas chromatography-mass spectrometry results with at least 17 positive specimens in each drug class. Specimens with the target drugs added at 16.7% above and below the cutoff, 33.3% above and below the cutoff, and 66.7% above the cutoff were also used to evaluate the test devices. Sensitivity and specificity calculations demonstrated that Triage performed most predictably in the donor urine specimens and the drug-added specimens. In addition, it required the least amount of test volume and was the only device in which the appearance of a colored line indicated a positive result. Therefore, of the devices studied, Triage was the most dependable and reproducible on-site drug-screening device.

Enzyme Multiplied Immunoassay Technique↗
PubMed1990

Drugs-of-abuse testing. Screening and confirmation.

It is essential to understand that any rapid urine drugs-of-abuse screening test should be confirmed by an equally sensitive and more specific test. In this regard, the confirmation procedure chosen should provide the most accurate and unequivocal results possible. Confirmation techniques other than GC/MS may be adequate for certain drugs of abuse, but GC/MS is generally accepted as the most rigorous confirmation technique for most drugs of abuse. It provides the best confirmatory information when performed appropriately. Consumers should be aware of the limitations of screening tests and the need for more specific confirmatory testing. Each drug-of-abuse testing claim must be supported by appropriate data. Labeling instructions and other pertinent information must be accurate. Labeling for drug-testing devices must provide adequate information about the intended use and expected performance, in addition to instructions for use, known limitations, and indications of the quality of performance.

Gas Chromatography-Mass Spectrometry↗
PubMed2006

Screening for substance use patterns among patients referred for a variety of sleep complaints.

Virtually all psychiatric and substance use disorders are associated with sleep disruption. Studies indicate that psychiatric disorders are related closely to chronic insomnia and that psychoactive substances have acute and chronic effects on sleep architecture. Several aspects of sleep are compromised in individuals taking these substances, ranging from difficulty initiating sleep to difficulty maintaining sleep and hypersomnia. Sleep disturbances are apparent in person taking psychoactive drugs or alcohol and have been found to persist long after withdrawing from these drugs. For some, sleep disturbance can be so severe as to reverse treatment success and precipitate relapse to addiction or dependence. There is increasing evidence that primary insomnia without a concurrent psychiatric disorder is a risk factor for later developing substance use disorders. Patients were asked to complete two brief screening tools, the Michigan Alcohol Screening Test and Drug Abuse Screening Test, to examine substance use patterns among patients referred for a variety of sleep complaints in a sleep disorders clinic. We found that patients who demonstrated a variety of sleep complaints were more likely to have alcohol and drug problems than those in the general populations.

Acute Disease↗
PubMed2003

Low emotional intelligence as a predictor of substance-use problems.

This study explored the relationship between low emotional intelligence and substance-use problems in adults. One hundred and forty-one participants completed the Self-Administered Alcoholism Screening Test, the Drug Abuse Screening Test, an emotional intelligence scale, and a measure of psychosocial coping. Low emotional intelligence was a significant predictor of both alcohol-related problems and drug-related problems. Poorer coping predicted drug-related problems, but not alcohol-related problems. Coping was not found to be a significant mediator between emotional intelligence and substance-use problems. Possible implications for intervention and treatment efforts are discussed.

Adaptation, Psychological↗
PubMed1986

Role of the laboratory in the evaluation of suspected drug abuse.

Despite the high incidence of substance abuse, it remains a common cause of misdiagnosis. In patients who have abused or who are currently abusing drugs, symptoms of a psychiatric illness may be mimicked by either the drug's presence or absence. The laboratory can aid in making a differential diagnosis and eliminating drugs from active consideration as a cause of psychosis, depression, mania, and personality changes. Treatment planning and prevention of serious medical consequences often rest on the accuracy of the admission drug screen. Testing is widely used to assess improvement in substance abuse in both inpatient and outpatient settings. In occupational settings, testing has been used as an early indicator that a problem exists and as a successful prevention tool. The appropriate use of analytic technology in drug abuse testing requires an understanding of available test methodologies. These include drug screens by thin-layer chromatography, comprehensive testing using enzyme immunoassay, and computer-assisted gas chromatography-mass spectrometry (GC-MS). Testing for specific drugs considered likely causes or precipitants of "psychiatric" complaints is available with enzyme assays, radioimmunoassay, or definitive forensic-quality testing using GC-MS.

Alcoholism↗
PubMed2003

A comparative evaluation of illicit drug use in patients with or without controlled substance abuse in interventional pain management.

The prevalence of illicit drug use by patients in a chronic pain management practice who concomitantly abuse prescription-controlled substances is not known. The purpose of this study was to determine the prevalence of illicit drug use by patients in an interventional pain management practice, based on whether or not there was evidence of simultaneous abuse of prescription drugs. One hundred and fifty patients in an interventional pain management practice who were prescribed controlled substances for pain treatment were selected for assessment of concomitant illicit drug use by urine drug testing. Patients were divided into two groups: Group I consisted of 100 consecutive patients without evidence of controlled substance abuse and Group II consisted of 50 consecutive patients with documented abuse of prescription controlled substances. All patients underwent urine testing with the Rapid Drug Screen test. The test is a one-step, lateral flow immunoassay for the simultaneous detection of four illicit drugs (i.e., amphetamine, methamphetamine, marijuana, and cocaine). Results showed a prevalence of illicit drug abuse in patients without a history of controlled substance abuse of 14%. In contrast, illicit drug abuse in patients with a history of controlled substance abuse was 34%. Marijuana was the drug of choice in both groups, with 22% in the prescription abuse group and 10% in the non-abuse group. The second most commonly used illicit drug in both groups was cocaine. This study demonstrated a clinically significant use of illicit drugs, particularly marijuana and cocaine in an interventional pain management setting, in patients with or without evidence of concomitant abuse of prescription controlled substances.

Journal Article↗
PubMedDate not supplied

Development of an in vitro multicellular tumor spheroid model using microencapsulation and its application in anticancer drug screening and testing.

In this study, an in vitro multicellular tumor spheroid model was developed using microencapsulation, and the feasibility of using the microencapsulated multicellular tumor spheroid (MMTS) to test the effect of chemotherapeutic drugs was investigated. Human MCF-7 breast cancer cells were encapsulated in alginate-poly-l-lysine-alginate (APA) microcapsules, and a single multicellular spheroid 150 mum in diameter was formed in the microcapsule after 5 days of cultivation. The cell morphology, proliferation, and viability of the MMTS were characterized using phase contrast microscopy, BrdU-labeling, MTT stain, calcein AM/ED-2 stain, and H&E stain. It demonstrated that the MMTS was viable and that the proliferating cells were mainly localized to the periphery of the cell spheroid and the apoptotic cells were in the core. The MCF-7 MMTS was treated with mitomycin C (MC) at a concentration of 0.1, 1, or 10 times that of peak plasma concentration (ppc) for up to 72 h. The cytotoxicity was demonstrated clearly by the reduction in cell spheroid size and the decrease in cell viability. The MMTS was further used to screen the anticancer effect of chemotherapeutic drugs, treated with MC, adriamycin (ADM) and 5-fluorouracil (5-FU) at concentrations of 0.1, 1, and 10 ppc for 24, 48, and 72 h. MCF-7 monolayer culture was used as control. Similar to monolayer culture, the cell viability of MMTS was reduced after treatment with anticancer drugs. However, the inhibition rate of cell viability in MMTS was much lower than that in monolayer culture. The MMTS was more resistant to anticancer drugs than monolayer culture. The inhibition rates of cell viability were 68.1%, 45.1%, and 46.8% in MMTS and 95.1%, 86.8%, and 91.6% in monolayer culture treated with MC, ADM, and 5-FU at 10 ppc for 72 h, respectively. MC showed the strongest cytotoxicity in both MMTS and monolayer, followed by 5-FU and ADM. It demonstrated that the MMTS has the potential to be a rapid and valid in vitro model to screen chemotherapeutic drugs with a feature to mimic in vivo three-dimensional (3-D) cell growth pattern.

Breast Neoplasms↗
PubMed2000

[Detection of methamphetamine in a severely burned cadaver--a case report].

We report an autopsy case of a severely burned cadaver in which methamphetamine (MA) and amphetamine (A) were detected. A severely burned cadaver was found in a burned-out car on the seashore. At the autopsy, the drug screening test in the urine using Triage system gave positive result for MA and/or A. Qualitative analysis by gas chromatography/mass spectrometry (GC/MS) confirmed the presence of MA and A. The concentrations of MA and A (mumol/100 g) were 1.66 in the thermo-coagulated blood, 16.3 in the urine, 4.60 in the cerebrum, 4.11 in the lung, 7.84 in the liver, 0.94 in the skeletal muscle and 0.54 in the bone marrow. From these results, we concluded that the man had been under the moderate MA and A intoxication. The cause of death was diagnosed as the death of fire on the basis of autopsy findings, and the cadaver was identified as the owner of the car by the DNA typing. This case indicated the importance of drug screening tests in autopsy cases. Furthermore, the qualitative and quantitative analysis of MA and A should be successfully performed by GC/MS even in the case of severely burned cadaver.

Adult↗
PubMed2006

Advances and perspectives in Leishmania cell based drug-screening procedures.

Efforts for the development of new therapeutics, essential for the control of leishmaniasis rely mainly on screening of potentially effective compounds in pathogen growth/multiplication assays, both in vitro and in vivo. Screenings designed to closely reflect the situation in vivo are currently labor-intensive and expensive, since they require intracellular amastigotes and animal models. Screenings designed to facilitate rapid testing of a large number of drugs are not performed on the clinically relevant parasite stage, but the promastigotes. The ability to select transgenic Leishmania expressing reporter proteins, such as the green fluorescent protein (GFP) or the luciferase, opened up new possibilities for the development of drug screening tests. In this review we will focus on available methodologies for direct drug screening purposes against the mammalian stage of the parasite, with emphasis on the future developments that could improve sensitivity, reliability, versatility and the throughput of the intracellular model screening.

Animals↗