9.23 Drugs of Abuse

Abstract

This chapter provides a review of the use of immunoassay in tackling drug abuse. There is an introduction to the multiple situations in which tests for drugs of abuse are applied, such as drug dependence treatment centers, psychiatric clinics, medical-legal applications, and drug abuse in the workplace. There is also an introduction to the most commonly used assay technology (radioimmunoassay, enzyme-multiplied immunoassay technique, cloned enzyme donor immunoassay, enzyme-linked immunosorbent assay, fluorescence polarization and microparticle enzyme immunoassay. Other issues that are critical to drug abuse situations, such as cross-reactivity and sample adulteration are discussed. The drugs are then reviewed in individual sections with these subsections: structure, dose and modes of administration, pharmacological effects, toxic effects and assay technology. The drugs described are: amphetamine, metamphetamine, methylenedioxyamphetamine, barbiturates, benzodiazepines, buprenorphine, cannabis, cocaine, lysergic acid diethylamide, methadone, opiates, heroin, oxycodone, phencyclidine, propoxyphene, tramadol, carbohydrate-deficient transferrin and cotinine. There is a section on steroid abuse in sport, focusing on testosterone and nandralone. Finally there is a section on rapid immunoassay tests.

Contributor

With over 30 years experience in the fields of analytical toxicology and medical informatics, Dr. Alun Hutchings has worked for the NHS and NPIS during his career, and has been Consultant Analytical Toxicologist and Head of the Cardiff Toxicology Laboratories since 2001. He holds a PhD in pharmacology, and is a Chartered Scientist (CSci) and a Fellow of the Institute of Biomedical Sciences (FIBMS).  Having a particular interest in the analysis of designer drugs and legal highs, Dr Hutchings recently co-founded the WEDINOS group (Welsh Emergency Departments Investigation of Novel Substances).

This chapter includes material contributed to previous editions of The Immunoassay Handbook by Brian Widdop, previously Laboratory Director of the highly respected Medical Toxicology Unit, Guy’s and St. Thomas’ Hospital Trust, London, UK.

Keywords

Drugs of abuse, drug abuse, substance abuse, drug dependence, hallucinogen, overdose, enzyme multiplied immunoassay technique, cloned enzyme donor immunoassay, fluorescence polarization, microparticle, enzyme-linked immunosorbent assay, cross-reactivity, amphetamine, metamphetamine, methylenedioxyamphetamine, barbiturate, secobarbital, benzodiazepine, oxazepam, buprenorphine, cannabis, tetrahydrocannabinol, cocaine, lysergic acid diethylamide, methadone, opiate, morphine, heroin, opium, codeine, oxycodone, phencyclidine, propoxyphene, tramadol, alcohol, ethyl alcohol, carbohydrate-deficient transferrin, nicotine, cotinine, steroid abuse, anabolic steroid, testosterone, nandralone.

Recent Review

Saitman, A., Park, H-D., & Fitzgerald, R.L. False-positive interferences of common urine drug screen immunoassays: a review. J. Anal. Toxicol. Doi: 10.1093/jat/bku075.