MSACL 2022 Abstract

Rapid Urine Drug Testing by Direct Analysis in Real-Time (DART)-Mass Spectrometry

Ibrahim Choucair (1), Gina Cassella-Mclane (1), Joe El-Khoury (1)
(1) Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT

Ibrahim Choucair, PhD (Presenter) University of Kentucky College of Medicine

Presenter Bio: I am an Assistant Professor and Director of the Special Chemistry and Toxicology Laboratory in the Department of Pathology and Laboratory Medicine at the University of Kentucky. I also serve as Associate Core Director of the Biofluids Biomarker Core at the University of Kentucky Alzheimer’s Disease Research Center and as Associate Medical Director of the Kentucky State Public Health Laboratory, where I lead Newborn Screening activities.

I received my Bachelor of Science in Clinical Laboratory Science and his master’s degree in Bioanalytical Toxicology from the American University of Science and Technology in Beirut, Lebanon. I later earned my PhD in Clinical Bioanalytical Chemistry through the joint program between Cleveland State University and the Cleveland Clinic and then completed a Clinical Chemistry fellowship at Yale School of Medicine.

My research is centered on two primary objectives: (1) advancing clinical laboratory testing through the development of innovative tools and methodologies, and (2) exploring the relationships between proteins or small molecules and disease pathogenesis to reduce the impact of conditions such as liver disease, cardiovascular disease, diabetes, and Alzheimer’s disease.

Through my work, I strive to deepen our understanding of the mechanisms underlying these disorders, identify novel therapeutic targets, and develop cutting-edge diagnostic tools and treatment approaches. To achieve these goals, I leverage advanced technologies such as mass spectrometry, as well as bioinformatics tools including R and Python, to analyze complex datasets and uncover actionable insights.

I am committed to bridging the gap between basic research and clinical practice, with the ultimate aim of translating scientific discoveries into meaningful improvements in patient care. My passion for this translational approach drives my dedication to advancing the fields of clinical chemistry and toxicology and contributing to better health outcomes.

Relevant Financial Disclosures (within past 24 months, reported on Jun 17, 2026) No relevant financial relationship(s) to disclose. Discussing Products? NO, presenter will NOT present educational content related to products/services of the ineligible company(ies) listed above. Conflict mitigation NOT REQUIRED.

Introduction
Since 1999, over 750,000 people in the U.S. have died from a drug overdose involving an opioid. What’s more concerning is the recent trend showing an increase in synthetic opioid-related deaths, with the U.S. Centers for Disease Control and Prevention (CDC) reporting a 10 to 53% increases year-over-year since 2017. This dramatic increase is largely being driven by the rise of stimulant (like methamphetamine and cocaine) and synthetic opioid co-use, in what the experts are now calling the “fourth wave” of the opioid epidemic. Fentanyl and analogues are largely responsible for this recent upward tick in drug-related deaths in the U.S., and this issue is quickly becoming a global crisis. Current clinical laboratory technologies are not adapting quickly enough to the evolving landscape of drug use, with immunoassays for fentanyl and synthetic analogues taking too long to develop, and liquid chromatography-tandem mass spectrometry methods not widely available and often taking days to result due to their complexity.

Methods
Direct analysis in real time (DART) tandem mass spectrometry (MS/MS). DART is a cutting-edge ionization technology that requires no sample preparation and no chromatography. While DART is currently used in several applications like food chemistry, it has not been validated for a clinical laboratory application.

Results and Discussion
We have developed a fast DART-MS/MS method for the qualitative analysis of 15 opioids in less than 10 seconds, the method’s limit of detection for all compounds is below 10ng/ml in pure standards. The DART temperature was optimized to 250˚C with sample scan speed of 1mm/s. The new method promises to cut turnaround time from days to minutes, and with the high sensitivity and specificity of mass spectrometry technology, we believe that it may one day replace or supplement immunoassays as a drug screening tool.