Posted on: 6 September 2016
Whether you are considering using new equipment in your current toxicology lab or are an employer who is making decisions regarding the lab you use for drug screenings, the use of mass spectrometry (MS) can have an influence over your decision. MS has several clear advantages over the use of assays in various types of toxicology laboratories and for drug screenings.
Differentiation Between Similar Compounds
With many prescription medications on the market, especially those used for pain, it can be difficult to differentiate between medicinal products and illicit drugs with standard bioassays. For example, opiates can include illicit drugs, such as heroin, or prescription drugs, such as morphine or codeine. MS will give you the ability to know the exact chemical compound found in your specimen and if the information matches that of prescribed medications.
Making the distinction between compounds also works well for pain management facilities that heavily rely on drug screenings as part of their contractual agreement with patients. For example, your patient may be prescribed a narcotic pain reliever. According to standard drug screenings, they may have an opiate in their system, as expected. Upon further investigation, you may determine they have been taking a similar narcotic pain reliever, not their prescribed one. Knowing this information can raise concerns about how fast they are taking their prescribed medication and how they are acquiring a different one.
Reduction Of False Positives
Just as differentiating between similar compounds can help medical practitioners make better decisions about treating patients, MS can reduce false positives in medical, forensic, or work-related circumstances. Some chemical compounds, such as supplements, prescribed medications, and over-the-counter medications, can give false positives on standard urine drug tests used to identify illicit drugs. One example may be the use of some nasal decongestants, which are used in the manufacturing of methamphetamines. False positives due to OTC medications and supplements can be especially troublesome because their purchase and use is harder to prove than prescriptions.
False positives may result in wasted time because you may need to secure a new sample if you do not have enough of the original sample remaining and send it to a different lab for further testing. Even worse may be false accusations that could lead to loss of employment, revocation of probation/parole, or criminal convictions. If you choose to use urine testing for drug screenings, it is best to confirm your results through MS before making any accusations. Equally as important as reducing false positives is having more confidence in your true positives. There may be circumstances where testing is more time-sensitive, such as forensic investigations where a dangerous suspect remains at-large or when the results of drug testing can help with treatment.
Standard assays do little to determine the concentration of any specific substance in a sample. For example, if an unresponsive patient is believed have taken an overdose or been poisoned, basic toxicology testing can determine whether a specific chemical compound is in their system. Since the patient may be on many medications or use drugs, this does not imply which compound is responsible for their symptoms, since any single compound may not be in a high enough concentration to be toxic. This is where MS can be critical for teasing apart which compound exists in the sample and at a toxic level. Quick testing of a sample via MS can take the guesswork out of matching symptoms to possible toxins and reduce the time between testing a sample and rendering the appropriate treatment.
Although there will always be situations when assays are appropriate and a more cost-effective method of toxicological testing and drug screening, there may be situations where the speed and accuracy of MS should be the first-line approach. By utilizing MS first in certain circumstances, you can reduce the time and costs associated with multiple tests.Share