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Issue 3 | July2020

Congratulations to the NADCP organization for hosting a successful RISE20 Virtual event. The Thermo Fisher Scientific Toxicology Team presents the third quarter edition of the Let’s Talk Tox newsletter. Our goal is to deliver relevant information to keep you abreast of current trends, current research and publications, educational content, technical tips and future events. This newsletter is the result of customer feedback, so we cordially invite you to send questions, comments or suggestions for topics to help us better serve you. Contact us at LetsTalkTox@thermofisher.com.

How is the COVID-19 Pandemic Affecting People with Substance Use Disorders?

The emergence of the COVID-19 pandemic around the world brought dramatic changes to daily life. In the United States, these changes included “stay at home” orders, travel restrictions and the closings of schools, restaurants, stores, bars, gyms, barber shops and hair salons. Hospitals closed their doors to everyone except patients needing urgent medical care. Physicians closed their offices to patients and were only available via telecommunications. Streets in major cities like New York, Chicago and Los Angeles were empty. Most Americans were self-isolating at home. Millions of Americans lost their job. Thousands of Americans were dying from the virus each day. Life, as we knew it, came to a screeching halt in a matter of days. 

The rapid onset of isolation distressed most Americans. For people struggling with substance abuse disorders or for those patients that are in an addiction recovery program, isolation and stress are particularly triggering. Loss of income, social distancing and sheltering at home for extended periods of time removes the critical social support needed by people trying to overcome their substance abuse. Access to medications that assist people in a recovery program may be limited or ceased. This environment could increase the incidence of substance use and of overdoses and perhaps death if first responders are not available to administer drugs like naloxone to reverse the effects of the drugs.

In response to the pandemic-caused ‘new normal,’ the Substance Abuse and Mental Health Services Administration and the Drug Enforcement Administration have enabled treatment programs to be more flexible with providing medications to patients to administer at home that will help with their addictions. But the isolation still remains a threat to these patients.

Social support is critical for the success of patients trying to overcome their addiction. Group and individual therapy sessions are being offered virtually but, are only useful for those people with access to the internet. The future for addiction treatment and the manner by which clinicians will offer treatment remains to be defined as America begins to open up socially. It’s important that the substance abuse population not be overlooked in the “new normal” world.

Technology Usage Increases as a Result of COVID-19 Pandemic

The opioid crisis in America has not stopped or lessened with the emergence of the COVID-19 pandemic. Many experts predict that the opioid crisis will worsen due to the extreme isolation measures taken to combat the transmission of the virus.

Telehealth technology has emerged as an easy-to-use solution for clinicians to establish and maintain continual contact with their patients struggling with opioid abdication. Videoconferencing with the patient has enabled continuation of counseling and treatment. It also enables group therapy which is a vital part of the recovery program.

Another technology that emerged is radio frequency identification or RFID. Many opioid drugs emerge in the street as a result of overprescribing or drug diversion by hospital staff such as physicians, nurses and pharmacists. RFID technology provides the means for auditing and tracking controlled substances from shipment to distribution and could help to minimize or eliminate overt activities for fear of getting caught.

Several organizations are implementing prescription drug monitoring programs as part of their electronic health record technologies to better monitor prescription habits and usage by patients. This allows visibility to both who is prescribing and how much opioids are being prescribed at the patient level.

In the News

A New Synthetic Opioid Hits the Streets!

Isotonitaneze, also known as “iso” has emerged in some American states including Tennessee, Illinois and Indiana. Iso is a derivative of etonitazene, a powerful analgesic opioid that is illegal. However, since isotonitaneze is not recognized on the US Drug Enforcement Administration’s list of controlled substances, it’s still legal!

Iso is either an off-white powder or pressed into a pill form. Iso has also been found mixed with cocaine. What’s alarming is that several reports claim that iso is even more potent than fentanyl and though naloxone can work, it may require more than one dose to reverse the symptoms of respiratory failure.

Law enforcement, first responders, hospitals and physicians must work together to keep abreast of new drugs that hit the street in order to have the resources available to help keep people alive. An extra dose of naloxone may save a life.

Did You Know?

Did you know that most clinical analyzer-related problems can be resolved by simply rebooting the system?

More than half of all technical problems related to instruments are fixable with a simple reboot and that applies for clinical analyzers too.

There are two main reasons for this:

  1. The computer may lose communication with the instrument or the LIS (Laboratory Information System).
  2. When the computer is running, there could be many behind-the-scenes processes that are also running. Rebooting the computer causes all programs and all background processes to end as the power leaves the computer during the restart process. Once the computer starts backup, the computer is a clean slate. By rebooting the computer and the clinical analyzer, you provide a chance for the computer analyzer software and LIS to re-establish communication. Make sure to check with the manufacturer regarding rebooting procedures first to safeguard data integrity.

Thermo Scientific™ CEDIA™, DRI™, QMS™ and Instrumentation Technical Support hotline:
Email: techservice.mgc@thermofisher.com
Phone: +1 800-232-3342, opt 2, opt 3.

Thank You!

RISE20 Virtual, from a technological perspective, was a huge success. Attendees and sponsors encountered very few glitches. We congratulate the NADCP organization for their coordination in hosting this event in the virtual environment.

Thermo Fisher Scientific expresses gratitude to those that visited our booth and attended our two workshops. 462 visitors attended the workshop titled This is How We Do It: Automated Drug Screening Strategies, featuring Jon Ridge, Chief Probation/Parole Officer from Washington County, Pennsylvania, Joel Carter, Program Coordinator/Probation Officer from Mount Vernon, Ohio and Andrew Cummings, Executive Director of Advanced Outcomes Consulting Group. 1,076 visitors attended the workshop titled CBD: Is it the New Miracle Drug or Marketing Hype?, featuring Patricia Pizzo, forensic toxicologist at DBP Consultants, Inc.

Q&A

How do I know my calibration is working?

In general, if QC is passing that means calibration is working well. Here are other general recommendations based on the Indiko™ Plus Clinical Analyzer:

  1. Check the coefficient of determination. It’s up to your laboratory to establish its own guidelines. In general, a coefficient of determination of 0.98 or above is considered passing.
  2. Check for error messages. Any error message will indicate root-cause of the problem.
  3. Check the calibration curve. Make sure the curve is ascending and check if the curve has shifted over time as these issues could have an impact on the QC performance.

What if the calibration fails?

  1. Review the amount of calibrator placed in the cup; ensure proper cup placement in the designated tray; review the calibrator cup positions in the tray.
  2. Rerun the calibration using fresh aliquots of the calibrator. Bubbles or artifacts may have interfered with the reaction at first and produced an unacceptable result.
  3. If calibration fails a second time, check the date when the calibrator was open. If approaching the expiration date or it has signs of contamination, open a new vial.

Thermo Scientific™ CEDIA™, DRI™, QMS™ and Instrumentation Technical Support hotline:
Email: techservice.mgc@thermofisher.com
Phone: +1 800-232-3342, opt 2, opt 3.

References:

1. https://www.drugabuse.gov/news-events/news-releases/2020/04/nida-director-outlines-potential-risks-to-people-who-smoke-use-drugs-during-covid-19-pandemic and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138334/
2. https://www.forbes.com/sites/forbestechcouncil/2020/06/01/how-technology-can-help-us-navigate-the-opioid-epidemic-during-the-pandemic/#4d3724041929  
3. https://www.newschannel5.com/news/local-health-officials-concerned-about-new-synthetic-opioid-in-tennessee  and https://www.thetimestribune.com/news/new-designer-opioid-is-linked-to-overdose-deaths-in-illinois-and-indiana-cincinnati-coroner-says/article_8795757e-9f63-11ea-83e4-2bbcfff92092.html

 

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