滥用药物检测
快速浏览
为何检测？
筛查药物使用情况，监测药物滥用成瘾者，检测并评估药物过量情况。
何时检测？
用人单位在新员工工作前，保险公司在投保人保单生效前进行检测；对某些工作场所人员和运动员随机检测；法院委托的检测；医生需要监测已知的或怀疑其滥用药物的患者时检测；当患者出现药物使用过量症状时检测。
何种样本？
随机尿标本;有时需要前臂静脉血标本；少数情况下需采集毛发、唾液或汗液标本。
是否需要作试验前准备？
不需要
检测样本
检测什么？
滥用药物检测就是在标本中中检测一种或多种非法的和/或合法的物质，通常采用尿液标本，少数情况下采用血液、唾液、毛发或汗液标本。通常包括初筛试验，而后进行确认一种或多种药物存在的二次试验。大多数实验室采用已经成熟和优化的组合试验来筛查尿液中“主要的滥用药物”。
对于大多数滥用药物试验来说，初筛试验结果要和预设的临界值（cut-off）进行比较，低于临界值视为阴性，高于临界值视为阳性。
在每一类药物检测中，都可能有很多化学性质类似的药物。在化学性质上与违禁药相似的合法药物可以导致阳性的筛查结果。因此，对于有一种或多种药物种类呈阳性的筛查试验通常采用一种非常敏感和特异的方法进行二次试验确认物质的存在，如气相色谱分析/质谱分析法(GC/MS)。
一些最常用的药物种类筛查见下表：
| 筛查药物种类 | 待确认药物 |
| 苯丙胺类 | 甲基苯丙胺、苯丙胺 |
| 巴比妥酸盐类 | 苯巴比妥、司可巴比妥、戊巴比妥 |
| 苯二氮卓类 | 安定、氯羟去甲安定 |
| 大麻类 | 大麻 |
| 可卡因类 | 可卡因和/或其代谢物（苯甲酰芽子碱） |
| 鸦片类 | 可待因、吗啡、海洛因代谢物 |
| 苯环己哌啶类(PCP) | 苯环己哌啶 |
了解更多有关药物和滥用药物分类的信息，请点击这里.
确认药物种类化学性质不相似的一些物质可以导致假阴性结果。一些药物用常规的分析方法难以检测出来，或者是因为试验本身不适用于这些药物的检测，例如亚甲二氧基甲基苯丙胺(MDMA, Ecstasy)、氧可酮(Oxycontin)或丁丙诺啡，或者是因为这些药物在体内留存时间过短，如γ-羟丁酸(GHB)。
对于与体育运动有关的激素和类固醇的检测，每种试验通常只针对某种单一物质，而且可以定量检测。运动员特别是国家级和世界级水平的那些运动员，除了要进行违禁药检测，还要进行一系列称为兴奋剂的禁用物质的检测。
由于医学和法律上的特殊要求，药物检测已经成为“无毒工作场所”或体育运动检测程序的一个组成部分。使用这些物质的人通过吞食、吸入、抽烟或注射的方式摄入体内。吸收的数量和作用的效果取决于摄入药物的种类、药物间的相互作用、药物的纯度和强度、药物的量、药物的作用周期、摄入的方式以及个体的代谢 和排泄药物的能力。一些药物能干扰其他药物的作用和代谢，产生叠加效应（例如使用两种都能抑制
测试样本如何采集？
尿液是最常用的检测样本，但是其他的机体标本例如毛发、唾液、汗液及血液也可以用于滥用药物的筛查，但不能取代尿液。
尿液和唾液要收集在干净的容器中，血标本通过采集前臂静脉血获得，采集贴近头皮的头发作为标本，汗液标本是在指定的一块皮肤区域内，在一个特定的时间段收集。
是否需要进行任何试验前准备以保证样本的质量？
不需要。
试验
常见问题
询问检验医学专家
*请根据需要选择字段。
相关页面
站内
疾病: 酒精中毒
站外
National Institute on Drug Abuse (NIDA)
NIDA: Commonly Abused Drugs
Familydoctor.org: Club drugs, Myths and Risks
Kidshealth.org: Talking to your child about drugs
U.S. Anti-Doping Agency
World Anti-Doping Agency
The World Anti-Doping Code, 2008 Prohibited List, International Standard
International Association of Athletics Federations: Anti-doping
参考文献
注意：本文是在此处引用的参考文献和医学检验项目在线介绍编辑审核委员会全体成员的经验和研究结果的基础上总结而成。本文由编辑委员会定期审核、更新。任何新引用的文献都会添加到列表中，并且会与原有的参考文献区分开。
Sources Used in Current Review
Pagana, K. D. & Pagana, T. J. (© 2007). Mosby’s Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 892-894.
Clarke, W. and Dufour, D. R., Editors (© 2006). Contemporary Practice in Clinical Chemistry: AACC Press, Washington, DC. Pp 472-474.
Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 1237-1517.
(Updated, 2009 April 14). Substance Abuse Problems. U.S. National Library of Medicine, MedlinePlus Health Topics [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/substanceabuseproblems.html through http://www.nlm.nih.gov. Accessed April 2009.
O'Connor, P. (Revised 2008 July). Drug Use and Dependence. The Merck Manual of Healthcare Professionals [On-line information]. Available online at http://www.merck.com/mmpe/sec15/ch198/ch198a.html through http://www.merck.com. Accessed April 2009.
(2008 January 1). The World Anti-Doping Code, 2008 Prohibited List, International Standard. WADA [On-line information]. PDF available for download at http://www.wada-ama.org/rtecontent/document/2008_List_Format_en.pdf through http://www.wada-ama.org. Accessed April 2009.
Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Burtis CA, Ashwood ER and Bruns DE, eds. 4th ed. St. Louis, Missouri: Elsevier Saunders; 2006, Pp 1317-1351.
Sources Used in Previous Reviews
Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].
Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby’s Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.
(2001 March). Drug Abuse: How to Break the Habit. Familydoctor.org [On-line information]. Available online at http://familydoctor.org/x2782.xml?printxml through http://familydoctor.org.
(2000 May 1). An Approach to Drug Abuse, Intoxication and Withdrawal. American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/20000501/2763.html through http://www.aafp.org.
NIDA Infofax (2001 November 29). Inhalants. The National Institute on Drug Abuse (NIDA) [On-line serial]. Available online at http://www.nida.nih.gov/Infofax/Inhalants.html through http://www.nida.nih.gov.
Office of the National Drug Control Policy (ONDCP) (1998 June) Rohypnol, NCJ-161843. The National Clearinghouse for Alcohol and Drug Information (SAMHSA) [On-line Fact Sheet]. Available online at http://www.health.org/nongovpubs/ondcp-rohypnol/ through http://www.health.org.
Segura, J. (1999 December 21). Sports Drug Testing, Medical and Regulatory aspects. University of Barcelona Olympic Studies Center [Online-index of articles]. Available online at http://www.blues.uab.es/olympic.studies/doping/segura.htm through http://www.blues.uab.es.
Bureau of Forensic Services (2001). Drug Summaries. Office of the Attorney General State of California Dept of Justice [On-line website information]. Available online at http://caag.state.ca.us/bfs/toxlab/summ.htm through http://caag.state.ca.us.
Bureau of Forensic Services (2001). An Introduction To Gas Chromatography / Mass Spectrometry (GC/MS). Office of the Attorney General State of California Dept of Justice [On-line website information]. Available online at http://caag.state.ca.us/bfs/toxlab/gcms.htm through http://caag.state.ca.us.
Dean, M. (2001 October 25). Why Britain is going Dutch. The Guardian [On-line serial]. Available E-mail: malcolm.dean@guardian.co.uk. Available online at http://www.guardian.co.uk/analysis/story/0,3604,580358,00.html through http://www.guardian.co.uk.
Harrie, D. (2004 January 28). To treat or lock up: Senate backs new drug-offense policy. The Salt Lake Tribune [On-line article]. Available online at http://www.sltrib.com/2004/Jan/01282004/utah/133259.asp?display=print through http://www.sltrib.com.
Downie, A. (2002 January 4). Brazil's drug users will get help, instead of jail. Sweeping new laws are based on the view that drug users need treatment, not criminal punishment. The Christian Science Monitor [On-line serial]. Available online at http://www.csmonitor.com/2002/0104/p7s2-woam.htm through http://www.csmonitor.com.
Reuters (2002 January 2). Florida Reports More Deaths from Oxycontin Abuse. Yahoo News Health Headlines [On-line News Release].
(2003 May 30). Race to develop drug abuse test. BBC News [On-line article]. Available online at http://news.bbc.co.uk/1/hi/health/2946344.stm through http://news.bbc.co.uk.
(2004 February 1). Online drug abuse rife. NEWS.com.au [On-line article]. Available online at http://news.com.au/common/story_page/0,4057,8554330%255E1702,00.html through http://news.com.au.
Locke, J. (2000 July). Alternative Matrices in Drug Testing. Clinical Laboratory Strategies. Available from Jalane: jtechwriter@yahoo.com.
Locke, J. (2000 July). Olympic and Sports Drug Testing. Clinical Laboratory Strategies. Interview with Larry Bowers, Ph.D., Professor and Director of Athletic Drug Testing and Toxicology Laboratory at Indiana University. Available from Jalane: jtechwriter@yahoo.com.
Locke, J. (2002 February). Drug Testing. Clinical Laboratory Strategies. Available from Jalane: jtechwriter@yahoo.com.
Locke, J. (2002 February). Drug Testing – Sidebar on Olympic Drug testing. Clinical Laboratory Strategies. Interview with Don H. Catlin, MD Director of the UCLA Olympic Analytical Laboratory and Lab Director of the Olympic drug lab for the SLC 2002 Olympics. Available from Jalane: jtechwriter@yahoo.com.
Valentine, J. & Kerrigan, S. (2001). Club or Rave Drugs. Manuscript. Available E-mail: valentinejimmiel@uams.edu.
Larry A. Broussard, PhD. Clinical Laboratory Sciences, LSU Health Sciences Center, New Orleans, LA.
Donald F. LeGatt PhD, FCACB. Clinical Professor, Clinical Biochemist, Department of Laboratory Medicine and Pathology, University of Alberta Hospital, Edmonton, Alberta.
