Comprehensive method for the detection and quantification of drugs of abuse in urine by liquid chromatography mass spectrometry in a drug rehabilitation clinical setting

Abstract

Within the clinical setting of drug rehabilitation, it is important to be able to monitor for the use of drugs using sensitive and selective techniques whilst accounting for high throughput and numbers of patients to provide rapid results to clinicians. To meet this need, a comprehensive LC-MS-MS method for the confirmation and quantitation of a wide variety of drugs of abuse relevant to drug rehabilitation in the United Arab Emirates has been developed, validated and applied to patient urine samples. Following automated solid phase extraction, detection and quantitation involved multiple reaction monitoring with electrospray ionization. With few exceptions, within and between-batch accuracy and precision performance was shown to be within 20% across all drug types including amphetamines and related stimulants, benzodiazepines, opiates/opioids, cocaine and metabolites, cannabinoids, hallucinogens and ketamine (including metabolites) in urine. Results for 280 drug positive patient specimens showed good agreement with the previous in-house GC–MS approach. The LC-MS-MS replaces the existing GC-MS approach and can be expanded easily with the introduction of additional MRM transitions as and when required (e.g. if new or other drugs of abuse are to be considered) to support the work of the clinical team in this special area of clinical toxicology and medicine.