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June 2012 CFTN

An AACC/CAP Educational Newsletter for Toxicology Laboratories

Read the June 2012 Issue

Anabolic Steroid Detection Poses Analytical Challenges
By Amy B. Cadwallader, Melinda K. Shelby, Ryan B. Paulsen, Dennis J. Crouch, and David L. Black
Anabolic androgenic steroids (AAS) and other anabolic agents are widely abused as performance-enhancing drugs by athletes of all abilities—from elite competitors to participants in amateur sports to high-school students. AAS and other anabolic compounds are banned by most amateur sports anti-doping programs, the World Anti-Doping Agency (WADA), and many professional sports organizations (1). In 2010, 60% of all adverse analytical and atypical findings reported by WADA were for AAS or related substances (2).

After reading this article, the reader will be able to:

  • Outline the challenges associated with anti-doping testing.
  • List new developments in anti-doping testing technology being used to detect the ever-changing scope of abused performance-enhancing drugs (including administration of endogenous steroids and the use of supposed undetectable black market and newly synthesized drugs).

New Tools Emerge to Test Newborns for Drug Exposure
By Joseph Jones
In utero drug and alcohol exposure is associated with a range of negative health outcomes, including intrauterine growth retardation, premature labor, placental abruption, convulsions, and even death (1). Over the past decade, neonatal abstinence syndrome has become more common as more babies are born to mothers who abuse prescription medications, such as pain-killing narcotics (2). The most recent National Survey on Drug Use and Health indicated that 5.1% of pregnant women self-report illicit drug use and almost 1% report heavy drinking (defined as five or more binges in the previous month), rates that have not changed significantly since 2002 (3).

After reading this article, the reader will be able to:

  • Discuss the three popular specimen types used for newborn toxicology.
  • Describe the advantages and disadvantages for each of the popular specimen types used for newborn toxicology.

Lactate Dehyrogenase can Cause False-Positive Ethanols
By Donald L. Frederick and Gregory S. King
A study of laboratories that participate in a College of American Pathologists (CAP) proficiency testing program shows that a high level of lactate and lactate dehydrogenase (LDH) can cause false-positive ethanol results in commonly used assays.

After reading this article, the reader will be able to:

  • Describe the enzymatic reaction involved with ethanol colorimetric tests.
  • Describe the possibility that a positive result may be obtained when no ethanol is present.
  • List the commercially available ethanol tests that may product false-positive ethanol results.

Use of On-Site Drug Testing Devices Continues to Expand
By Robert E. Willette
On-site drug testing has come a long way since the 1970s, when laboratory-based immunoassays were first introduced for opiates and other abused drugs. The first major workplace drug-testing program was launched by the U.S. Navy in the 1980s. It used portable benchtop immunoassay instruments at military bases and on board most large Navy ships. The portable instruments made it possible to test for a wide variety of drugs wherever there was an electrical outlet, but researchers continued to look for ways to cut the cord.

After reading this article, the reader will be able to:

  • Describe the complexities and variability of the large number of on-site drug test devices.
  • Review which workplace drug testing programs are allowed to use on-site drug test devices and which programs are not.
  • List the commercially available ethanol tests that may product false-positive ethanol results.

Earning ACCENT Credit
Clinical & Forensic Toxicology News readers can receive 4.0 ACCENT® continuing education credit hours per year (one credit per quarterly issue).