Narcotic Analgesics and Common Drugs of Abuse: Clinical Correlations and Laboratory Assessment

Pain management is an evolving discipline. New formulations mature with promises of improved pain control, better dosing, and fewer side effects. These agents also have an equal risk for abuse. Street chemists are adept at manipulating drugs to more potent versions and creating new compositions of matter. The clinical assessment of the patient is paramount to developing an index of suspicion of overdose, toxicity, or illicit drug use; the clinical laboratory can be a resource to support investigations and guide therapy. The clinical toxicology laboratory needs to keep in step, adapting technology and methodology to facilitate detection of such substances.