Friday, November 2, 2012

Drug Screens

I think there is a general misconception in the public that all drugs can be detected by a basic blood or urine drug screen. This is not true.

First, when is a drug screen done?

There are several instances where we would likely run a drug screen. Here are a few.

1. You are having suicidal ideation. Suicidal ideation means you are having thoughts/feelings of hurting yourself and either you have presented or someone has brought you to the ED. This is fairly standard to see what might be in your system. What also will be added will be an acetaminophen (Tylenol) and salicylate (Aspirin) level. These are blood levels.

2. You are acting crazy. Meaning-- you're hearing and seeing things that aren't there. There are gait disturbances, a decreased level of consciousness. Perhaps even seizure activity. A common set-up for this scenario is a child or teen that begins to act funny at school. Here, there is a concern for ingestion and it will be best to sort out what we might be working with.

3. An actual ingestion in any age group. The history will be looked at very closely but if it is--- toddler got into grandma's medicine cabinet (this happens more often than you would think) and the youngster just flat out began to go through boxes/bottles swallowing everything in sight-- he will get a urine drug screen.

A urine drug screen can be an effective screening tool. But it definitely does not rule out all substances. That is the most important thing to know.

So-- the following drugs are on a basic drug screen. It may also be called a "drugs of abuse" of panel. Something along those lines.

1. Amphetamines-- interesting thing about this is some ADHD drugs contain amphetamines so kiddos on these will show positive. If they are on an ADHD med in this drug class-- it doesn't mean that they are not also abusing other types of amphetamines.

2. Barbiturates: The Truth Serum Drugs (Amytal Sodium, Phenobarbital and Luminal). But, do these drugs really act as truth serum? Interesting article here:

3. Benzodiazepines: Drugs like Valium, Versed and Ativan are in this drug class.

4. THC: Tetrahydrocannabinol. Cannabis. The active ingredient in marijuana.

5. Cocaine

6. Opiates: Stuff of the opium poppy seed plant. Morphine, Fentanyl, Vicodin, Lortab, Codeine

7. PCP

Notice what is not on the basic drug screen? Alcohol... we would have to test separately for this.

Is this what you thought was on a drug screen?

1 comment:

  1. Jordyn, Good stuff! I've copied this into a Word document and saved it in my "resources" file. Appreciate the information.
    (Yes, I'm a doctor--No, I don't know everything. Sorry to burst the bubble of folks out there who think I do.)