Toxicology is the study of adverse effects of chemicals on living organisms. General toxicology is typically associated with environmental and industrial toxins and poisons. Chemicals such as ethylene glycol, heavy metals, pesticides, and carbon monoxide are commonly discussed in general toxicology courses. However, it is now very clear that DOA, specifically prescription drug abuse, is far more common in the clinical setting than environmental poisons or toxins. Drugs used in the management of pain are by far the most commonly abused prescription drugs.
The National Institute on Drug Abuse (NIDA) publishes data on abuse rates. See the link below to view statistics of the past decade. Prescription drug abuse has been increasing steadily since 2002. In 2015 the biggest increases in overdose deaths are seen with heroin (a 6.2-fold increase from 2002 to 2015). Cocaine and benzodiazepine deaths that involved an opioid used for pain increased by nearly 2 and 5 fold respectively over this same time period.
In 2018 67,367 people died of drug overdoses. More people now die each year from drug overdoses (specifically drugs with analgesic properties), than the number of people killed in the Vietnam War. Drug abuse is a staggering national problem. This course will focus on DOA testing in the clinical laboratory and specifically in the context of pain management. The laboratory has a key role to play in pain management in that it is only by detecting drugs and monitoring patient compliance, that we can address issues of prescription drug abuse.
DOA testing in non-medical settings, including employment testing and legal testing is not within the scope of this course.
