Clinical laboratory professionals are on the toxicology and therapeutic drug monitoring (TDM) front lines, ensuring proper and robust methods to detect drugs of abuse and determine concentrations of prescribed medications, and communicating and collaborating with clinicians to understand and interpret the results.

The 68th AACC Annual Scientific Meeting & Clinical Lab Expo offers many opportunities for clinical laboratorians to enhance their TDM and toxicology analytical expertise, learn about emerging methods, better understand toxicology-related testing and regulatory challenges, and further develop strategies for working with physicians to unravel complex TDM and toxicology cases.

The centerpiece of this exceptional content is the Toxicology Topic Track on Wednesday and Thursday, which examines major trends impacting the field of toxicology, including the latest developments in cannabis testing, the use of mass spectrometry for drug screening, and the potential of oral fluid as a drug testing matrix.

Wednesday in the Toxicology Top Track features the oral abstract session: What's New in Toxicology and Therapeutic Drug Monitoring, and an afternoon short course: Oral Fluid in the Clinical Toxicology Laboratory: Ready for Prime Time? During the latter, speakers will present advantages and drawbacks of the utility of oral fluid as a drug testing matrix in clinical laboratories, as well as the potential for interpreting oral fluid drug concentrations.

A brown bag session, Mass Spectrometry in the Clinical Lab: Applications for Emergency Toxicology (44103) (Repeats as 54203), explores how mass spectrometry can be employed in emergency situations, while another brown bag session, Evaluation of Time-of-Flight High Resolution Mass Spectrometry for Broad Spectrum Drug Screening in Urine (44122) (repeats as 54222), highlights applications of time-of-flight high resolution mass spectrometry in drug testing. These sessions are limited to just 10 participants and cost an additional $25 each.

On Thursday, Marilyn Huestis, MD, PhD, of the University of Maryland School of Medicine, delivers the plenary session: The Great Cannabis Experiment: Medical Miracle? Harmless High? Civil Consequences? Her lecture will explore recent developments in the science and use of marijuana, including the effects of acute and chronic exposure, its impact on driving ability, and measurement of cannabinoids in blood and oral fluid, as well as the detection of these compounds and their effects after sustained abstinence.

Another cannabis-focused session later that day, Marijuana from the Street to the Clinic: Medicalization, Legalization, and Unintended Consequences, focuses on the impact of cannabis use in various populations. The speakers will highlight prenatal and perinatal use of marijuana, the impact of marijuana on neurodevelopment in different populations, and challenges for the clinical laboratory in the context of cannabis testing.

Several other sessions address a wide variety of TDM and toxicology topics, including:

When Toxicology Results and Clinical Presentation Do Not Correlate: How to Communicate With Clinicians and Guide Further Testing Decisions. This short course emphasizes how to effectively communicate with clinicians regarding the presence of certain drugs that require further testing.

Recently Revised CLSI Protocol C52: Toxicology and Drug Testing in the Clinical Laboratory - Approved Guideline. This symposium reviews changes in the latest revision of the CLSI document C52, “Toxicology and Drug Testing in the Clinical Laboratory; Approved Guideline 3rd Edition.”

Several brown bag sessions are also available. Each is offered from 7:30 to 8:30 a.m. and from 12:30 to 1:30 p.m. They cost an additional $25 and are limited to 10 people.

Ethanol Metabolites Testing in Non-Traditional Matrix Types: Case Studies focuses on ethanol metabolites as direct biomarkers to test for alcohol exposure.

Therapeutic Drug Management in Pregnant Patients addresses the physiological and pharmacokinetic changes that occur in pregnancy.

How People Try to Beat Drug Testing and Defend Positive Results highlights the methods individuals use to hide evidence of drug use and approaches labs can take to detect adulterants.

Drug Interference - The Unsolved Problem focuses on approaches to identify and interpret drug interferences in routine clinical work, with recommendations on the best way to perform interference studies.

Hair as a Long Term Adherence Marker for HIV Medications explores the potential of hair as a biomatrix for the long-term assessment of antiretroviral drug exposure.

Common Pitfalls and Misinterpretations of Urine Drug Testing offers a discussion on areas in which urine testing is poorly understood or misinterpreted.