Multi-Class Analysis of 57 Drugs Quantitatively in Blood and Qualitatively in Urine by LC-MS/MS to Complement Comprehensive DFC, DUID and Postmortem Testing

J Anal Toxicol. 2024 Sep 10:bkae077. doi: 10.1093/jat/bkae077. Online ahead of print.

Abstract

A streamlined LC-MS/MS method utilizing protein precipitation and filtration extraction was developed to consolidate analyses for drug-facilitated crime (DFC), postmortem investigations, and driving under the influence of drugs (DUID) testing. Fifty-seven target drug and metabolite analytes eluted in under 6-minutes and compromised of GHB precursors (1), hallucinogens (3), muscle relaxants (3), anticonvulsants (7), antidepressants (20), antihistamines (5), antipsychotics (11), antihypertensives and alpha-adrenergics (3), analgesics and anesthetics (3), and miscellaneous (1) in blood (quantitatively) and urine (qualitatively). Limits of detection were set to meet the more challenging sensitivity requirements for DFC, and are therefore also suitable for postmortem investigations, and other forensic casework, including DUID. Comprehensive ASB/ANSI validation was performed, and applicability studies examined 72 proficiency test blood and urine samples, along with 9,206 unique blood and urines samples from 5,192 authentic forensic cases that resulted in 11,961 positive analytes in samples. By expanding the analytical reach across multiple drug classes through a unified approach and screening a wider number of drugs, the technique can identify substances that might have previously evaded detection, thereby enhancing laboratory efficiency by minimizing the need for multiple tests. When combined with a recently developed in-house method, this integrated testing strategy meets the testing requirements outlined in ASB/ANSI standards and recommendations for DFC, postmortem, and Tier 1 DUID analyses.

Keywords: ASB/ANSI OSAC Standards; Comprehensive Toxicology; Driving Under the Influence of Drugs (DUID); Drug-Facilitated Crime (DFC); Drugs of Abuse; Efficiency; Multi-class; Postmortem (PM); SOFT Recommended Drugs; Sensitivity; Therapeutic Medications.