使用护理点和确认性药物检查技术检测非管制药品供应中的苯二氮卓类药物：一项验证性研究

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-02-28 DOI:10.1016/j.drugalcdep.2025.112631

Hannah Crepeault , Samuel Tobias , Jennifer Angelucci , Stephanie Dubland , Mark Lysyshyn , Evan Wood , Lianping Ti

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引用次数: 0

摘要

目的：在不列颠哥伦比亚省（BC）不受管制的阿片类药物供应中，苯二氮卓类药物的掺假率有所上升。鉴于与阿片类药物和苯二氮卓类药物共同摄入相关的健康风险，使用即时药物检查技术准确检测苯二氮卓类药物至关重要。本研究旨在验证傅里叶变换红外光谱（FTIR）和苯二氮卓类免疫测定条与金标准实验室技术的比较。方法2018年10月至2023年11月，使用FTIR和苯二氮平免疫测定条对BC省危害减少站点提交的药物样本进行分析。这些样品的一部分被送去使用定量核磁共振光谱、气相色谱-质谱和/或液相色谱-质谱进行验证性分析。我们计算了即时护理技术的诊断准确性（例如，敏感性，特异性）。结果在1922份具有即时护理和确认结果的样本中，390份（20%）苯二氮卓类药物检测呈阳性。FTIR灵敏度为26%(95%可信区间[CI]:21 - 30%)，特异性为99% （95% CI:99 - 100%）。免疫测定条的敏感性为67% (95% CI:62 ~ 72%)，特异性为82% （95% CI:79 ~ 85%）。当FTIR和免疫测定条结果联合使用时，灵敏度为75% (95% CI:70 - 79%)，特异性为82% （95% CI: 79 - 84%）。排除乙替唑仑后，免疫测定条的敏感性为98% (95% CI:94 ~ 99%)，特异性为83% （95% CI:81 ~ 86%）。结论sftir在护理点检测苯二氮卓类药物及相关化合物的存在不一致。然而，当FTIR与免疫测定条结合使用时，灵敏度提高了，强调了同时使用这两种技术的重要性。由于乙唑仑不是真正的苯二氮卓类药物，因此使用现有的即时药物检查技术对它构成了相当大的挑战。

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Detection of benzodiazepines in the unregulated drug supply using point of care and confirmatory drug checking technologies: A validation study

Objective

Benzodiazepine adulteration in British Columbia's (BC) unregulated opioid supply has risen. Given the health risks associated with co-ingestion of opioids and benzodiazepines, accurate detection of benzodiazepines using point-of-care drug checking technologies is critical. This study aimed to validate the use of Fourier-transform infrared spectroscopy (FTIR) and benzodiazepine immunoassay strips compared to gold standard laboratory technologies.

Methods

From October 2018 to November 2023, drug samples submitted to harm reduction sites in BC were analyzed using FTIR and benzodiazepine immunoassay strips. A subset of these samples was sent for confirmatory analysis using quantitative nuclear magnetic resonance spectroscopy, gas chromatography-mass spectrometry, and/or liquid chromatography-mass spectrometry. We calculated measures of diagnostic accuracy (e.g., sensitivity, specificity) for the point-of-care technologies.

Results

Of 1922 samples with point-of-care and confirmatory results, 390 (20 %) tested positive for a benzodiazepine. FTIR sensitivity was 26 % (95 % confidence interval [CI]:21–30 %) and specificity was 99 % (95 % CI:99–100 %). Immunoassay strip sensitivity was 67 % (95 % CI:62–72 %) and specificity was 82 % (95 % CI:79–85 %), respectively. When FTIR and immunoassay strip results were combined, sensitivity was 75 % (95 % CI:70–79 %) and specificity was 82 % (95 % CI: 79–84 %). When etizolam was excluded, the sensitivity and specificity of immunoassay strips were 98 % (95 % CI:94–99 %) and 83 % (95 % CI:81–86 %), respectively.

Conclusions

FTIR did not consistently detect the presence of benzodiazepines and related compounds at point-of-care. However, sensitivity improved when FTIR was combined with immunoassay strips, underscoring the importance of using both technologies in tandem. As etizolam is not a true benzodiazepine, it poses considerable challenges using existing point-of-care drug checking technologies.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.