Introduction to Drugs of Abuse Testing

Tai C. Kwong, PhD

Contents

1.

Introduction

2.

Specimen Matrices

3.

Urine Drug Testing Processes

4.

Confirmation Tests

5.

Onsite Testing

6.

Urine Collection

7.

Testing for drugs of abuse for clinical or forensic purposes has become a significant service of a toxicology laboratory. This chapter will summarize the basic practice of the various technical processes of drug testing, from specimen collection to analysis and reporting. Although urine remains the primary test specimen, the advantages and disadvantages of performing testing on alternate specimen matrices (hair, oral fluid, and sweat) will be discussed. The importance of initial test immunospecificity on test accuracy will be examined for the common drug groups. The need for confirmation will be discussed and the basic principles of mass spectrometry including gas chromatography-mass spectrometry, liquid chromatography-mass spectrometry, and tandem mass spectrometry will be presented.

Key Words: Abused drugs; alternative specimens; GC-MS; immunoassays; urine testing.

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