Quest Diagnostics launches test panel for novel psychoactive substances

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Quest Diagnostics will start testing for novel psychoactive substances (NPSs) using a panel that tests for 88 compounds associated with designer drugs and illicit additives.

The new "confirmatory testing service" will use definitive liquid chromatography with advanced tandem mass spectrometry-based testing to establish NPS misuse, according to a Quest statement. NPSs are versions of established prescription and illicit drugs that are routinely chemically altered to enhance drug effects and evade tracking by law enforcement. Drug classes include designer opioids, designer benzodiazepines, synthetic cannabinoids, fentanyl analogs, and designer stimulants.

The Centers for Disease Control and Prevention (CDC) issued an advisory in June 2023 about xylazine, for example. Xylazine has been implicated in causes of death across the U.S. as an illicitly manufactured fentanyl drug product.

Other common NPS analytes detected in testing include acetyl fentanyl, bromazolam, and dimethyl pentylone. Quest Diagnostics' analysis suggests substances are being combined. In another example, nearly one in five amphetamines-positive specimens tested by Quest showed fentanyl combinations.

In its statement, Quest said the opioid epidemic has shifted to NPSs. Because the chemical composition of these substances frequently evolves, conventional point of care and laboratory test methods may fail to detect them. This increases risks for individual patients and challenges efforts to understand the long-term health effects or prevalence of NPSs in communities, the company said. The new test panel is for patients prescribed controlled medications.

In combination with the testing announcement, Quest revealed its new Health Trends report, Drug Misuse in America 2023: The Growing Crisis of Novel Psychoactive Substances, highlighting illicit drug use trends. The report was gleaned from more than 3.6 million clinical laboratory drug tests performed by Quest in 2022 and analysis of more than 3,730 randomly selected "remnant" specimens tested using a pilot version of the new NPS test panel. Quest's team of toxicologists, medical experts, and data analysts plan to periodically review and update the test panel, according to Quest.

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