Citation

Ford LT, Berg JD. Ann. Clin. Biochem. 2016; 54(2): 219-229.

Affiliation

SWBH NSH Trust.

Copyright

(Copyright © 2016, Royal Society of Medicine Press)

DOI

10.1177/0004563216651646

PMID

27166311

Abstract

IntroductionLegal highs also known as novel psychoactive substances (NPS) mimic the effects of classic drugs of abuse. Challenges to developing screening services for NPS include identifying which NPS available to target. Using new techniques such as exact mass time of flight (TOF) can help identify common NPS to target for screening patient samples by routine methods such as tandem mass spectrometry. We demonstrate this strategy working in our own clinical toxicology laboratory after qualitative analysis of 98 suspect materials for NPS by UPLC-MS/TOF.

RESULTSFrom July 2014 to July 2015 we received 98 requests to test a range of different suspect materials for NPS including herbs, tobacco, liquids, pills and powders. Overall 87% of the suspect materials tested positive for NPS, and 15% for controlled drugs. Three common NPS were present in 74% of the suspect materials; methiopropamine a methamphetamine analogue, ethylphenidate a cocaine mimic, and the third generation synthetic cannabinoid 5F-AKB-48. For the 55 branded products we tested only 24% of the stated contents matched exactly the compounds we detected.

CONCLUSION Testing suspect materials using UPLC-MS/TOF has identified three common NPS in use in the UK, simplifying the development of a relevant NPS screening service to our population. By incorporating these into our routine liquid chromatography tandem mass spectrometry (LC-MS/MS) drugs of abuse screen, then offers a clinically relevant NPS service to our users. This strategy ensures our clinical toxicology service continues to remain effective to meet the challenges of the changing drug use in the UK.

© 2016 Sage Publications, Inc.

Language: en