engleski

Frequency of drugs of abuse testing in emergency unit

During 2004, a total of 125, 658 samples of critically ill patients were examined at Emergency Unit of the University Department of Chemistry. Of these 466 (0.37%) samples were tested for drugs of abuse in urine by EMIT method on a Viva VITALAB Dade Behring for panel of 7 drugs (amphetamines/methamphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, methadone and opiates). Of 466 urines, 322 (69%) were tested for the complete panel, and the rest of 144 (31%) were tested for target drugs. In 322 samples tested for the complete panel 139 (43%) was negative. Of the remaining 183 (57%) samples, 14 (4.3%) were positive for mphetamines/methamphetamines, 16 (4.9%) for barbiturates, 153 (47.5%) for benzodiazepines, 31 (9.6%) for cannabinoids, 8 (2.5%) for cocaine, 32 (9.9%) for methadone and 40 (12.4%) for opiates. Of 144 samples tested for target drugs, 57 (39.6%) were free from drugs. Of the remaining 5 (3.5%) were positive for amphetamines/methamphetamines, 7 (4.8%) for barbiturates, 60 (41.7%) for benzodiazepines, 3 (20.1%) for cannabinoids, 1 (0.7%) for cocaine, 2 (1.4%) for methadone, and 12 (8.3%) for opiates. Of 57 samples negative for target drug, 6 (10%) were positive for other drugs. According to NACB AACC recommendation for toxicological testing, clinical screening is performed by qualitative immunoassays in spite of their limited sensitivity and specificity. Results are reported as "probably positive" and "probably negative". Result verification by GC-MS is difficult to use in emergency service, and according to the recommendation issued by UNDCP, result confirmation is not necessary for diagnostic or therapeutic purposes. Screening tests are part of medical care and positive test results are exclusively intended for appropriate patient management, implying no legal consequences.

EMIT; drugs of abuse; urine; emergency unit

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