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A Single Method for 127 Recommended and Additional DUID Drugs in Blood and Urine by LC-MS/MS.

Megan FarleyHelena TranSteven TowlerJirair GevorkyanSue PearringLuke N Rodda
Published in: Journal of analytical toxicology (2021)
Driving under the influence of drugs (DUID) cases continue to challenge forensic toxicologists as both the volume and complexity of casework increases. Comprehensive DUID testing should also meet the drafted ASB/ANSI standard and the NSC-ADID recommendations. A simple method using protein precipitation followed by filtration extraction with an 8-minute run time by LC-MS/MS was developed, and a comprehensive ASB/ANSI validation performed. Assessed in blood quantitatively, and urine qualitatively, is 127 target drug and metabolite analytes including cannabinoids (12), amphetamines (11), cocaine and metabolites (6), benzodiazepines (36), Z-drugs (5), opioids (27), anticonvulsants (3), first-generation antihistamines (6), muscle relaxants (2), dissociatives and hallucinogens (6), barbiturates (10), and miscellaneous substances (3). Limits of detection are appropriate for DUID, and other forensic casework such as drug-facilitated crime (DFC) and postmortem investigations. To demonstrate applicability, 78 proficiency test blood and urine samples, and 1,645 blood and urine samples from authentic cases samples demonstrated effective detection of target analytes in forensic casework. By increasing the analytical scope of multiple drug classes via a single method, this technique detects drugs that may have previously gone undetected, such as flualprazolam, etizolam, mitragynine, gamma-hydroxybutyric acid, and psilocin, and improves laboratory efficiency by reducing the number of tests required. The described method is, to the authors' best knowledge, the only published single procedure to meet all drugs listed in the drafted ASB/ANSI standard, and recommended Tier 1 and traditional drugs from Tier 2 for DUID screening, whilst also achieving many drugs recommended for DFC and postmortem testing.
Keyphrases
  • drug induced
  • healthcare
  • chronic pain
  • randomized controlled trial
  • clinical practice