Abstract

Background

NIDA’s National Drug Early Warning System (NDEWS) was established in 2014 with the mission of identifying and monitoring emerging drugs in the United States. Identification of emerging drugs has been complicated, however, by the rapid development of novel psychoactive substances such that users often cannot identify and report the drugs they have ingested. Biologic testing of urine, hair or blood is the only way to reliably identify the substances recently used. Unfortunately, the large number of up-to-date tests required is beyond the resources available to most organizations.

Methods

The DOTS study tested the feasibility of recruiting organizations to submit up to 25 de-identified urine specimens for testing for approximately 240 drugs, at no cost to them. The results were for epidemiologic purposes only and not for clinical use. Eleven sites who had questions about their patients or the results of their organization’s more limited urinalysis screens participated. These sites included drug treatment programs, medical examiners, hospitals and a criminal justice testing program.

Results

Extensive polydrug use and geographic differences in the drugs detected were found. All sites found the DOTS collaborating laboratory’s test results to be very useful for understanding the types of drugs being used recently and to assess the adequacy of their testing protocols.

Conclusions

The U.S. should consider establishing a program of expanded testing of already collected de-identified urine specimens in order to identify emerging drugs and track local patterns of use and availability.

中文翻译：

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建立现有尿液样本扩大检测的国家系统：药物爆发检测服务 (DOTS)

摘要

背景

NIDA 的国家药物早期预警系统 (NDEWS) 成立于 2014 年，其使命是识别和监测美国的新兴药物。然而，由于新型精神活性物质的快速发展，新出现的药物的识别变得复杂，以至于使用者往往无法识别和报告他们摄入的药物。尿液、头发或血液的生物检测是可靠识别最近使用的物质的唯一方法。不幸的是，所需的大量最新测试超出了大多数组织可用的资源。

方法

DOTS 研究测试了招募组织免费提交多达 25 份去识别化尿液样本以测试大约 240 种药物的可行性。结果仅用于流行病学目的，不用于临床用途。11 个对患者或其组织的尿液分析筛查结果有疑问的站点参与了此次活动。这些网站包括药物治疗计划、体检医师、医院和刑事司法测试计划。

结果

在检测到的药物中发现了广泛的多种药物使用和地域差异。所有站点都发现 DOTS 合作实验室的测试结果对于了解最近使用的药物类型和评估其测试方案的充分性非常有用。

结论

美国应该考虑建立一个对已经收集的去识别化尿液样本进行扩展测试的计划，以识别新出现的药物并跟踪当地的使用和可用性模式。