The well-documented U.S. opioid crisis causes thousands of overdose deaths annually. Efforts to stem the rising tide of deaths have relied on laboratories to accurately detect illicit opioid use, but the proliferation of novel psychoactive substances (NPS), including novel opioids, has challenged laboratories to generate assays to identify these new drugs.

The short course, “Avoiding the Bleeding Edge of the Opioid Epidemic: A Tale of Using Seized Drugs, DUID, and Postmortem Cases to Keep the Laboratory at the Front-Line,” gives a crash course on the multi-factorial approaches necessary for labs to recognize novel opioids.

This session covers four actions that will position labs at the forefront of work on the opioid crisis: surveillance efforts; methods of analysis and workflow; public-private partnerships; and data sharing. AACC recently published a position paper, “Stopping the Opioid Epidemic: Integral Role of Clinical Laboratorians,” and this session will support and emphasize the significance of this document.

Donna Papsun, MS, shares from her experience in designing workflows and assays for detecting NPS. “NPS are intentionally disguised by design; they act on the body like the substances they are supposed to mimic but typically evade the scope of routine testing,” she says. Papsun explains that because of limitations in accurate testing, the extent of the threat posed by NPS is not fully understood.

Further complicating matters, the prevalence of drug use shifts frequently. Therefore, Papsun emphasizes the need for ongoing surveillance and tracing, which requires “the scientific community to establish partnerships and form collaborations to identify and counter the threats.”

Also addressing the challenges of NPS testing, Alex Krotulski, PhD, believes that “it is more likely than not that [labs] will come across cases associated with synthetic drug use, and therefore they should be prepared with how to handle these cases.” He shares several approaches to drug testing novel opiates, so each lab can find the option that works best for its needs, capabilities, and resources.

“Attendees will understand these processes are not easy but are obtainable with the right commitments,” he says. Krotulski also highlights the need for laboratories to share information, noting that “we are stronger together when sharing data and resources.” In doing so, individual labs can be better prepared to accurately identify novel substances before they encounter their first sample.

Fredrick Strathmann, PhD, stresses a multi-step approach for labs to successfully tackle the challenges of recognizing NPS, which covers both testing and sharing data among laboratories. He emphasizes the need for data, information, and resource sharing.

“A laboratory cannot do [novel opioid testing] in isolation, and the expertise that is needed crosses several functional areas and even stretches outside the bounds of a single organization,” Strathmann says. “The discipline needed in coordination and the continuous effort are key aspects that will come through.”

Strathmann describes this session as, “the manual that would come with an Opioid Epidemic Laboratory-in-a-Box,’ caution: Read instructions before use, as failure to do so may cause severe frustration later.” Attendees of this course can gain significant, practical insights into opioid testing that can be applied in any setting.