Drug and alcohol dependence · 2025
Detection of benzodiazepines in the unregulated drug supply using point of care and confirmatory drug checking technologies: A validation study.
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Crepeault Hannah, Tobias Samuel, Angelucci Jennifer, Dubland Stephanie, Lysyshyn Mark, Wood Evan, Ti Lianping
Аннотация
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.
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.