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David Martin, Ph.D.
25 Years of Drug Testingand its
Technical and Clinical Future
www.questdiagnostics.com
25 Years of Drug Testing and its Technical and Clinical Future
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
SalivaSaliva
Urine
Saliva-Urine-Hair Drug Tests Saliva-Urine-Hair Drug Tests
Time:Time:
Cut off
Hair
Hours Hours DaysDays Months
Hair Drug Testing
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
Saliva Drug Testing
SIMILAR TO BLOOD
IMPAIRMENT TESTING
INSTANT TESTING LABORATORY TESTING
Anti-Drug Testing Products
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,
SPORTS PRESCRIPTION DRUG ABUSE
“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”……
11
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
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
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