Center for Substance Abuse Research (CESAR), University of Maryland, College Park, Maryland, USA.
Division of Forensic Toxicology, Armed Forces Medical Examiner System (AFMES), Dover, Delaware, USA.
Subst Use Misuse. 2021;56(11):1576-1585. doi: 10.1080/10826084.2021.1928213. Epub 2021 Jul 19.
NIDA's National Drug Early Warning System (NDEWS) was established in 2014 with the mission of identifying and monitoring emerging drugs in the United States. Identification of emerging drugs has been complicated, however, by the rapid development of novel psychoactive substances such that users often cannot identify and report the drugs they have ingested. Biologic testing of urine, hair or blood is the only way to reliably identify the substances recently used. Unfortunately, the large number of up-to-date tests required is beyond the resources available to most organizations.
The DOTS study tested the feasibility of recruiting organizations to submit up to 25 de-identified urine specimens for testing for approximately 240 drugs, at no cost to them. The results were for epidemiologic purposes only and not for clinical use. Eleven sites who had questions about their patients or the results of their organization's more limited urinalysis screens participated. These sites included drug treatment programs, medical examiners, hospitals and a criminal justice testing program.
Extensive polydrug use and geographic differences in the drugs detected were found. All sites found the DOTS collaborating laboratory's test results to be very useful for understanding the types of drugs being used recently and to assess the adequacy of their testing protocols.
The U.S. should consider establishing a program of expanded testing of already collected de-identified urine specimens in order to identify emerging drugs and track local patterns of use and availability.
NIDA 的国家药物早期预警系统（NDEWS）成立于 2014 年，其使命是识别和监测美国的新兴药物。然而，新型精神活性物质的快速发展使得识别新兴药物变得复杂，以至于使用者通常无法识别和报告他们摄入的药物。尿液、头发或血液的生物检测是可靠识别最近使用的物质的唯一方法。不幸的是，大多数组织都缺乏进行大量最新测试的资源。
DOTS 研究测试了招募组织提交多达 25 份匿名尿液样本进行大约 240 种药物检测的可行性，对他们来说是免费的。结果仅用于流行病学目的，不适用于临床用途。有 11 个对患者或组织更有限的尿液分析屏幕检测结果有疑问的站点参与了该研究。这些站点包括戒毒治疗计划、法医、医院和刑事司法检测计划。
发现了广泛的多药物使用和检测到的药物在地理上的差异。所有站点都发现 DOTS 合作实验室的测试结果非常有助于了解最近使用的药物类型，并评估其测试方案的充分性。
美国应考虑扩大对已收集的匿名尿液样本的检测计划，以识别新兴药物并跟踪当地的使用和供应模式。
