25 Years of Drug Testing and its Technical and Clinical Future
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Transcript of 25 Years of Drug Testing and its Technical and Clinical Future
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David Martin, Ph.D.
25 Years of Drug Testingand its
Technical and Clinical Future
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www.questdiagnostics.com
25 Years of Drug Testing and its Technical and Clinical Future
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Drug Testing Emerging Technologies
20121992
12 MILLION DRUG TESTS
5 MILLION MANDATED DRUG TESTS
FRAGMENTED AND NON-CENTRALIZED IT
200+ MILLION DRUG TESTS
15 MILLION MANDATED DRUG TESTS
CONSOLIDATED AND CENTRALIZED IT
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SalivaSaliva
Urine
Saliva-Urine-Hair Drug Tests Saliva-Urine-Hair Drug Tests
Time:Time:
Cut off
Hair
Hours Hours DaysDays Months
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Hair Drug Testing
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Instant Urine Drug Testing Kits Instant Urine Drug Testing Kits
ALERE TOXICOLGY SYSTEMS
PRINCETON BIOMEDICA (PBM)
SYVA RAPID TEST
ACCUSIGN
STATUS
ABI TESTCUP
BIO SITE TRIAGE
> 70 KITS ON MARKET
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Saliva Drug Testing
SIMILAR TO BLOOD
IMPAIRMENT TESTING
INSTANT TESTING LABORATORY TESTING
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Anti-Drug Testing Products
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BREATH ALCOHOL TESTING
• Breathalyzer - Uses a chemical reaction involving alcohol that produces a color change
• Intoxilyzer - Detects alcohol by infrared (IR) spectroscopy
• Alcosensor III or IV - Detects a chemical reaction of alcohol in a fuel cell NHTSA
• Urine, Hair, Blood Spot –urine ETG/ETS for zero tolerance, PeTH binge monitoring,
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SPORTS PRESCRIPTION DRUG ABUSE
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“COCAINE PLUS” Additives
• PHENACETIN: a cancer causing pain reliever • DILTIAZEM: a cardiac medicine • ANFEPRAMONA: similar to amphetamine• BENZOCAINA: a local anesthetic• LIDOCAINA: a local anesthetic• LEVAMISOL: used to expel parasitic worms • HYDROXYZINE: an antihistamine
• “HEROIN PLUS”, “METH PLUS”, “MARIJUANA PLUS”……
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EXTENDED 10 DRUG CLASS PANEL
• Amphetamines– Amphetamine– Methamphetamine– MDA– MDMA– MDEA
• Cocaine• Opiates
– Codeine– Morphine– Hydrocodone– Hydromorphone– 6-MAM
• Oxycodone– Oxymorphone
• PCP• Marijuana
• Barbiturates– Butabital– Amobarb– Pentobarb– Secobarb– Phenobarb
• Methadone• Propoxyphene
• Benzodiazepines– Oxazepam– Nordiazepam– Temazepam– Lorazepam– Flurazepam– Nitrazepam– Triazolam– Alprazolam– Flunitrazepam– Midazolam– Clonazepam
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SUMMARY
• BEST PRACTICES: LAB ON ADMISSION, BAC
• HAIR, SALIVA AND URINE= DRUG HISTORY
• INSTANT IN TREATMENT, PASSES AND OUTPATIENT
• PRESCRIPTION MEDICATION, SYNTHETICS
• VARY THE DRUGS TESTED - LAB AND INSTANT
• NEW TECHNOLOGIES LC/MS/MS, NANO, CLOUD
• TREAT PATIENT NOT THE TEST