EDITORIAL: Analytical Challenges in Drugs of Abuse Testing

Abstract

Drugs of Abuse (DOA) group includes drugs ranging from therapeutic drugs e.g., benzodiazepines, opioids to illegal drugs e.g., Phencyclidine, lysergic acid diethylamide etc. Prevalence of DOA is on the rise in our society.¹ According to United Nations Office of Drugs and Crime(UNODC) there are 6.7million drug users in Pakistan which also happens to be the largest consumer of heroin in south east Asia.²  Besides addiction, drug abuse is linked to a variety of health problems, including HIV/AIDS, cancer, heart disease, and many more. It is also linked to homelessness, crime, and violence. In essence, DOA addiction is costly to both individuals and society. Keeping in view the increasing use of DOA in our society, its testing has become an indispensable service in modern laboratories and many large or medium sized medical laboratories in Pakistan are involved in DOA testing. From emergency departments and workplace compliance programs to pain management clinics and forensic investigations, laboratories play a central role in detecting these drugs that can impair judgement, threaten safety or contribute to morbidity and mortality. However, as new patterns of substance of abuse evolve and analytical technologies advance, laboratories face mounting scientific, operational, ethical and regulatory challenges in delivering accurate and clinically meaningful results. One of the most pressing challenges is the rapid proliferation of new psychoactive substances leading to shifting in patterns of drug abuse.³ Synthetic cannabinoids, designer stimulants, novel benzodiazepines and synthetic opioids like fentanyl analogues have complicated traditional testing paradigms. Standard immunoassay screening panels that are designed to detect common drugs like opiates, cannabinoids, cocaine, amphetamines, benzodiazepines and barbiturates often fail to identify newer compounds or cross react unpredictably. This puts the laboratories under pressure to develop and validate methods for the new drugs that have joined the DOA menu.........................