Forensic Drug Detection in Occupational Medicine

Forensic drug analysis refers to the identification and quantification of illegal drugs, or drugs administered beyond therapeutic indications. Particularly, the use of drugs by people in the workplace has significant safety and economic consequences. Workers, especially in safety sensitive positions, can be monitored for the use of recreational drugs, or the administration of certain medications without a prescription. In general, enforcing these standards requires pre‐employment, random, and for‐cause drug testing.
  • Anabolic steroids, β-agonists: promotion of muscle growth and lean muscle mass
  • Synthetic cannabinoids, synthetic cathinones (e.g. methcathinone): recreational use and abuse
  • Antidepressants, sedatives: sedation, mood disorders alleviation
  • Antipsychotics: psychotic disorders control
  • Hallucinogens, anesthetics: distortion of individual’s perception of reality
  • Narcotic analgesics (e.g. methadone, morphine), pain control drugs (e.g. oxycodone, fentanyl): addiction
  • Anti-inflammatory drugs: pain control 
  • Stimulants (e.g. amphetamine, cocaine): alertness
Forensic drug analysis is carried out in two steps: screening and confirmation. Forensic drug screening is performed through the use of various test kits (e.g. immunoassays). Samples are then sent to more advanced laboratories for confirmation tests. Confirmation requires high sensitivity and selectivity toward drugs, as well as their metabolites, and is frequently carried out by gas chromatography / mass spectrometry. 

Forensic drug detection in the workplace may require blood or urine samples measurements. However, there are also tests using other matrices, such as oral fluid, sweat, and hair.

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