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Published on: April 23, 2019
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Benzodiazepine analysis by an improved LC-MS/MS method illustrates usage patterns in Washington State.
Ka Keung Chan1, Andrea J Moore1, Andrew N Hoofnagle1
1Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98195, USA.
Summary
The enhanced liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay improves benzodiazepine detection, identifying new illicit drugs and reducing false positives from immunoassays. This leads to better patient care and laboratory practices.
Area of Science:
- Clinical Chemistry
- Forensic Toxicology
- Analytical Chemistry
Background:
- The rise in illicit benzodiazepine use necessitates improved detection methods.
- Current standard methods involve immunoassay followed by LC-MS/MS.
Purpose of the Study:
- To develop and validate an improved LC-MS/MS assay for urine benzodiazepine detection.
- To expand the benzodiazepine testing panel and assess immunoassay performance.
Main Methods:
- Developed and validated an enhanced LC-MS/MS assay for urine benzodiazepines.
- Expanded the drug panel by five, totaling fifteen benzodiazepines.
- Compared immunoassay results with LC-MS/MS findings for performance evaluation.
Main Results:
- Clonazepam and alprazolam were the most frequently detected benzodiazepines.
- Etizolam and flualprazolam showed regional prevalence.
- Immunoassays exhibited cross-reactivity, causing false positives/negatives; the enhanced LC-MS/MS assay reduced these inaccuracies.
Conclusions:
- Emerging illicit benzodiazepines require updated detection capabilities.
- The expanded LC-MS/MS assay accurately characterizes benzodiazepine epidemiology, improving patient care.
- This study offers a model for clinical laboratories expanding testing or updating instrumentation.
