title: Identification of polysubstance abuse in the parturient.
abstract: Illicit drugs are widely used by inner city patients and their use by pregnant women has increased in recent years. The aim of this study was to determine the prevalence of polysubstance abuse among parturients at our institution who received no prenatal care ('unbooked') and to determine the accuracy of the Ontrak TesTcup an in vitro immunodiagnostic assay. We prospectively analysed urine from 50 'unbooked' parturients and found that 26 (52%) tested positive for cocaine. Of these, six patients (23%) were also positive for morphine. All TesTcup results were confirmed by the hospital laboratory using alternate chemical methods. When comparing TesTcup to the hospital laboratory, there were no false positive or negative results. Given the high frequency of concomitant opioid abuse in cocaine-abusing parturients, anyone suspected of cocaine abuse should be tested for other illicit substances. TesTcup is a clinically accurate test that allows the rapid assessment of several drugs of abuse, which may impact on anaesthetic care.
authors.affiliation: Department of Anesthesiology and Obstetrics and Gynecology, St Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons of Columbia University, 1000 Tenth Ave., New York, NY 10019, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Birnbach
authors.forename: I M
authors.initials: IM
authors.lastname: Browne
authors.forename: A
authors.initials: A
authors.lastname: Kim
authors.forename: D J
authors.initials: DJ
authors.lastname: Stein
authors.forename: D M
authors.initials: DM
authors.lastname: Thys
mesh_terms: D019970:Cocaine-Related Disorders / Q000175:diagnosis; D005260:Female; D006801:Humans; D007159:Immunologic Tests / Q000379:methods; D009293:Opioid-Related Disorders / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011295:Prenatal Care / Q000379:methods; D011446:Prospective Studies; D011934:Reagent Strips; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis*
chemical_list: D011934:Reagent Strips