BACKGROUND: Propofol is a widely used anesthetic in anesthesia and sedation. Though it is not regulated under the controlled substance act, the public media broadcasted apprehensive programs about propofol abuse of laypersons. We attempted to determine whether the propofol is abused by the medical personnel working in the operation room in Korea. METHODS: We surveyed the 95 delegates who sat in the back benches in the Korean Society of Anesthesiologists. The questionnaire included the job of the propofol abuser, the rehabilitation, drug abuse history, stressful condition, family history of drug abuse in medical personnel in operation room. Additional question was what is the adequate method to prevent propofol abuse. RESULTS: Seventy two delegates among 95 candidates were responded. Seven of 72 responders answered that they knew 9 medical personnel who abused propofol in operation room. Four of them were anesthesiology residents, two were other departments' residents, one was a nurse in anesthesiology and the other two were unknown. Among nine subjects, two had tried to rehabilitate but failed, and all abusers quit working within 1 year. As for the prevention methods, 9 of 12 responders suggested that propofol should be controlled like other centrally acting anesthetics. CONCLUSION: Although propofol has not been traditionally considered a drug of abuse, a few medical team members abuse it working in operation room. A stricter pharmacy control of propofol or controlled substance act for propofol should be needed to prevent abusing it and to protect medical team members.
Anesthesia ; Anesthesiology ; Anesthetics ; Humans ; Korea ; Pharmacy ; Propofol ; Substance Abuse Detection ; Substance-Related Disorders ; Surveys and Questionnaires

BACKGROUND: AU5822 Automated Clinical Chemistry Analyzer (Beckman Coulter, USA) is a fully automated analytical platform designed for the analysis of general chemistry, specific serologic proteins, therapeutic drug monitoring, and drug abuse testing. AU5822 is a high-throughput system that can process up to 5,800 tests per hour and is easy to maintain. In this study, we evaluated the performance of AU5822 on 31 analytes. METHODS: The precision, linearity, correlation, and sample carryover of 31 analytes were evaluated in accordance with the guidelines of the Clinical Laboratory Standards Institute (CLSI). Lyphochek (Bio-Rad Laboratories Inc., USA), Liquichek (Bio-Rad Laboratories Inc.), Validate (Marine Standard Company, USA), and patient sera were used in the analysis. For the correlation study, we carried out a comparison of AU5822 and Cobas 8000 Modular Analyzer (Roche, Switzerland). RESULTS: The coefficients of variation of all samples showed values below 5%. The coefficient of determination (R2) was > or =0.99, with linearity in the clinically important range. The comparison with Cobas 8000 showed a good correlation, with a correlation coefficient of >0.975 for all of the analytes, excluding sodium that had a correlation coefficient of 0.9641. The test values of percentage sample carryover were less than 0.89%. CONCLUSIONS: AU5822 performed well in terms of precision, linearity, comparison, and sample carryover in the established assays for 31 analytes. Therefore, Beckman Coulter AU5822 Automated Clinical Chemistry Analyzer is expected to be useful for routine chemistry analysis in hospitals with large test volumes.
Chemistry ; Chemistry, Clinical* ; Drug Monitoring ; Humans ; Sodium ; Statistics as Topic ; Substance Abuse Detection

Although doping with growth hormone (GH) is banned, there is anecdotal evidence that it is widely abused. GH is reportedly used often in combination with anabolic steroids at high doses for several months. Development of a robust test for GH has been challenging because recombinant human 22 kDa (22K) GH used in doping is indistinguishable analytically from endogenous GH and there are wide physiological fluctuations in circulating GH concentrations. One approach to GH testing is based on measurement of different circulating GH isoforms using immunoassays that differentiate between 22K and other GH isoforms. Administration of 22K GH results in a change in its abundance relative to other endogenous pituitary GH isoforms. The differential isoform method has been implemented; however, its utility is limited because of the short window of opportunity of detection. The second approach, which will extend the window of opportunity of detection, is based on the detection of increased levels of circulating GH-responsive proteins, such as insulin-like growth factor (IGF) axis and collagen peptides. Age and gender are the major determinants of variability for IGF-I and the collagen markers; therefore, a test based on these markers must take age into account for men and women. Extensive data is now available that validates the GH-responsive marker approach and implementation is now largely dependent on establishing an assured supply of standardized assays. Future directions will include more widespread implementation of both approaches by the World Anti-Doping Agency, possible use of other platforms for measurement and an athlete's passport to establish individual reference levels for biological parameters such as GH-responsive markers. Novel approaches include gene expression and proteomic profiling.
Doping in Sports ; Growth Hormone ; administration & dosage ; Humans ; Substance Abuse Detection ; methods

Amphetamines are chemical synthetic drugs that are becoming increasingly popular in China. As a common sample in the inspection of poisons, hair has the advantages of easy storage, good stability, and long detection time compared with traditional human body fluid samples （blood, urine）, thus possesses an unique application value in the field of forensic toxicology analysis. By now, methods for detecting amphetamines in human hair have been widely used, and validity of the results has been recognized and adopted by the court. This paper reviews domestic and foreign research progress of the detection of amphetamines in hair samples, including the pretreatment and analytic methods.
Amphetamines/analysis* ; China ; Forensic Toxicology ; Hair/chemistry* ; Humans ; Substance Abuse Detection

Methamphetamine （MAMP） is a kind of amphetamine-type stimulants （ATS） which contains one chiral carbon atom in its structure. Therefore a pair of enantiomers, S-（+）-MAMP and R-（-）-MAMP exist. R type and S type methamphetamines possess similar physicochemical properties, but has largely different pharmacological and toxic effects. S-（+）-MAMP is the main component of addictive drug "Ice" at present, seriously affecting human health and public safety. The separation analysis and mechanism of toxic effects discussions on MAMP are the current research focuses. This paper reviews the research progress of separation analysis methods and toxic effects of methamphetamine enantiomers to provide reference for forensic study and forensic practice.
Central Nervous System Stimulants ; Humans ; Methamphetamine/chemistry* ; Stereoisomerism ; Substance Abuse Detection

Drug problem is a major social and public security problem in the world. Drug abuse poses a great threat to economic development, social stability and public health. In recent years, synthetic drugs represented by methamphetamine have surpassed traditional drugs such as morphine, heroin, ketamine and become one of the most abused drugs in the world. In order to solve the problem of drug abuse, it is of great theoretical value and practical significance to carry out all-round and multi-level scientific research on drug-related issues. Based on the current situation of drug abuse, this article reviews research progresses on the epidemiology of methamphetamine abuse, the monitoring technology, the basic researches on toxicity damage, the withdrawal drug screening, the related clinical comorbidity and the testing technologies, comprehensively presenting the development trend of methamphetamine abuse related issues.
Amphetamine-Related Disorders/epidemiology* ; Heroin ; Humans ; Illicit Drugs ; Methamphetamine/adverse effects* ; Substance Abuse Detection

In recent years, the types and quantities of fentanyl analogs have increased rapidly. It has become a hotspot in the illicit drug control field of how to quickly identify novel fentanyl analogs and to shorten the blank regulatory period. At present, the identification methods of fentanyl analogs that have been developed mostly rely on reference materials to target fentanyl analogs or their metabolites with known chemical structures, but these methods face challenges when analyzing new compounds with unknown structures. In recent years, emerging machine learning technology can quickly and automatically extract valuable features from massive data, which provides inspiration for the non-targeted screening of fentanyl analogs. For example, the wide application of instruments like Raman spectroscopy, nuclear magnetic resonance spectroscopy, high resolution mass spectrometry, and other instruments can maximize the mining of the characteristic data related to fentanyl analogs in samples. Combining this data with an appropriate machine learning model, researchers may create a variety of high-performance non-targeted fentanyl identification methods. This paper reviews the recent research on the application of machine learning assisted non-targeted screening strategy for the identification of fentanyl analogs, and looks forward to the future development trend in this field.
Fentanyl ; Substance Abuse Detection/methods* ; Mass Spectrometry/methods* ; Illicit Drugs/analysis*

Objective To establish accurate and rapid methods to identify four new synthetic cannabinoids （JWH-203, JWH-122, 5F-APINACA and AB-CHMINACA） in blood samples. Methods The whole blood samples were extracted by acetonitrile and methanol, screened by gas chromatography-mass spectrometry （GC-MS） then confirmed by liquid chromatography-tandem mass spectrometry （LC-MS/MS） method, and multiple reaction monitoring （MRM） mode was used for quantitative analysis. Results The GC-MS method needed 21 min to complete the analysis, while the LC-MS/MS method needed 5 min. The AB-CHMINACA, JWH-203, 5F-APINACA and JWH-122 all used quasi molecular ion peak as a parent ion. The precursor-product ion combinations were m/z 357.4→312.2, m/z 340.2→125.0, m/z 384.1→135.1 and m/z 356.4→169.2. The four synthetic cannabinoids in blood samples had good linearity in the 1-250 ng/mL mass concentration range （r>0.99）. The limits of detection （LODs） were in the range of 0.1-0.5 ng/mL, the recovery rate was 85.4%-95.2%, the RSD less than 10.0%, and the matrix effect was 80.3%-92.8%. Conclusion The GC-MS and LC-MS/MS chromatographic behaviors and mass spectrometry analysis information of four synthetic cannabinoids were obtained in this study, and the possible causes of differences in chromatographic behaviors were discussed preliminarily. Therefore this study has a suggestive effect on judging the development trend of synthetic cannabinoids. This method can be used for rapid identification of four synthetic cannabinoids in blood, which can provide reference for identification of new synthetic cannabinoids when they are proliferating at present.
Blood Chemical Analysis/methods* ; Cannabinoids/blood* ; Chromatography, Liquid ; Humans ; Limit of Detection ; Substance Abuse Detection/methods* ; Tandem Mass Spectrometry

OBJECTIVES: To establish a combined high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) and gas chromatography-mass spectrometry (GC-MS) method to detect the synthetic cannabinoid CUMYL-PEGACLONE in e-cigarette oil and hair. METHODS: HPLC-MS/MS and GC-MS were used to establish the detection method of CUMYL-PEGACLONE, and the hair of drug-involved persons and the seized e-cigarette oil were detected. RESULTS: The main mass spectrometry characteristic ions m/z of CUMYL-PEGACLONE measured by GC-MS were 91, 179, 197, 254 and 372. CUMYL-PEGACLONE had a good linear relationship in the mass concentration range of 2-50 ng/mL, and the linear correlation coefficient (r) was greater than 0.99. The limit of detection (LOD) of CUMYL-PEGACLONE in hair was 0.01 ng/mg, and the limit of quantitation (LOQ) was 0.02 ng/mg. The LOD of CUMYL-PEGACLONE in e-cigarette oil was 1 ng/mg, and the LOQ was 2 ng/mg. The average recoveries of CUMYL-PEGACLONE under the attempt at high, intermediate and low levels in blank human hair and e-cigarette oil matrix were 98.2%-132.4% and 93.5%-110.6%, and the intraday and intraday precision were 1.2%-12.9% and 0.7%-2.9%. CUMYL-PEGACLONE was detected in the hair of 15 drug-involved persons. Except for 1 person who was lower than LOQ, the concentration of CUMYL-PEGACLONE in the hair of other 14 persons was 0.035-0.563 ng/mg. The mass fraction of CUMYL-PEGACLONE in 2 e-cigarette oil were 0.17% and 0.21%, respectively. CONCLUSIONS The established HPLC-MS/MS and GC-MS methods are applied to the detection of HPLC-MS/MS in drug-related cases, which provides strong evidence support for the handling authority to quickly investigate these cases, and also provides a reference for the identification of such substances in future.
Humans ; Illicit Drugs/analysis* ; Tandem Mass Spectrometry ; Electronic Nicotine Delivery Systems ; Cannabinoids ; Hair/chemistry* ; Limit of Detection ; Substance Abuse Detection/methods*

Recently the cases after drinking are increasing, but the systematic studys on ethanol content in vivo and correlative problems are still absent. According to the measured results of ethanol content in vivo, ethanol metabolic distributed rules, mechanisms of ethanol toxicological effect and its production in vivo, this study analysed systematically the time after drinking, total quantity of absorbed ethanol, psychological situations, behavioral dominated ability, death causes and manners in order to find out the implied forensic medical information and provide the reference for colleague.
Alcohol Drinking/metabolism* ; Alcohol-Induced Disorders ; Ethanol/metabolism* ; Forensic Medicine ; Humans ; Postmortem Changes ; Substance Abuse Detection/methods* ; Time Factors