Journal of analytical toxicology
-
Chronic pain patients are frequently maintained on one or more powerful opioid medications in combination with other psychoactive medications. Urine tests provide objective information regarding patient compliance status. Little information is available on testing this unique population. ⋯ Of the 10,922 positive specimens, 15,859 results were reported as positive in various drug Classes, and 27,197 drug/metabolites were measured by gas chromatography-mass spectrometry. The frequency of illicit drug use (cannabis, cocaine, ecstasy) was 10.8%. Being the first study of this type, these data present a large array of information on licit and illicit drug use, drug detection frequencies, drug/metabolite patterns, and multi-drug use combinations in pain patients.
-
Etomidate is a commonly used anesthetic agent often utilized to induce anesthesia as it has a short half-life and allows for central nervous system depression without causing major cardiovascular disturbances, making it one of the preferred medications for trauma and hemodynamically unstable patients. Thus, etomidate is commonly found during a postmortem drug screen conducted for medicolegal reasons. ⋯ We report of a case of suicide by etomidate with concentrations of 0.40 mg/L in the femoral blood, 0.46 mg/L in the bile, and 0.30 mg/L in the vitreous with a blood alcohol content of 0.119 g/dL. For comparison, we identified two cases in which etomidate was administered during resuscitation after trauma with levels of 0.05 mg/L and < 0.026 mg/L, respectively.