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William E. Schreiber. An Introduction to Testing for Drugs of Abuse
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
An Introduction to Testing for Drugs of Abuse
Preface
1 Introduction
What Is a Drug?
How Drugs Work
Drug Misuse and Abuse
Terminology
Economic Impact of Drug Abuse
Controlled Substance Schedules
Why Test for Drugs of Abuse?
What You Will Find in This Book
General references
Textbooks
Review article
Websites
Further Reading. Articles and reports
Websites. National Institute on Drug Abuse
Videos
AACC Pearls of Laboratory Medicine
2 How the Body Handles Drugs
Absorption
Distribution
Metabolism
Excretion
Further Reading. Book chapter
Websites
MSD Manual
Videos
3 Specimen Collection
Types of Specimens. Blood
Urine
Oral Fluid
Hair
Other Specimens
Specimen Validity Testing
How Cheaters Try to Beat Drug Tests
Assessing Validity
Interpretation of Specimen Validity Testing
Further Reading. Articles
Book chapter
Technical assistance publication
4 Screening Tests: Immunoassays
How Immunoassays Work
Labels for Competitive Immunoassays
Types of Assays
Enzyme Multiplied Immunoassay Technique (EMIT)
Cloned Enzyme Donor Immunoassay (CEDIA)
Kinetic Interaction of Microparticles in Solution (KIMS)
Why Immunoassays Sometimes Fail
Cross‐reactivity
Antibody Interference
Matrix Effect
Prozone
Point‐of‐Care Immunoassays
Further Reading. Articles
Book chapter
Videos
AACC Pearls of Laboratory Medicine
5 Confirmation Tests: Chromatography and Mass Spectrometry
What is Chromatography?
Thin‐Layer Chromatography (TLC)
Gas Chromatography (GC)
Columns
Detectors
Derivatizing Samples
Liquid Chromatography (LC)
Stationary and Mobile Phases
Detectors
Advantages of LC
Mass Spectrometry (MS)
Mass Analyzers
Further Reading. Book chapters
Websites
Videos
AACC Pearls of Laboratory Medicine
6 Cocaine
How Cocaine Works
Physiological Effects
Therapeutic Uses
Potential for Abuse
Metabolism
Testing for Cocaine. Screening
Confirmation
Window of Detection
Interferences
Case Studies
Case 6.1 Throat Lozenges
Discussion
Takeaway messages
Case 6.2 The Morning After
Discussion
Takeaway messages
Case 6.3 The Incredible Hulk
Discussion
Takeaway messages
Further Reading. Article
Book chapter
Websites. National Institute on Drug Abuse
Centre for Addiction and Mental Health
Video
7 Amphetamines
How Amphetamines Work
Physiological Effects
Therapeutic Uses
Potential for Abuse
Individual Drugs
Amphetamine
Methamphetamine
Illicit Drugs. Methylenedioxymethamphetamine (MDMA)
Paramethoxyamphetamine (PMA) and Paramethoxymethamphetamine (PMMA)
Cathinones
Over‐the‐Counter and Prescription Drugs. Pseudoephedrine/Ephedrine
Methylphenidate
Phentermine
Testing for Amphetamines. Screening
Confirmation
Window of Detection
Interferences
Case Studies. Case 7.1 An Unexpected Result
Discussion
Takeaway messages
Case 7.2 Party Time at The Adrenaline
Discussion
Takeaway messages
Case 7.3 Angry Doctor
Discussion
Takeaway messages
Case 7.4 On the Road Again
Discussion
Takeaway messages
Further Reading. Articles
Book chapter
Websites. National Institute on Drug Abuse
Centre for Addiction and Mental Health
Videos
AACC Pearls of Laboratory Medicine
8 Benzodiazepines and Z‐drugs. Benzodiazepines
How Benzodiazepines Work
Physiological Effects
Therapeutic Uses
Potential for Abuse
Metabolism
Testing for Benzodiazepines. Screening
Confirmation
Window of Detection
Interferences
Z‐Drugs
How Z‐Drugs Work
Therapeutic Uses
Potential for Abuse
Metabolism
Testing for Z‐Drugs
Window of Detection
Case Studies
Case 8.1 Nervous, Anxious, and Worried
Discussion
Takeaway messages
Case 8.2 Too Much Information
Discussion
Takeaway messages
Case 8.3 Empty Medicine Bottle
Discussion
Takeaway messages
Case 8.4 Problems at School
Discussion
Takeaway messages
Further Reading. Articles
Book chapters
Websites. National Institute on Drug Abuse
Centre for Addiction and Mental Health
Videos
9 Other Sedative‐Hypnotic Drugs
Barbiturates
How Barbiturates Work
Physiological Effects
Therapeutic Uses
Potential for Abuse
Metabolism
Testing for Barbiturates. Screening
Confirmation
Window of Detection
Interferences
Gamma‐Hydroxybutyric Acid (GHB)
How GHB Works
Physiological Effects
Therapeutic Uses
Potential for Abuse
Metabolism
Testing for GHB
Chloral Hydrate
Case Studies. Case 9.1 Frat Party
Discussion
Takeaway messages
Case 9.2 Sleepy Kid
Discussion
Takeaway messages
Case 9.3 Celebrity
Discussion
Takeaway messages
Further Reading. Articles
Book chapters
Websites. National Institute on Drug Abuse
Centre for Addiction and Mental Health
Videos
10 Opioids
How Opioids Work
Physiological Effects
Therapeutic Uses
Potential for Abuse
Individual Drugs
Naturally Occurring Opioids. Morphine
Codeine
Semisynthetic Opioids. Heroin
Hydrocodone and Oxycodone
Hydromorphone and Oxymorphone
Synthetic Opioids. Methadone
Fentanyl
Other Synthetic Opioids
Opioid Antagonists. Naloxone
Buprenorphine
Testing for Opioids. Screening
Confirmation
Window of Detection
Interferences
Case Studies
Case 10.1 Bad Coke
Discussion
Takeaway messages
Case 10.2 Bagels for Lunch
Discussion
Takeaway messages
Case 10.3 A Fruity Urine Specimen
Discussion
Takeaway messages
Case 10.4 One Drug Too Many
Discussion
Takeaway message
Case 10.5 The Boss Wants to See You
Discussion
Takeaway messages
Epilogue
Case 10.6 Dr Titus Saves the Day
Discussion
Takeaway messages
Further Reading. Articles
Book chapter
Websites. National Institute on Drug Abuse
Centre for Addiction and Mental Health
Videos
11 Cannabinoids
How Cannabinoids Work
Physiological Effects
Therapeutic Uses
Potential for Abuse
Metabolism
Testing for Cannabinoids. Screening
Confirmation
Window of Detection
Interferences
Case Studies
Case 11.1 Busted
Discussion
Takeaway messages
Case 11.2 The Cannabidiol Conundrum
Discussion
Takeaway messages
Case 11.3 An Olympic Gold Medal
Discussion
Takeaway messages
Case 11.4 Dr Titus Saves the Day – Again
Discussion
Takeaway messages
Further Reading. Articles
Book chapter
Websites. National Institute on Drug Abuse
Centre for Addiction and Mental Health
Videos
AACC Pearls of Laboratory Medicine
12 Hallucinogens
Classic Hallucinogens
Lysergic Acid Diethylamide (LSD)
Psilocybin
Mescaline
How Hallucinogens Work
Physiological Effects
Therapeutic Uses
Potential for Abuse
Metabolism
Testing for Hallucinogens
Window of Detection
Interferences
Dissociative Drugs
Phencyclidine (PCP)
Ketamine
How Dissociative Drugs Work
Physiological Effects
Therapeutic Uses
Potential for Abuse
Metabolism
Testing for Dissociative Drugs
Window of Detection
Interferences
Case Studies
Case 12.1 Where's Dixon?
Discussion
Takeaway messages
Case 12.2 We Don't Offer that Test
Discussion
Takeaway messages
Further Reading. Article
Book chapters
Websites. National Institute on Drug Abuse
Centre for Addiction and Mental Health
Videos
13 Alcohols
Ethanol
How Alcohol Works
Physiological Effects
Recreational and Therapeutic Uses
Potential for Abuse
Metabolism
Laboratory Testing
Direct Measurement of Ethanol
Metabolites
Indirect Markers
Window of Detection
Toxic Alcohols
Methanol
Ethylene Glycol
Isopropanol
Laboratory Testing. Direct Measurement of Toxic Alcohols
Osmolal Gap
Blood Gases, Anion Gap, Urinalysis
Treatment
Case Studies
Case 13.1 Rough Weather
Discussion
Takeaway messages
Epilogue
Case 13.2 A Clean Bill of Health?
Discussion
Takeaway messages
Case 13.3 Preparing for Clinic
Discussion
Takeaway messages
Case 13.4 Trivia Night
Discussion
Takeaway messages
Case 13.5 Unconscious Man with an Osmolal Gap
Discussion
Takeaway messages
Case 13.6 Mass Poisoning in Estonia
Discussion
Takeaway messages
Further Reading. Articles
Report
Book chapters
Websites. National Institute on Alcohol Abuse and Alcoholism
National Highway Traffic Safety Administration
Centre for Addiction and Mental Health
Videos
Appendix A How to Read a Toxicology Report
Format
Screening Tests
Confirmation Tests
Drugs and Their Metabolites
Further Reading
Appendix B Guideline Documents: Pain Management and Addiction Medicine
Pain Management
Addiction Medicine
Further Reading
Index
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