Evaluation of a urine on-site drugs of abuse screening test in patients admitted to a psychiatric emergency unit.
The objective of this study was to characterize the usefulness and reliability of a commonly used urinary on-site drugs of abuse screening test device when used routinely at admittances to a psychiatric emergency unit. Urine samples from 262 emergency psychiatric admittances representing 217 patients were analyzed by a commercially available on-site test for the detection of amphetamines, benzodiazepines, cannabis, cocaine, and opiates in urine. The samples were first screened by nurses at the psychiatric department, thereafter by 2 technicians at the laboratory, and finally, analyzed by liquid chromatography/mass spectrometry. Results of 45.8% of the screening tests were true negative for all 5 drugs/drug groups tested, whereas those of 29.4% were true positive for 1 or several drugs/drug groups and true negative for the others. Thus, in total, 75.2% were correct for all 5 drugs/drug groups. In general, the sensitivities (42.9%-90.0% for the various drug groups) were lower than the specificities (92.7%-100.0%). The accuracies were 86.3% for benzodiazepines, 92.4% for cannabis, 94.7% for opiates, and 97.0% for amphetamines. No cocaine was found in any of the samples. For cannabis, the accuracy was higher among the laboratory technicians than among the nurses. The results from on-site screening testing should not be considered as the final conclusion on the intake of drugs of abuse but must be interpreted with caution.
Østmarka Department of Psychiatry, St Olav University Hospital, Trondheim, Norway. gunnhild.bagoien@ntnu.no
Gunnhild
G
Bagøien
Gunnar
G
Morken
Kolbjørn
K
Zahlsen
Trond
T
Aamo
Olav
O
Spigset
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002853:Chromatography, Liquid / Q000379:methods; D004637:Emergency Services, Psychiatric / Q000379:methods*; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000652:urine*; D008297:Male; D013058:Mass Spectrometry / Q000379:methods; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000379:methods*; D016482:Urinalysis / Q000379:methods; D055815:Young Adult
D013287:Illicit Drugs