This is a guide for the implementation and use of liquid chromatography-mass spectrometry (LC-MS) – based toxicological screening, a more advanced alternative to traditional immunoassay.
LC-MC provides a multi-targeted, highly selective, and sensitive screening capability compared with the screening of limited drug classes or target analytes offered by traditional immunoassay. Various LC-MS approaches have been used as an alternative, including LC-MS/MS, LC-TOF-MS, and LC-QTOF-MS. These techniques are amenable to toxicological screening, using routine postmortem or antemortem specimens. MS-based screening has received significant attention because of the proliferation of novel psychoactive substances (NPS) and the need for increased and rapidly adaptable testing scope and sensitivity. These benefits are an important consideration for NPS (e.g., novel synthetic opioids, benzodiazepines, cathinones, and cannabinoids), the use of which is typically transient and dominated by geographic trends, requiring flexibility regarding analytical testing. Since cost is a significant issue in the adoption of this procedure, this report discusses anticipated implementation costs and potential funding sources. Considerations are also addressed regarding the provision of this analytical service, instrument selection and issues in conducting method development and validation. Data interpretation is also addressed. 32 resource listings