Topic: Tox / TDM / Endocrine
Podium Presentation in Room 1 on Wednesday at 9:20 (Chair: Stephen Roper / Scott Borden)
Authors: Scott A. Borden(1,2), Gregory W. Vandergrift(1,2), Armin Saatchi(1), Jan Palaty(3), Erik T. Krogh(1,2) and Chris G. Gill(1,2,4,5)
INTRODUCTION: Almost 13,000 Canadians have died in the last 3 years from opioid overdoses. Drug checking is a harm reduction service showing promise, where clients (drug users) test their drugs immediately before use, with counselling and health care providers present. Clients provided with drug test data are observed to alter their behaviour, including dose reduction or discarding dangerous substances. Limitations of existing on-site drug testing (immunoassay test strips and FTIR) have resulted in low client uptake of offered drug checking services (~1%). To increase uptake, ideal harm reduction drug checking must be sensitive, quantitative, specific, adaptable, free of sample carryover, fast, field-deployable, and be easy to use and interpret results. Paper Spray Mass Spectrometry (PS-MS) can meet and exceed all these criteria.
OBJECTIVES: Develop and demonstrate PS-MS for rapid, sensitive and quantitative on-site harm reduction illicit drug testing at a Health Canada approved, supervised consumption site (SCS).
METHODS: All experiments used a triple quadrupole PS-MS system (Thermo Scientific VeriSprayTM with FortisTM QqQ). During SCS tests, 1 mg illicit drug was mixed in 1 mL of methanol. Following 100-fold methanol dilution, 10 µL was spotted on a PS-MS sample strip (with pre-spotted internal standards) and dried. Solvent (90/10/0.1 methanol/water/formic acid) and high voltage (4 kV) was applied to the paper strip to initiate extraction and ionization. Targeted drugs (fentanyl analogs, other opioids, amphetamines, benzodiazepines, hallucinogens, etc.) were quantified using MRMs, and a full scan also employed to detect non-targeted drugs. Data analysis and reporting was automated to a ‘one-click’ procedure, generating a simplified, printed report.
RESULTS: A two-day PS-MS pilot test was conducted at the Powell Street Getaway SCS in the downtown Eastside of Vancouver, BC (Aug. 2019). This was the first use of PS-MS for harm reduction drug checking, and part of the Health Canada Drug Checking Technology Challenge. 113 illicit drug samples, provided by clients, were tested using PS-MS, with 61% drug testing service uptake. The predominant drug measured was fentanyl (>75% of samples, [0.44-38%] fentanyl), but other drugs including etizolam, and carcinogenic intermediates (4-ANPP) were also quantified.
CONCLUSION: PS-MS has been demonstrated for on-site, direct and quantitative analysis of illicit street drug components, representing its first global demonstration for harm reduction drug checking services. PS-MS harm reduction drug testing was well received by clients and harm reduction workers. Test results, available in two minutes, were immediately relayed to clients to assist them in making informed drug use decisions. Future applications will involve further simplification to allow for minimally trained operators, with longer-term goals including instrument miniaturization.
For Research Use Only. Not for diagnostic procedures.
|Grants||yes||Thermo Scientific (in kind Instrumentation Loan)|
|Expenses||yes||Thermo Scientific - Travel Expenses to Attend|
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