Analysis of Hospital Based Urine Drug Screening Tests over 2 Years. Does it Mirror the Actual Prevalence of Drug Abuse!
DOI:
https://doi.org/10.48165/jiafm.2023.45.1.5Keywords:
Urine drug screen, Benzodiazepines abuse, Cannabis abuseAbstract
Effect of drugs often interplays with the diagnosis and treatment of patients presenting to Emergency and critical care services of the hospital. Urine drug screen (UDS) is a qualitative toxicological screening tool which is simple, fast and has a relatively low cost providing a clue in acute care settings. The present study aims to determine the prevalence of drugs of abuse determined by UDS in suspected patients in a hospital set up and compare it to national prevalence study. It is a retrospective study conducted in the Toxicology lab in KIMS Medical College and Hospital, in Odisha over a period of 30 months where urine samples received from the hospital were included. Commonly abused substances were detected by urine drug screen by the help of a commercially available lateral flow assay kit. We received 232 samples in this study period of which 108 (46.5%) tested positive by urine drug screen.The highest positivity among the samples was noted in the age group of 21-30 (33.3%) closely followed by 11-20 (30.6%) with a male preponderance.(32.3%) cases where single drug was found in urine drug screen while 33 (14.2%) of cases had multiple drugs detected in the UDS. Most common substance of abuse was benzodiazepines in 43.2% cases. THC (29.05%) and OPI (14.2%) were the other commonly abused drugs. In poly drug abusers, commonest drug combination consisted of OPI and THC with or without BZO in 36.36 % (12 /33) cases. Thus, in spite of having many limitation of urine drug screen will help in the acute patient care set up particularly for diagnosis of poly drug abuse.
Downloads
References
Paul ABM, Simms L, Mahesan AA, Belanger EC. Teens, drugs and Vegas : Toxicological surveillance of illicit prescription and illegal drug abuse in adolescents (12-17 years) using postmortem data in Clark County, Nevada from 2005 to 2015. J Forensic Leg Med. 2018; 58: 20-4.
Ambekar A, Agrawal A, Rao R, Mishra AK, Khandelwal SK, Chadda RK. Magnitude of substance abuse. Ministry of social justice and empowerment government of India. National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi. 2019.
Lager PS, Attema-de Jonge ME, Gorzeman MP, Kerkvliet LE, Franssen EJF. Clinical value of drugs of abuse point of care testing in an emergency department setting. Toxicology Reports 2018; 5: 12–7.
Carrigan TD, Field H, Illingworth RN, GaVney P, Hamer DW. Toxicological screening in trauma. J Accid Emerg Med. 2000; 17:33–7.
Dyer EM, Salehian S. How to interprete urine toxicology tests. Arch Dis Child Educ Pract Ed. 2020;105:84–88.
Tijdink JK, van den Heuvel J, Vasbinder EC, van de Ven PM, Honig A. Does on-site urine toxicology screening have an added diagnostic value in psychiatric referrals in an emergency setting? Gen Hosp Psychiatry. 2011;33:
–630.
Woo B and Chen W. Substance misuse among older patients in psychiatric emergency service. Gen Hosp Psychiatry.
; 32: 99–101.
Bast RP, Helmer SD, Henson SR, Rogers MA, Shapiro WM, Smith RS. Limited utility of routine drug screening in trauma patients. South Med J. 2000;93:397–9.
Buchfuhrer LA, Radecki SE. Alcohol and drug abuse in an urban trauma center: predictors of screening and detection. J Addict Dis. 1996;15:65–74.
Vitale S, Van de Mheen D. Illicit drug use and injuries: a review of emergency room studies. Drug alcohol depend. 2006;82:1–9.
Langdorf MI, Rudkin SE, Dellota K, Fox JC, Munden S. Decision rule and utility of routine urine toxicology screening of trauma patients. Eur J Emerg Med. 2002;9:115–21.
Soderstrom CA, Dischinger PC, Kerns TJ, Kufera JA, Mitchell KA, Scalea TM. Epidemic increases in cocaine and opiate use by trauma center patients: documentation with a large clinical toxicology database. J Trauma. 2001;
:557–64.
Blondell RD, Dodds HN, Looney SW, Lewis CM, Hagan JL, Lukan JK, et al. Toxicology screening results: injury
associations among hospitalized trauma patients. J Trauma. 2005;58:561–70.
Richards CF, Clark RF, Holbrook T, Hoyt DB. The effect of cocaine and amphetamines on vital signs in trauma patients. J Emerg Med. 1995;13(1):59-63.
Telo S, Kaman D, Korkmaz S. Illicit substance use in Eastern Turkey. Saudi Med J. 2016; 37 (7); 773-7.
Archer JR, Wood DM, Dargan PI. How to use toxicology screening tests. Arch Dis Child Educ Pract Ed. 2012;97:194–9.
Nelson ZJ, Stellpflug SJ, Engebretsen KM. What can a urine drug screening immunoassay really tell us? J Pharm Pract. 2016;29:516–26.
Orsinia J , Dina N , Elahib E ,Gomezb A, Rajayera S, Malika R, et al. Journal of community hospital internal medicine perspectives. 2017 ; 7(4): 202–7.
Liakoni E, Dolder PC, Rentsch K, Liechti ME. Acute health problems due to recreational drug use in patients presenting to an urban emergency department in Switzerland. Swiss Med Wkly. 2015;145:w14166.
Dines AM, Wood DM, Yates C, Heyerdahl F, Hovda KE, Giraudon I, et al. Acute recreational drug and new psychoactive substance toxicity in Europe: 12 months data collection from the European Drug Emergencies Network (Euro-DEN). Clin Toxicol (Phila). 2015;53(9):893–900.
Sorge M, Weidhase L, Bernhard M, Gries A, Petros S. Selfpoisoning in the acute care medicine 2005-2012. Anaesthesist. 2015;64(6):456–62.
Loiselle JM, Baker MD, Templeton JM Jr, Schwartz G, Drott H. Substance abuse in adolescent trauma. Ann Emerg Med. 1993;22: 1530–4.3. Akosile W, McDermott BM. Use of the urine drug screen in psychiatry emergency service. Australasian Psychiatry. 2015; 23(2): 128–31.
Radovanovic Z, Pilcher CWT, Al-Nakib T, Shihab-Eldeen A. On substance abuse in Kuwait (1992-1997) evidence from toxicological screening of patients. Journal of Substance Abuse.2000; 12:363-71.
Sloan EP, Zalenski RJ, Smith RF, et al. Drug prevalence and its relationship to trauma severity and management. J Trauma. 1989;29:1647–53.
Chaouali N, Moslah B, Salem K B, Amira D, Hedhili A, Salah N B. Illicit substances identified in the urine of 11.170
suspected drug users in North Tunisia. Pan African Medical Journal. 2021;38(20).10.11604/pamj.2021.38.20.26781
Naveen A, Naik SK, Murari A, Kataria D. Magnitude of medicolegal issues among people who inject drugs in New Delhi: A cross-sectional study. J Indian Acad Forensic Med. 2022; 44 (2): 55-61.
Palimar V, Gupta C, Pratap B. A study on pattern and outcome of poisoning cases in tertiary care hospital in South India. J Indian Acad Forensic Med 2022; 44 (3):64-6.29. Akhgari M, Kahfi MS, Akha HS. Analysis of intoxication deaths: Causes and manners of death. Indian J Pharm Sci.
; 81(1): 32-8.
