CLN Article

Not Your Mother's Bath Salts

Challenges of New Designer Drugs

David Colantonio, PhD

Synthetic cathinones, also known as bath salts, and synthetic cannabinoids, or Spice, present clinicians and laboratorians with new challenges in bridging patients’ clinical presentation with lab test results. And just as designer drugs keep changing, so too do the technologies to detect them, with mass spectrometry leading the way. With more than 40 entirely new designer drugs identified by the U.S. Drug Enforcement Agency in the first five months of 2013, designer drugs are the latest face of drug abuse.

A symposium tomorrow morning, Clinical and Analytical Issues of New Designer Drugs, will feature Marilyn Huestis, PhD, Kara Lynch, PhD, and Robert Kronstrand of the National Board of Forensic Medicine. The speakers will discuss designer drug trends, testing methods, and intoxication effects, so that attendees will be better prepared to respond to drug testing demands in their own communities.

One trend the symposium will take on is the emergence of synthetic cannabinoids. These widely-abused cannabimimetic drugs do not produce positive screening results on traditional cannabinoid immunoassays. Identification and quantification of new designer drugs is an important public health and safety issue; however, the metabolism of synthetic cannabinoids and appropriate urinary target analytes are frequently unknown.

Huestis will review her work on the use of human hepatocyte cultures and high-resolution mass spectrometry to characterize unknown synthetic cannabinoid metabolic profiles. She will also discuss her work on validating and optimizing commercially available synthetic cannabinoid immunoassay performance, developing sensitive and specific qualitative and quantitative liquid chromatography-tandem mass spectrometry (LC-MS/MS) synthetic cannabinoid assays. In addition, she will cover validating a high resolution mass spectrometry screening method for synthetic cannabinoids in urine.

Heustis will then explain how LC-MS/MS offers increased sensitivity and specificity for identifying synthetic cannabinoids and their metabolites, and the ability this instrumentation offers to add newly emerging analytes to screening libraries. High-resolution mass spectrometry is capable of full MS range data collection and simultaneous MS/MS confirmation, providing an ideal platform for screening specified targets and unregulated new analogues.