scholarly journals Cocaine use and dependence in clients attending a drug treatment centre in Dublin

2009 ◽  
Vol 33 (3) ◽  
pp. 88-91
Author(s):  
Mpho Abel Thula
Keyword(s):  
Drug Testing ◽  
Addiction Treatment ◽  
Cocaine Dependence ◽  
Cocaine Addiction ◽  
Publicly Funded ◽  
Behavioural Treatment ◽  
Urine Drug Testing ◽  
Proven Efficacy ◽  
Urine Drug ◽  
Treatment Centre

Aims and MethodTo assess the number of cocaine-dependent clients attending a typical addiction clinic, using urine drug testing for screening and a structured clinical interview for diagnostic assessment.ResultsOf the 419 clients whose urine records were analysed, 38 were regular users of cocaine (9.1%), with at least half of their urine samples positive for cocaine in a 12-week period; 84.2% of these regular users of cocaine satisfied the criteria for cocaine dependence (7.7% of the total number of those attending the clinic).Clinical ImplicationsPublicly funded addiction treatment centres in Ireland are mostly designed for the treatment of opiate addiction. There is, however, a significant problem of concomitant cocaine dependence in these centres. Increased availability of psychological/behavioural treatment programmes with proven efficacy in cocaine addiction may help improve overall treatment outcome.

Trends in drug use from urine drug testing of addiction treatment clients

2015 ◽  
Vol 11 (1) ◽  
Author(s):  
Kenneth L. Kirsh, PhD ◽  
Howard A. Heit, MD ◽  
Angela Huskey, PharmD, CPE ◽  
Jennifer Strickland, PharmD, BCPS ◽  
Kathleen Egan City, MA, BSN, RN ◽  
...  
Keyword(s):  
Drug Use ◽  
Drug Testing ◽  
Addiction Treatment ◽  
National Laboratory ◽  
Prescription Medication ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Liquid Chromatography Tandem Mass ◽  
Testing Company ◽  
National Trends

Objective: Urine drug testing (UDT) can play an important role in the care of patients in recovery from addiction, and it has become necessary for providers and programs to utilize specific, accurate testing beyond what immunoassay (IA) provides.Design: A database of addiction treatment and recovery programs was sampled to demonstrate national trends in drug abuse and to explore potential clinical implications of differing results due to the type of testing utilized.Setting: Deidentified data was selected from a national laboratory testing company that had undergone liquid chromatography tandem mass spectrometry (LCMS/MS).Patients/Participants: A total of 4,299 samples were selected for study.Interventions: Descriptive statistics of the trends are presented. Results: In total, 48.5 percent (n = 2,082) of the samples were deemed in full agreement between the practice reports and the results of LC-MS/MS testing. The remaining 51.5 percent of samples fell into one of seven categories of unexpected results, with the most frequent being detection of an unreported prescription medication (n = 1,097).Conclusions: Results of UDT demonstrate that more than half of samples yield unexpected results from specimens collected in addiction treatment. When comparing results of IA and LC-MS/MS, it is important to consider the limits of IA in the detection of drug use by these patients.

scholarly journals Fingerstick Plasma Drug Testing of Chronic Pain Patients: Comparison of Paired Fingerstick Plasma and Urine Specimens

2020 ◽  
Vol 5 (1) ◽  
pp. 5-10
Author(s):  
MP George ◽  
◽  
Roza George ◽  
Jessica Almonds ◽  
◽  
...  
Keyword(s):  
Drug Testing ◽  
Addiction Treatment ◽  
Illicit Drugs ◽  
Complete Agreement ◽  
Current Standard ◽  
Perfect Agreement ◽  
Limit Of Quantitation ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Urine Specimens

Aim A clinical study was conducted to evaluate fingerstick blood as a viable biological matrix for monitoring prescription and illicit drugs in a clinical setting on patients undergoing pain and addiction treatment. The current standard for monitoring patients’ medication use, misuse, and diversion is urine drug testing (UDT). Materials and Methods This study compared 632 paired urine and fingerstick blood specimens collected at three pain management clinics and one suboxone clinic for 35 drugs and/or metabolites. Plasma from the fingerstick blood was used for the analysis. The urine and plasma specimens were analyzed by validated liquid chromatography–tandem mass spectrometry (LC-MS-MS) procedures. The urine cutoff used by most pain testing laboratories were used to identify positive and negative drugs in urine. Limit of quantitation was used to identify positive and negative drugs in plasma. Drugs and/or metabolites were quantified in both urine and plasma using deuterium-labeled internal standards. Results Results were tabulated for urine and plasma specimens for data analysis. The results showed that 8.7% of plasma specimens detected more drugs compared to the corresponding urine specimens, and 2.2% of the urine specimens detected a drug that was negative in the corresponding plasma specimen. Overall 89.1% of the specimens had complete agreement between urine and plasma specimens for detection. The observed Cohen’s Kappa value for overall drug detection was 0.96 an “almost perfect” agreement as characterized by Landis and Koch. Conclusion Based on the observed data, the authors conclude that plasma collected from fingerstick blood is a better matrix to monitor patients currently prescribed pain medications or patients currently undergoing medication-assisted opioid treatment compared to urine drug testing.

Analytical and technical aspects of testing for drug abuse: confirmatory procedures.

1988 ◽  
Vol 34 (3) ◽  
pp. 471-473 ◽  
Author(s):  
M A Peat
Keyword(s):  
Drug Testing ◽  
Analytical Procedure ◽  
Gas Chromatography Mass Spectrometry ◽  
Technical Aspects ◽  
Governmental Agencies ◽  
Accuracy And Precision ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Chemical Technique ◽  
Layer Chromatography

Abstract Many laboratories are now performing urine drug testing for employers, governmental agencies, and other institutions. It is now recognized that presumptive positive screening results have to be confirmed by an analytical procedure based on a different chemical technique with greater than or equal sensitivity to the screening test. Thin-layer chromatography has been widely used for this; however, it is relatively insensitive for certain drugs, and it cannot satisfy the accuracy and precision requirements needed to determine threshold concentrations reliably. Gas chromatography-mass spectrometry is able to satisfy these threshold requirements and has become the method of choice for confirming initial immunoassay results.

Buprenorphine not detected on urine drug screening in supervised treatment

2021 ◽  
Vol 17 (7) ◽  
pp. 69-76
Author(s):  
Nazila Jamshidi, MBBS, FRACP, FAChAM, BPharm (hons), PhD ◽  
Akshay Athavale, MBBS, FRACP, BPharm (hons), MMed ◽  
Bridin Murnion, MBChB, FRACP, FFPMANZCA, FAChAM
Keyword(s):  
Cytochrome P450 ◽  
Child Protection ◽  
Drug Testing ◽  
Addiction Treatment ◽  
Clinical Decision ◽  
Gas Chromatography Mass Spectrometry ◽  
Cytochrome P450 3A4 ◽  
Opioid Agonist ◽  
Detection Rates ◽  
Urine Drug

Introduction: Urine drug screens (UDS) assist in clinical planning and assessment of adherence in opioid agonist treatment (OAT). Urine drug screens may also be used in criminal justice and child protection settings. Buprenorphine (BPN) UDS testing is complex. Immunoassay often does not detect BPN and gas chromatography-mass spectrometry (GC-MS) is needed. A limited understanding of testing can negatively influence UDS interpretation and clinical decision making.Objectives: The primary aim was to determine detection rates of BPN in UDS in participants on BPN or buprenorphine/naloxone (BNX) treatment. The secondary aim was to identify if comorbidities, sex, co-prescribed medications, or dosing site and observation were associated with BPN detection.Setting: Public outpatient clinic in a specialist addiction treatment service.Design/participants: In this retrospective observational study, records of clients on supervised BPN/BNX treatment between September 2017 and 2018 were reviewed.Measures: Data extracted included UDS results, age, sex, indication for BPN, frequency of observed doses, dose of BPN, dosing site, co-morbid medical conditions, and medications.Results: One hundred and sixty-one medical records were reviewed. Ninety-seven (60 percent) underwent screening urine immunoassay. Of these 97, 51 (53 percent) had further GC-MS testing for BPN of which 22 (43 percent) did not detect BPN despite directly observed OAT. Co-prescription of medications known to interact with cytochrome P450 3A4 was associated with nondetection of BPN (p 0.05). No significant association between median dose, dosing site, and observed dosing and BPN detection was identified.Conclusion: Urine drug testing for BPN is complex. Failure to detect BPN does not betoken nonadherence to treatment and is associated with co-prescription of drugs interacting with cytochrome P450 3A4.

Use of LC-HRMS in full scan-XIC mode for multi-analyte urine drug testing - a step towards a ‘black-box’ solution?

2017 ◽  
Vol 52 (8) ◽  
pp. 497-506 ◽  
Author(s):  
N. N. Stephanson ◽  
P. Signell ◽  
A. Helander ◽  
O. Beck
Keyword(s):  
Drug Testing ◽  
Black Box ◽  
Urine Drug Testing ◽  
Urine Drug ◽  
Full Scan

Estimating the Prevalence of Opiates Use by Unlinked Anonymous Urine Drug Testing: A Pilot Study in Iran

2008 ◽  
Vol 43 (3-4) ◽  
pp. 513-520 ◽  
Author(s):  
Nouzar Nakhaee ◽  
Kouros Divsalar ◽  
Manzume Shamsi Meimandi ◽  
Shahriar Dabiri
Keyword(s):  
Pilot Study ◽  
Drug Testing ◽  
Urine Drug Testing ◽  
Urine Drug
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