Point-of-Care Drug of Abuse Testing in the Opioid Epidemic

Context.— The United States is experiencing an opioid overdose epidemic. Point-of-care (POC) drug of abuse testing is a useful tool to combat the intensified opioid epidemic. Objectives.— To review commercially available POC drug of abuse testing involving opioids, to review opportunities and challenges for POC opioid testing and emerging testing methods in research literature, and finally to summarize unmet clinical needs and future development prospects. Data Sources.— The Google search engine was used to access information for commercial opioid POC devices and the Google Scholar search engine was used to access research literature published from 2000 to 2019 for opioid POC tests. Conclusions.— The opioid epidemic provides unprecedented opportunities for POC drug testing, with significant clinical needs. Compared with gold standard tests, limitations for commercially available opioid POC testing include lower analytical sensitivity, lower specificity, and cross-reactivity. In response to unmet clinical needs, novel methods have emerged in research literature, such as microfluidics and miniature mass spectrometry. Future prospects include the development of quantitative POC devices and smarter and real-time drug testing.