Untargeted Mass Spectrometry Applications for Clinical Toxicology.

Area of Science:

• Forensic Toxicology
• Analytical Chemistry
• Public Health

Background:

• The United States faces a severe overdose crisis driven by polydrug use.
• Existing drug testing methods are insufficient for the evolving drug landscape.
• Identifying novel psychoactive substances and adulterants is crucial for public health.

Purpose of the Study:

• To highlight the limitations of traditional drug testing in the current polydrug epidemic.
• To advocate for the adoption of untargeted mass spectrometry for comprehensive drug analysis.
• To discuss the potential of high-resolution mass spectrometry in clinical toxicology.

Main Methods:

• Utilizing untargeted mass spectrometry for broad-spectrum drug detection.
• Employing high-resolution mass spectrometry platforms for detailed data acquisition.
• Exploring various data analysis modes tailored to clinical toxicology applications.

Main Results:

• Untargeted mass spectrometry effectively detects novel psychoactive substances.
• This approach identifies active adulterants within the drug supply.
• It aids in diagnosing complex polypharmacy cases presenting clinically.

Conclusions:

• Untargeted mass spectrometry is essential for addressing the polydrug overdose crisis.
• High-resolution mass spectrometry offers advanced capabilities for drug testing.
• Increased accessibility of these technologies is vital for public health laboratories.