Toxicology is the study of the 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. In 2021, 106,699 drug-involved overdose deaths were reported in the United States. From 2015 to 2021, synthetic opioids other than methadone (mainly fentanyl) were the main cause of these deaths, with a nearly 7.5-fold increase from 2015 to 2021.
In 2021, 80,411 people died of drug overdose involving opioids, including prescription opioids, synthetic opioids other than methadone (mainly fentanyl), and heroin. 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.
