Titre du document / Document title

Can an immunoassay become a standard technique in detecting oxycodone and its metabolites?

Auteur(s) / Author(s)

ABADIE Jude M. ⁽¹⁾ ; ALLISON Kim H. ⁽¹⁾ ; BLACK David A. ⁽¹⁾ ; GARBIN James ⁽¹⁾ ; SAXON Andrew J. ⁽¹⁾ ; BANKSON Daniel D. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Departments of Pathology and Laboratory Medicine, Veterans Affairs Puget Sound Health Care System and University of Washington Medical Center, Seattle, Washington 98195, ETATS-UNIS

Résumé / Abstract

Opiate toxicology testing is routinely performed in the hospital setting to identify abusers and/or to determine those patients who are not taking prescribed opiate analgesics such as oxycodone. Commercially available assays for opiate detection in urine have decreased sensitivity for oxycodone, which contributes to a high false-negative rate. Functioning as a beta site, our Veterans Affairs hospital evaluated a new enzyme immunoassay, DRI® Oxycodone Assay, for its use in the qualitative and semiquantitative detection of oxycodone in urine. We hypothesize that an immunoassay for oxycodone with superior sensitivity and specificity, when compared to the traditional opiate assays, would reduce the need for more expensive and time-consuming confirmatory testing. We used the new liquid homogenous enzyme immunoassay to determine oxycodone results in a total of 148 urine samples from 4 different sample groups. Gas chromatography-mass spectroscopy was subsequently used to confirm the presence or absence of oxycodone (or its primary metabolite, noroxycodone). We also evaluated within-run, between-run, and linearity studies and conducted a crossover study to establish a cutoff value for oxycodone. In our patient population, we used the new DRI immunoassay to evaluate 17,069 urine samples to estimate oxycodone misuse profiles (patients not taking prescribed oxycodone or taking oxycodone without a prescription) during a 4-month period. The sensitivity and specificity of the new oxycodone immunoassay were 97.7% and 100%, respectively, at the cutoff concentration of 300 ng/mL. The assay linearity was 1250 ng/mL, and the sensitivity was 10 ng/mL. Within-run precision and between-run coefficient of variation were 2.3% and 1.8%, respectively. None of the 15 compounds that we evaluated for interference had crossover significant enough to produce a positive oxycodone result when using 300 ng/mL as the cutoff value. None of the 17,069 oxycodone immunoassays was followed with a request for confirmation. Among patients with positive results (n = 224), 93 (41.5%) were not prescribed oxycodone. The new DRI Oxycodone Assay is a sensitive and specific screening test for the determination of oxycodone. The improved opiate screening results may lead to better patient and prescription management, to decreased laboratory spending, and to the identification of oxycodone abusers, which could result in decreased oxycodone-related mortality.

Revue / Journal Title

Journal of analytical toxicology   ISSN 0146-4760   CODEN JATOD3 

Source / Source

2005, vol. 29, n^o8, pp. 825-829 [5 page(s) (article)] (14 ref.)

Langue / Language

Anglais

Editeur / Publisher

Preston, Niles, IL, ETATS-UNIS  (1977) (Revue)

Mots-clés anglais / English Keywords

Opiates ; Biological fluid ; Narcotic analgesic ; Human ; Urine ; Quantitative analysis ; Chemical analysis ; Enzyme immunoassay ; Metabolite ; Oxycodone ; Immunological method ;

Mots-clés français / French Keywords

Opiacés ; Liquide biologique ; Analgésique narcotique ; Homme ; Urine ; Analyse quantitative ; Analyse chimique ; Méthode immunoenzymatique ; Métabolite ; Oxycodone ; Méthode immunologique ;

Mots-clés espagnols / Spanish Keywords

Opiados ; Líquido biológico ; Analgésico narcotico ; Hombre ; Orina ; Análisis cuantitativo ; Análisis químico ; Método inmunoenzimático ; Metabolito ; Oxicodona ; Método inmunológico ;

Localisation / Location

INIST-CNRS, Cote INIST : 17415, 35400012138963.0110