The objective of drug screening is to detect and identify in a precise and unambiguous way all substances of interest that were consummed by the patient. Within the last decade, LC-HRMS emerged as a very powerful approach for the development of screening procedures. The availability of highly sensitive and specific instruments opened the way for faster and more comprehensive screening procedures that require minimal sample volume.
Urine is considered the gold standard for initial investigation. This matrix, which concentrates drugs and their metabolites, can be collected non-invasively in large volumes and offers a relatively large detection window. However, urine gives information on the past behavior of the patient. The information on whether the patient was under the influence of any substance at a given time can only be provided by blood. In addition, the way urine is generally collected gives way to potential tampering. Because all steps of blood collection are directly supervised, this risk is greatly limited.
One limitation of blood screening is that conventional approaches require a venipuncture to be performed by a phlebotomist. This can be a important logistical issue, particularly in the context of on-field interventions such as DUID investigations or work-place testing. HemaXis™ DB10 offers a convenient solution to collect blood, in a way that is much less invasive and easy than a conventional venipuncture. The group of Pr Thomas of the University Center of Legal Medicine in Geneva evaluated the performances of a broad-spectrum blood screening procedure by LC-HRMS on DBS samples.