A new partnership between the American College of Medical Toxicology (ACMT) and the Center for Forensic Science Research and Education (CFSRE) was established to comprehensively assess the role and prevalence of drugs, adulterants, NPS, and other relevant substances among suspected overdose events in the U.S.
SAMPLE SOURCE: Patients presented to EDs within the Toxicology Investigators Consortium (ToxIC) Drug Overdose Toxico-Surveillance (DOTS) Reporting Program experiencing a suspected opioid or simulant related overdose. Blood samples were obtained for testing against an expansive library of drugs and other substances. Our findings provide near real-time assessment of drug markets and allude to resulting implications on clinical and forensic institutions.
TOXICOLOGY TESTING: Analysis was performed via liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) and liquid chromatography tandem quadrupole mass spectrometry (LC-QQQ-MS). The scope of LC-QTOF-MS testing targeted more than 1,200 drugs, including a vast majority of NPS and metabolites. Drug classes included opioids, benzodiazepines, cannabinoids, stimulants, and hallucinogens, among other drugs. The LC-QQQ-MS test was quantitative, targeting fentanyl, norfentanyl, methamphetamine, amphetamine, cocaine, benzoylecgonine, xylazine, and naloxone. Additional targets included for quantitative testing were NPS of interest (e.g., bromazolam, cathinones, nitazene analogues, and others).
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