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      William E. Schreiber

       Clinical Director of Chemistry, LifeLabs

       Professor, Department of Pathology and Laboratory Medicine

       The University of British Columbia

       Vancouver, Canada

      All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

      The right of William E. Schreiber to be identified as the author of this work has been asserted in accordance with law.

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      Limit of Liability/Disclaimer of Warranty The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

       Library of Congress Cataloging‐in‐Publication Data

      Names: Schreiber, William Edward, 1954– author.

      Title: An introduction to testing for drugs of abuse / William Edward Schreiber, University of British Columbia, Vancouver, Canada.

      Description: Hoboken, NJ : Wiley, 2022. | Includes bibliographical references and index.

      Identifiers: LCCN 2021058984 (print) | LCCN 2021058985 (ebook) | ISBN 9781119794059 (paperback) | ISBN 9781119794066 (adobe pdf) | ISBN 9781119794073 (epub)

      Subjects: LCSH: Drug testing.

      Classification: LCC HV5823 .S45 2022 (print) | LCC HV5823 (ebook) | DDC 615.7/040724–dc23/eng/20220107

      LC record available at https://lccn.loc.gov/2021058984

      LC ebook record available at https://lccn.loc.gov/2021058985

      Cover Design: Wiley

      Cover Image: © luchschenF/Adobe, Kondor83/Shutterstock, Stephen Orsillo/ Shutterstock, monticello/Shutterstock

      Toxicology is one of the most complex fields in laboratory medicine, and it is a frequent source of consultations. Doctors, nurses, patients, and other clients ask me a lot of questions about drug testing and what the results mean. Here are some examples.

       Can passive exposure to marijuana smoke cause a positive test for cannabis?

       Which drugs are detected by your amphetamine assay?

       If my patient is taking oxycodone, why was the screening test for opiates negative?

       How long can heroin be detected in a urine sample?

       Could this level of cocaine in blood be fatal?

      It has taken years to learn the answers and, perhaps more importantly, to locate the resources where those answers can be found. There is a huge literature on drugs of abuse and their measurement. However, it is hard to find a publication that summarizes both the testing process and the interpretation of test results. That is what laboratory and clinical practitioners need, and that is the subject of this book.

      My goal is to provide a readable account of the most common drugs of abuse – what they are, how they work, therapeutic uses, potential for abuse, and how laboratories test for them. Enough practical information is included so that readers can understand and interpret the results of drug tests. The book is an introduction, not a compendium – more detailed information is available in textbooks, journal articles, and websites, some of which are listed at the end of each chapter.

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