Evaluation of Illicit Drugs in Pediatric Emergency Patients Using LC-MS/MS

Introduction: Illicit drug use is an ever-increasing problem all over the world also reflected in emergency services as drug-induced toxicities. There is limited data about illicit drugs that pose pediatric emergency cases in our country which of most are based on immunochemical screening test results that are prone to false positivity and negativity or insufficient for some drugs. Materials and methods: We established validated LC-MS/MS methods for 39 illicit drug analytes and used them to evaluate blood and urine samples of pediatric emergency patients (n=50, mean age: 15.9 y, 72% male; %28 female) along with an easy and short sample preparation step. Results: Acceptable method validation results by means of linearity, repeatability, accuracy, sensitivity, and selectivity were achieved. Illicit drugs were detected in 60% of patients, of these 71.4% were male, and 40% of patients showed mixed drugs. Amphetamine-type drugs and synthetic cathinones were the most found illegal drugs in samples. Conclusion: This study was the first to use LC-MS/MS for the determination of 39 illicit drug analytes in pediatric emergency patients in our country. LC-MS/MS is a reliable, sensitive tool for the evaluation of drug-suspected emergency patients. In particular, drug use profiles that cause urgent health problems should be kept up-to-date and shared through a national network so that physicians and toxicologists, as well as officials who make regulations on illicit drug policy, should be informed.