Menu Global The Importance of Evidence-Based Medicine in Point-of-Care Testing African First Ladies Mobilize to End Transmission of Mother-to-Child HIV and Syphilis Call for Action in Acute Heart Failure: “Time is Life!” Allaying Employees' Concerns About Workplace Drug Testing Antimicrobial Resistance: Getting Straight to the Point! about Rapid CRP Testing in Primary Care Overcoming the screening challenges of new psychoactive substances Comprehensive Diabetes Patient Care Program Yields Measureable Results Fighting the Growing Threat of Antimicrobial Resistance Zika Virus: A Growing Public Health Threat Reflecting on Progress in Total Analytical Error Reduction in Diagnostic Tests Strengthening Referrals and Linkages in Swaziland Designer Stimulant Testing: A Fast Moving Target Left Behind in the Global Response to HIV Eliminating Malaria in India New Guidance for Physicians for Accurately Diagnosing C. difficile Infection Clinicians Gather to Encourage Point-of-Care Testing in Latin America Diagnostics at Davos: A Call to Deploy POCT to Address the Tolls of Antimicrobial Resistance RSV. It’s Not Just for Kids Anymore! Improving Type 2 Diabetes and Hypertension Services in Honduras The Global Threat of Drug-Resistant Tuberculosis – Are We Doing Enough? Workplace Policies for Prescription Drugs Diagnosis and Management of the Diabetes Epidemic in the Pacific Islands Diagnostic Access in Africa: The Evolution of HIV Point-of-Care Testing in Uganda The Benefits of Pre-Employment Drug Testing The Expanded Role for Australian Community Pharmacy in Chronic Disease Management Shifting Paradigms in Connectivity: How Knowledge Management Can Strengthen Point of Care Programs VTE Cardiometabolic Services Legionnaire's Disease Influenza (Flu) Malaria Mononucleosis MRSA Mumps Pneumonia RSV S. aureus Strep A pharyngitis Streptococcus pneumoniae Syphilis C-reactive Protein Diagnostic Tests Tuberculosis Other Infectious Disease Alere Influenza A & B Test Alere NMP22 Alere PBP2a Alere Pima CD4 Alere q Alere TestPack Alere Toxicology Alere Triage Clearview epoc NycoCard TECHLAB Additional Brands SD BiOLINE TECHLAB Home Viewpoints Overcoming the screening challenges of new psychoactive substances Viewpoints Insight 08/12/16 Overcoming the Screening Challenges of New Psychoactive Substances The “designer drug” (referred to as new psychoactive substances or NPS by government agencies) phenomenon started decades ago with the development and production of drugs that mimic the effects of controlled drugs (such as amphetamines, cocaine, cannabis and heroin) but avoid legislation based on different chemical structures. There are now hundreds of such substances available via the Internet and they create a number of global analytical and legislative challenges. The laboratory challenge is focused on the detection and identification of a variety of chemical structures that are associated with NPS. Immunological techniques that have been successful for screening traditional drugs require significant redesign for NPS. Presumptive detection requires the use of specific and selective techniques such as gas or liquid chromatography with mass-spectrometry for accurate identification, especially in a forensic and medicolegal setting. The challenge of these techniques revolves around the choice of targeted (specific) or non-targeted (more general) analytical screening procedures. Targeted techniques use increased specificity to detect NPS present at very low concentrations, which is a necessary requirement for analysis of synthetic cannabinoids and other potent NPS such as LSD derivatives and other drugs with hallucinogenic effects. Non-targeted techniques allow for the detection of a very wide range of substances but can be inhibited by sensitivity, which is not always a problem for many NPS as many users ingest significant doses. Consequently, the laboratory will select the most appropriate analytical techniques, and may use a combination of them to ensure effective analysis of NPS. Newer techniques involving high resolution mass spectrometry to measure mass assist with elucidation of chemical structures, including metabolites in blood and urine. In recent years, the increasing use of NPS has meant that detection now needs to be conducted in a number of different settings, from drug abuse clinics to post-mortem and criminal casework. The fact that NPS are challenging to detect has made them the drug of choice in certain situations, including workplace or prison environments. However, improvements in detection capabilities and screening tools, as well as increased awareness of NPS, have improved detection of these substances. This is especially important when determining their role in deaths, which may have previously been missed or underestimated. The presence of multiple drugs (including other NPS) presents additional analytical as well as interpretative challenges to toxicologists. Although there has been an increase in the number of NPS that have been internationally controlled, there have also been changes in national legislative approaches. Specifically, whilst there has been some generic control based on analogue or chemical similarities, some countries (most recently the UK) have applied legislation based on the psychoactive effect rather than chemistry alone. The effectiveness and outcomes of this approach will be interesting to monitor. Regardless of the legislative method employed by a country, an appropriate and effective laboratory testing protocol can positively support the ultimate goal of identifying and controlling NPS. Workplace Substance abuse Illicit drugs Drug abuse Laboratory Simon Elliott Consultant Forensic Toxicologist, Alere Forensics Related Articles View all Insight The Benefits of Pre-Employment Drug Testing July 19, 2017 Insight Workplace Policies for Prescription Drugs May 31, 2017 Simon Elliott Consultant Forensic Toxicologist, Alere Forensics Select a Topic Insight Innovation Impact Featured Articles: Shifting Paradigms in Connectivity: How Knowledge Management Can Strengthen Point of Care Programs The Expanded Role for Australian Community Pharmacy in Chronic Disease Management The Benefits of Pre-Employment Drug Testing Diagnostic Access in Africa: The Evolution of HIV Point-of-Care Testing in Uganda Diagnosis and Management of the Diabetes Epidemic in the Pacific Islands Workplace Policies for Prescription Drugs Sign Up for Email Updates How much is: Answer: Submit About People & Culture Corporate Responsibility Alere Stories News & Events Our History Alere Locations Viewpoints Products & Services Cardiometabolic Infectious Disease Toxicology Other Browse by Brand Solutions Investors Annual Meetings & Reports SEC Filings & Financials Financial Releases Corporate Governance Presentations & Events Contact Information Support Contact Us Product Document Search Product Demos Laboratory Test Support Resources Medical Webinars Discover how our innovative diagnostics deliver reliable and actionable information. Alere-epoc.com Alere-i.com TestTargetTreat.com Contact Us Product Document Search Careers ©2010-2017 Alere. All rights reserved. The Alere Logo and Alere are trademarks of the Alere group of companies. All other trademarks referenced are trademarks of their respective owners. This website is governed by applicable U.S. laws and governmental regulations. The products and information contained herewith may not be accessible in all countries, and Alere takes no responsibility for such information which may not comply with local country legal process, regulation, registration and usage. Your use of this website and the information contained herein is subject to our Website Terms and Conditions and Privacy Policy. Photos displayed are for illustrative purposes only. Any person depicted in such photographs is a model. California Transparency in Supply Chains Act | Declaration for California Compliance Law Alere - A Leader in Rapid Point-of-Care Diagnostics.