Cur r e nt T r e nds in Can you find out De te c table Dr ugs - - PDF document

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Cur r e nt T r e nds in De te c table Dr ugs

Pe te r Bowr

• n

T

• xic ology Unit - PaL

MS

Can you find out what dr ugs the patie nt has take n? Dr ug Analysis

• Rapid T

e sts

• AS 4308
• Routine Clinic al
• Br
• ad Base d

PaL MS T e sting

• Appr
• ximate ly 130,000
• Half “T

ar ge te d”

• Half “Br
• ad te sting”

T e c hnique s

• Immunoassays
• HPT

L C

• T

ar ge te d GC/ MS

• Br
• ad Sc r

e e n GC/ MS

HPT L C

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Data L imitations

• Pe r

sample not patie nt

• Diffe r

e nt c linic pr

• toc ols
• L
• ng half-life vs. shor

t

• What’s on the list?
• How muc h is pr

e sc r ibe d?

1000 2000 3000 4000 5000 6000 7000 8000 9000 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Morphine MethAmp

“Sle e ping Pills”

• Bar

bitur ate s

• Me thaqualone
• Be nzodiaze pine s
• Mor

e Be nzodiaze pine s

• Z-Dr

ugs

20 40 60 80 100 120 140 160 180 1998 2000 2002 2004 2006 2008 2010 2012

Nitrazepam

50 100 150 200 250 300 350 1998 2000 2002 2004 2006 2008 2010 2012

Flunitrazepam

100 200 300 400 500 600 700 800 1998 2000 2002 2004 2006 2008 2010 2012

Clonazepam

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200 400 600 800 1000 1200 1400 1998 2000 2002 2004 2006 2008 2010 2012

Alprazolam

200 400 600 800 1000 1200 1400 1998 2000 2002 2004 2006 2008 2010 2012

Alprazolam Nitrazepam Flunitrazepam Clonazepam

Dr ugs in Pr isons

1427 2014 Illic it T he r ape utic

Pr isons 11-12

200 400 600 800 1000 1200 Ca n Bup Mir taz MA Alpr az Oxaz Morph Mdn Clonaz Que t

200 400 600 800 1000 1200 1400 1600 1800 1998 2000 2002 2004 2006 2008 2010 2012

Mirtazepine

200 400 600 800 1000 1200 1998 2000 2002 2004 2006 2008 2010 2012

Quetiapine

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50 100 150 200 250 300 350 400 450 500 1998 2000 2002 2004 2006 2008 2010 2012

Oxycodone

What ar e we missing? Spe c ial T e sts

• Ke tamine
• F

e ntanyl

• Bupr

e nor phine

Challe nge s

• L

SD

• Ste r
• ids
• Spic e
• De signe r

Amphe tamine s