TOXICOLOGY RESEARCH PROJECTS
ACMT TOXIC FENTALOG STUDY
- Investigators -- Dr. Alex Manini, Dr. Jeffrey Brent, Dr. Paul Wax
- Ongoing collaboration between CFSRE’s NPS Discovery (forensic toxicology drug testing laboratory) and ACMT's ToxIC (nationwide team of medical toxicologists)
- Waste biological specimens collected from patients presenting to emergency departments after suspected opioid overdose (or experiencing unknown drug toxicity)
- Goal -- Determine what drugs, adulterants, and/or other substance are responsible for clinical toxidrome (signs and symptoms) and monitor prevalence across the U.S.
- 10 hospital sites -- Denver, CO, Los Angeles, CA, Allentown, PA, New York, NY, Pittsburgh, PA, Newark, NJ, Grand Rapids, MI, Atlanta, GA, St. Louis, MO, and Portland, OR
- Findings disseminated through ToxIC Fentalog Study Group - Quarterly NPS Reports
- Funding -- NIH (Award# R01DA048009), CDC (Award# 3R01DA04800904S1)
- Notable Publications:
- Geographic Trends in Nonfatal Overdose Involving or Exposed to Opioids and Xylazine Across U.S. Emergency Departments
- Heroin or fentanyl: Prevalence of confirmed fentanyl in ED patients with suspected heroin overdose
- Notes from the Field: Detection of Medetomidine Among Patients Evaluated in Emergency Departments for Suspected Opioid Overdoses — Missouri, Colorado, and Pennsylvania, September 2020–December 2023
ACMT TOXIC DOTS STUDY
- Investigators -- Dr. Jeffrey Brent, Dr. Paul Wax
- 2023-2024 collaboration between CFSRE’s NPS Discovery (forensic toxicology drug testing laboratory) and ACMT's ToxIC (nationwide team of medical toxicologists)
- Blood specimens collected from patients presenting to emergency departments after suspected opioid, stimulant, or drug-suspected overdose
- Goal -- Comprehensively assess the role and prevalence of drugs, adulterants, NPS, and other relevant substances among suspected overdose events in the U.S.
- 17 participating medical centers -- Portland, OR, Sacramento, CA, San Francisco, CA, Los Angeles, CA, Phoenix, AZ, Denver, CO, Minneapolis, MN, Iowa City, IA, Boston, MA, New York, NY, Philadelphia, PA, Baltimore, MD, Washington, DC, Pittsburgh, PA, Detroit, MI, St. Louis, MO, Jackson, MS
- Findings disseminated through DOTS Reporting Program — Quarterly Reports
- Funding -- FDA (Task Order 75F40122D00028/75F40123F19002)
- Notable Publications:
NYU NIGHTCLUB SALIVA TESTING
- Research Team -- Dr. Joseph Palamar, Nina Abukahok, Patricia Acosta
- Goal -- Monitor recreational drug markets and drug use in New York City through the collection of oral fluid (saliva) from individuals attending night clubs and music events
- Ongoing collaboration to comprehensively screen samples by LC-QTOF-MS against our extensive in-house library database containing more than 1200 substances, including drugs, therapeutics, metabolites, and NPS
- Funding -- NIH (Award# 23-A1-00-1008299, R01DA057289, P30DA01104)
- Notable Publication:
- Tusi use among the New York City nightclub-attending population
- Exposures to synthetic cathinones, fentanyl, and xylazine among nightclub attendees in New York City, 2024
- Saliva detection of the cannabinoids tetrahydrocannabinolic acid A (THCA-A) and cannabinol (CBN) among nightclub attendees in New York City, 2024
UMASS SENTANYL STUDY
- Investigators -- Dr. Kavita Babu, Dr. Roland Merchant
- Ongoing, long-standing collaboration between the UMass Chan Medical School, UMass Memorial Health, and CFSRE’s NPS Discovery
- Goal -- Inform the creation of clinical care guidelines on naloxone dosing and the clinical management of patients who present to emergency departments with an apparent opioid overdose in the era of fentanyl, fentanyl analogues, non-fentanyl synthetic opioids, and concomitant polysubstance exposures
- Blood samples are collected from patients who present to the emergency department with an apparent opioid overdose. Comprehensive toxicological testing is performed for drugs of abuse, NPS, therapeutics, adulterants, cutting agents, etc. Quantitative confirmatory analysis is performed for fentanyl, cocaine, methamphetamine, additional novel synthetic opioids (e.g., carfentanil, nitazenes) and adulterants (e.g., xylazine, medetomidine).
- Summarizations of participant clinical and demographic characteristics, opioid overdose and substance use history, clinical course, treatments received, and disposition are performed.
- An evaluation of xylazine pharmacokinetics alongside fentanyl overdoses was conducted in 2024-2025 to calculate xylazine half-life in humans
- Funding -- NIH (Award# R21DA046734)
- Notable Publication:
CHEMISTRY RESEARCH PROJECTS
NPS DISCOVERY’S DRUG CHECKING INITIATIVES
- Extensive ongoing collaborations -- Brandeis University, Cook County and Chicago Departments of Public Health, Philadelphia Department of Public Health, PA Groundhogs, Thomas Jefferson University Hospital, and many others
- Goal -- Perform comprehensive drug testing on drug materials submitted by public health departments and collaborating agencies to develop real-time insights in recreational drug supplies across the United States
- Qualitative and quantitative testing of drug materials (e.g., pills, powders, etc.)
- Development and implementation of a real-time data hub -- Drug Testing Portal (link coming soon!)
- Data analysis for visualizing substance emergence, prevalence, and trends over time and across geographical regions (e.g., Northwest, Mid-Atlantic, Midwest, West)
- Ongoing development of new analytical methods (e.g., DART-QQQ-MS)
- Findings disseminated through -- Drug Checking Reports
- Funding -- CDC OD2A and a variety of sources
SMOKE SHOP TESTING
- NPS Discovery initiative to purchase products from local smoke shops to test for the presence of NPS and other substances
- Perform qualitative identification of psychoactive components in samples using GC-MS and LC-QTOF-MS
- Development of quantitative methods on LC-QQQ-MS for substances of particular concern (e.g., 7-OH mitragynine, THCP, 4-AcO-DMT)
- Accept samples (drug product and/or biological specimens) from forensic agencies, clinical institutions, and other stakeholders to test products of concern (i.e., patient in hospital after consumption of product from smoke shop)
- Findings disseminated through -- Smoke Shop Testing Reports
- Funding -- NIJ (Award# 15PNIJ-22-GG-04434-MUMU)
SYNTHETIC CANNABINOID IN JAIL AND PRISON SAMPLES
- Ongoing collaboration between CFSRE’s NPS Discovery and the Cook County Sheriff’s Office and the Fulton County Sheriff's Office
- We are actively seeking additional collaborators – contact us for more information!
- Our laboratory collaborates with jail and prison staff to receive seized materials infused with synthetic cannabinoids and/or biological specimens for comprehensive drug testing offer at no-cost under our current NIJ/DOJ funding
- Synthetic cannabinoid and precursor concentration profiles are determined using an in-house analytical method to quantify substances by LC-QQQ-MS
- Funding -- NIJ (Award# 15PNIJ-22-GG-04434-MUMU)
- Notable Publication:
EVALUATION AND IMPLEMENTATION OF DART-QQQ-MS
- In collaboration with Bruker Corporation, CFSRE chemists and graduate students are researching novel methods to detect drugs and trace substances in drug materials and toxicology samples using the Evoq DART-TQ+ system
- Direct Analysis in Real Time (DART) techniques are chromatography-free and allow for rapid screening of substances in seconds
- Our laboratory has developed a screening method for a variety of nitazene analogues, with current research focused on benzodiazepines, fentanyl analogues, and other drug classes
- Stay tuned for more updated as this exciting research continues in 2025!
NEUTRAL LOSSES AND COMMON FRAGMENT SCREENING BY LC-QTOF-MS
- Ongoing development of a liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) screening methods aimed at identifying NPS by utilizing characteristic neutral losses (NL) and common fragments (CF) associated key structural features
- Our approach aims to overcome widespread challenges with emerging NPS detection, enabling early-stage identification and classification of structurally related substances in complex matrices
- Our approach offers greater flexibility in responding to rapidly evolving drug trends
- A data independent acquisition (DIA) method was developed using a SCIEX X500R LC-QTOF-MS
- Refinement of data processing methods remains ongoing, and our preliminary work demonstrates a promising approach for detecting unknown NPS
- Our current work focuses on the nitazene analogues – an emergent class of novel synthetic opioids continually appearing in drug markets across the U.S.
- Future work will focus on applying this methodology to different NPS subclasses (e.g., orphine analogues, cathinones, etc.)
- Funding -- NIJ (Award# 15PNIJ-22-GG-04434-MUMU)
TEST STRIP EVALUATIONS
- Our laboratory conducts performance evaluations on immunoassay-based drug checking test strips for the purpose of identifying key drugs and adulterants in drug materials
- We perform assessments in-laboratory to determine true cutoff concentrations and what substances may interfere with test results producing false positives (or false negatives)
- To date, our laboratory has assessed several test strips:
For more information about the CFSRE, NPS Discovery, and our related programs, initiatives, or research projects, contact This email address is being protected from spambots. You need JavaScript enabled to view it..
