The rise of designer drugs is creating new challenges for both law enforcement and forensic toxicology laboratories, leading to new methods to identify and combat the often-deadly substances.
Designer drugs are analogs of controlled substances that are designed to mimic the pharmacological effects of the original drug. They range from synthetic marijuana, also called “spice,” to stimulants known as “bath salts,” to fentanyl analogs that are thousands of times more powerful than pharmaceutical fentanyl and that can kill in very small doses.
George Behonick, PhD, laboratory director and chief toxicologist at Axis Forensic Toxicology in Indianapolis, says the most pressing focus today is on fentanyl analogs, which have proliferated in recent years. “Some of these drugs seem to just show up overnight,” he says. “We are now testing for about a dozen of these analogs.”
According to the National Institute on Drug Abuse, there are at least 16 fentanyl analogs, including acetyl fentanyl, carfentanyl and cyclopropofentanyl. The Centers for Disease Control and Prevention (CDC) estimates that drug overdose deaths exceeded 60,000 in 2016 and were partially driven by a fivefold increase in overdose deaths involving synthetic opioids, including fentanyl analogs. Carfentanyl (carfentanil) which is 5,000 times as potent as a unit of heroin and 10,000 times as potent as morphine, is one of the deadliest forms of these analogs.
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Fentanyl Analogs Present Threats to Law Enforcement
Not only do fentanyl analogs kill users at a high rate, but they also are a significant threat to law enforcement personnel and first responders. Minute amounts – equivalent to a few grains of salt – of fentanyl can be lethal and visually can be mistaken for cocaine or white powder heroin, says the Drug Enforcement Administration (DEA), which issued a warning to law enforcement personnel in June 2016 to exercise extreme caution when handling possible fentanyl-containing materials.
“One of the biggest challenges for law enforcement is the immediate identification of substances that they find on a crime scene,” notes Behonick. “They are trying to identify it in solid-dose forms whereas post-mortem toxicology labs are trying to combat the problem by identifying it through blood and urine.”
Police officers often use handheld spectrometers to scan unknown substances for presumptive testing. Confirmatory testing is still required by toxicology testing, but the presumptive tests can be useful in determining treatment options for those who have overdosed.
While the gold-standard technology for identifying drugs in the lab remains mass spectrometry, the rapid rise of new designer drugs challenges toxicology laboratories to constantly develop tests or modify existing assays to identify these toxins.
“The challenge for us is in developing new methods for these emerging drugs in biological matrices which are inclusive of the pre-analytical phase, the analytical phase and the post-analytical management and interpretation of data,” says Behonick.
QTOF Detects Fentanyl Analogs in Minute Quantities
SCIEX’s X500R QTOF (quadrupole time-of-flight) is among the current generation of mass spectrometers that can detect fentanyl analogs in minute quantities. Introduced in 2015, the X500R uses high-resolution MS technology to detect illicit substances down to the picogram level, which can then be cross-referenced through ChemSpider, a chemical structure database.
Phil Taylor, global marketing manager, food, environment and forensics for SCIEX, sees mass spectrometry technology moving from nominal mass instrumentation, such as the triple quadrupole instrumentation, to more advanced platforms that will provide a higher level of detail than previous technology.
“The pursuit in forensic toxicology is accuracy,” says Taylor. “The demand from the judicial system is for accurate and concise results. That’s what’s driving the market.”
Advancements in Rapid Detection of Fentanyl Analogs
According to a study published in Forensic Chemistry in June 2017, advancements are also being made in using thermal desorption direct analysis in real time mass spectrometry (TD-DART-MS) and ion mobility spectrometry (IMS) as tools for the rapid and sensitive (nanogram to picograms) detection of fentanyl, 16 fentanyl analogs and five additional opioids (heroin, U-47700, buprenorphine, methadone and naloxone).
TD-DART-MS is sensitive to picogram levels of a wide range of illicit drugs, reports the study by NIST researchers, noting that these instruments have potential applications in mobile laboratories, emergency vehicles and hospitals.
“Current guidelines recommend an enzyme-linked immunosorbent assay (ELISA) screen for fentanyl followed by gas chromatography/mass spectrometry (GC/MS) analysis,” write the study authors. “As NPF concentrations in blood can be quite low, a wipe-based technique, such as TD-DART-MS targeting solid trace contamination on the individual or their belongings, may be a more effective approach. TD-DART-MS may also be useful in emergency medicine, providing a rapid identification of the specific NPF to make informed choices about treatment.”
IMS instruments are commonly used in airports, where a security officer might swab a piece of luggage or a passenger’s hands, and then insert the swab into the instrument to check for traces of explosive residue.
“Currently, police officers have to handle drugs to test them,” says Edward Sisco, a research chemist at NIST and one of the lead authors of the NIST study. “But with these technologies, they can just swab the outside of the bag to test for fentanyl.” If the test comes back positive, they can take extra precautions.
IMS instruments cost around $25,000 and are about the size of a microwave oven, small enough to be transported by a mobile hazmat unit. TD-DART-MS instruments, which are more sensitive but larger and more expensive, could potentially be used for screening incoming material at a forensic lab before it is handled by evidence examiners.
NIST was the first to publish the IMS and TD-DART-MS signatures for the 16 fentnyl analogs tested. According to NIST, Sisco and his co-authors are speaking with IMS manufacturers about adding the newly identified signatures to their product software.
“We hope this makes a real difference to the people who come into contact with synthetic opioids,” says Sisco. “The opioid epidemic is a huge problem. This might be one small way to try to get a handle on it.”