Hallucinogens

5.1. Lysergic Acid Diethylamide

Lysergic acid diethylamide (LSD) is a hallucinogenic substance that has been abused since the 1960s. The effects begin 20-80 min after oral administration and last approximately 3-4 h. Physiological effects include an increase in heart rate and blood pressure, lacrimation, salivation and pupillary dilatation. Subjective effects include mental disorientation, euphoria, altered sensory perception and hallucinations (24).

The plasma half-life of LSD is about 3h. A number of metabolites have been detected in the urine following LSD use. The major urinary metabolite appears to be 2-oxo-3-hydroxy LSD. Desmethyl LSD (nor LSD) is also a minor metabolite (25).

To detect LSD use, there are a number of commercially available assays. Each is designed to target parent drug at a concentration of 0.5 ng/mL (Table 4). However, most clinical laboratories do not include LSD testing as part of their immunoassay panel. Even if an immunoassay for LSD is performed, the window of detection following last use is in terms of hours as opposed to days for most abused drugs. In addition, LSD is heat and light sensitive such that a loss of drug may occur while the specimen is in storage. As a result, a negative result does not preclude prior use of LSD (24).

There are a number of chromatographic techniques available for LSD analysis, either as a screening technique or as a confirmation technique for a positive screening result. Gas chromatography without a mass spectrometer as a detector or high performance liquid chromatography (HPLC) with an ultraviolet detector lacks the sensitivity to detect LSD or its metabolites. Because of its native fluorescence, HPLC with a

Table 4

LSD Commercially Available Immunoassays'1

Table 4

LSD Commercially Available Immunoassays'1

Assay

% Reactivity

Calibrator

Cutoff concentration

Intended specimen types

CEDIA® Opiate Assay

100%

LSD

0.5 ng/mL

Urine

Emit® II LSD Assay

100%

LSD

0.5 ng/mL

Urine

Immunalysis LSD

100%

LSD

0.5 ng/mL

Whole blood, oral

Direct ELISA

fluids, serum,

plasma, urine

a Data from manufacturer package inserts. LSD, lysergic acid diethylamide.

a Data from manufacturer package inserts. LSD, lysergic acid diethylamide.

fluorescence detector can be utilized. HPLC-MS can also be used without derivati-zation. When gas chromatography/mass spectrometry is used, a derivatization step is required; the most common derivative formed is the trimethylsilyl derivative. Tandem mass spectrometry, either attached to a gas chromatography or HPLC, offer the best chance to detect LSD, but these technologies are generally not available routinely to a clinical laboratory (24).

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