The opioid crisis continues to pose challenges for clinicians and laboratorians as use of not only fentanyl and fentanyl analogs rises, but also novel synthetic opioids. This afternoon’s  session, “Opioids and Beyond: The Clinical Laboratory’s Role in the Opioid Epidemic,” presented by Sara Love, PhD, Sarah Wheeler, PhD, Jennifer Colby, PhD, and Ann Arens, MD, will be highly interactive with the speakers jointly presenting case studies rather than giving individual talks.

Each case will begin with discussion of a bedside clinical evaluation, progress through chemistry and toxicology lab testing, and return to the bedside to describe interventions undertaken in response to a patient’s test results and clinical picture. This presentation format mirrors the partnerships the speakers will emphasize between clinicians and laboratorians and how these partnerships positively affect individual patient care as well as public health efforts like toxicosurveillance initiatives. Additionally, this case-based presentation format will illustrate the different perspectives of clinicians and laboratorians, which in practice sometimes seem unclear.

Laboratorians and clinicians need to understand each other’s challenges in treating a patient with an opioid exposure no matter the setting in which they may be practicing. Today’s presenters will discuss the everchanging landscape of opioid use and its implications in patient care. Clinicians face the challenge of treating patients experiencing intoxications from new substances with unknown effects, while laboratorians have to clear the hurdle of identifying these compounds even as they face declining reimbursement, increasing volumes, and ongoing analytical complications.

The speakers will specifically demonstrate these challenges in case studies involving basic opioid testing and fentanyl analogs, in discussions of drug look-alikes, and pediatric opioid diversion. This session will also demonstrate the importance of laboratorians as stewards for ensuring clinicians get the most out of the toxicology tests by using testing algorithms properly, interpreting results correctly, and understanding test limitations.

Because the opioid crisis affects the entire nation, toxicology expertise and specialized testing may be in short supply. With this in mind, Love, Wheeler, Colby, and Arens seek to leave all attendees with a deeper understanding of opioid testing and how to interpret results appropriately for productive consultations with clinicians. This session is intended to be fun and engaging yet detailed and educational for laboratorians, toxicologists, and clinicians.

The case presentations will bring out different scenarios in which multiple approaches would be appropriate. In exploring these different approaches the speakers will emphasize that we all play a role in improving care for patients who use opioids, while also demonstrating how important clinician-laboratorian partnerships are in individual patient care and in public health efforts.