The opioid epidemic has only gotten worse since the advent of covid-19, with some areas in the United States reporting a 50% increase in drug overdoses during the pandemic. With no end in sight to this public health crisis, scientific sessions during the virtual 2020 AACC Annual Scientific Meeting & Clinical Lab Expo explored the integral role of clinical laboratories in efforts to manage it, as well as the latest drug tests needed to do so.
The Role of Labs on the Frontline of the Crisis
Synthetic opioids are responsible for nearly half of the drug overdoses in the United States, yet many of these drugs aren’t included in standard drug testing panels and new synthetic drugs are emerging every year. In the session, “Avoiding the Bleeding Edge of the Opioid Epidemic,” three experts from the leading forensic and clinical laboratory NMS Labs—Frederick Strathmann, PhD; Donna Papsun, MS, D-ABFT-FT; and Alex Krotulski, PhD—explained how labs’ toxicology expertise is central to making sure that drug testing keeps pace with these rapidly evolving trends. In particular, this session underscored the power of partnerships between laboratories and federal agencies to monitor the latest designer drugs, as well as the critical role that labs play in keeping these agencies informed about new drugs as they come on the scene.
“What we want attendees to take away from this session is the complexity associated with labs keeping up with the latest drug trends,” says Strathmann. “Also, how strong of a partnership there is amongst labs, public agencies, and private agencies to make sure we are doing what we can to stop the opioid epidemic.”
The Best Tests for Combating the Opioid Epidemic
In a second session, “Fentanyl and Fentanyl Analogs: From Overdose to Outbreaks to Laboratory Detection,” toxicology experts Sarah Riley, PhD, of St. Louis University, and Kara Lynch, PhD, of the University of California San Francisco, took an even deeper dive into the ongoing fight against deadly synthetic opioids such as fentanyl and fentanyl analogs, with a focus on what the most effective methods are for detecting these drugs. Riley and Lynch explained how each of the major drug testing methods work, and provided insight into why the most common type of drug test—the immunoassay—is no longer sufficient to meet the unique challenges of the opioid epidemic. They also discussed how labs can improve their testing capabilities with more advanced methods such as mass spectrometry and quadrupole time-of-flight mass spectrometry.
“We hope to make it evident that immunoassay platforms are just not able to keep up with the everchanging drug trends that we are seeing now, and present approaches for laboratories to either expand testing or collaborate with colleagues to keep up with drug trends,” says Riley.
Other breaking research on the opioid epidemic presented at the 2020 AACC Annual Scientific Meeting included a study on a new urine test for fentanyl analogs. The meeting also featured a second study that looked at response to opioid analgesia in patients at three hospitals, and found that interactions between opioids and certain prescription drugs increases the risk of opioid addiction.
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