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Controlling drug abuse
Understanding the global drug problem
In 2010, up to 300 million people worldwide used an illicit drug substance at the age between 15 and
64. An approximate 10 percent share of them is consisting of heavy drug users which the United
Nations World Drug Report 2012 claims a major worldwide problem. Among them, many suffer
from infectious disease such as HIV and Hepatitis. It’s because of contaminated syringes used.
Roughly, every second injecting drug user has Hepatitis C and every fifth is a potential carrier of
HIV.1
While cannabis remains the most widely used drug worldwide, evidence is shown about an
increasing popularity of amphetamine-type stimulants. These include amphetamine and
methamphetamine agents. One of them is Ecstasy, an amphetamine derivate with hallucinogenic
effect. In common, people believe that the substances are safe and not harmful. However,
amphetamines and their derivatives cause serious health problems. Today, amphetamine-type drugs
are the world’s second most used stimulants after cannabis.
Fig.1: Popularity of amphetamines
worldwide (Source: United Nations
2012)
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Besides, the global figures indicate an increasing non-medical use of prescription drugs such as
tranquilizers and sedatives. A prevalence of illicit users in some regions is reported to be higher than
the number of legal drug intake. Among females, there is an alarming pattern of growing daily
abuse of tranquilizers, similar to the developing situation of amphetamines.
Due to the growing popularity and spread of illicit drug substances, more and more countries
conduct drug testing procedures in order to early intervene, e.g. by pre-employment testing or postaccident testing. This either needs to collect urine or blood samples from subjects. Roche’s portfolio
for urine and whole blood testing currently comprises more than 15 different drug tests.
The need of testing expanded rapidly and led to a huge increase in the number of drug tests
performed in both therapeutic and legal/forensic settings. Roche is offering a set of dedicated
solutions for toxicology analysis, law court-mandated sobriety programs, anti-doping reports and
crime scene investigations. Another area of drug abuse testing aims to improve patient safety and
treatment efficacy when accurate therapeutic drug dosing becomes crucial.
The major drug types identified by drug abuse testing include psychostimulants (Amphetamine,
Methamphetamines, Cocaine), analgesics (Opiates), Hallucinogens (Cannabinoids, Phencyclidine),
and Anesthetics (Barbiturates, Benzodiazepines).

Amphetamine (colloquial name: Base, Speed, Whizz) is a stimulant that increases the
activity of neurotransmitters in the brain such as norepinephrine and dopamine. It is
occasionally therapeutically used for the treatment of narcolepsy and attention deficit
hyperactivity disorder (ADHD). Because of its stimulating action, the drug has a high
potential for abuse and users are at considerable risk of developing tolerance and addiction.

Methamphetamine (colloquial name: Crank, Crystal Meth, Ice, Meth, Pervitin,
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Shabu, Speed) is similar to amphetamine in terms of its pharmacological effects and it is the
most widely abused, highly addictive synthetic psychotropic drug. Methamphetamine can be
easily and cheaply manufactured in illicit laboratories.

Cocaine (colloquial name: Charlie, Coke, Crack, Snow, White) is a natural compound being
extracted from the leaves of the coca plant. It owns limited medical use as a topical
anesthetic. Purified cocaine has similar biological effects to amphetamine and has been
abused as a CNS stimulant since the early 20th century.

Heroin (colloquial name: Brown, H, Horse, Smack) is a semi-synthetic analgesic opioid used
therapeutically for the treatment of severe pain. The illicit form of the drug is usually
smoked or solubilized with a weak acid and injected, causing drowsiness, euphoria, and a
sense of detachment. Tolerance and physical dependence caused by repeated use and
cessation.

Cannabis (colloquial name: Block, Dope, Ganja, Grass, Green, Hash, Pot) comprises the
dried flowers and leaves of the plant cannabis sativum and is one of the most widely
consumed drugs. Cannabis is typically smoked, often mixed with tobacco, and long-term use
carries the same associated health risks as cigarette smoking.

Phencyclidine (PCP, colloquial name: Angel dust, rocket fuel) was briefly used as a surgical
anesthetic but has since been removed from the market due to severe side effects, such as
convulsive seizures and hallucinations. Recreational use of PCP peaked in the USA during
the 1960s and 1970s. PCP is usually produced as either a liquid or a powder, but is also
comes across in tablet or spray form.

Barbiturates (colloquial name: Barbs, Downers) are depressants with effects ranging from
mild sedation to general anesthesia. The parent compound barbituric acid was first
synthesized in 1864 and the first pharmacologically active agent, barbital, was introduced in
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1904. Just about 50 of the more than 2,500 synthesized derivatives of barbituric acid have
ever been used medically.

Benzodiazepines (colloquial name: Benzos, Blues, Nerve Pills) are CNS depressants that
induce a feeling of calm and drowsiness. They are broader used than barbiturates as their
lower risk of dependency and therapeutic range. Benzodiazepines are widely used to treat
anxiety, insomnia, and other psychological conditions.
First introduced in the 1970s, immunoassays are the most widely used method for screening
biological samples for drugs of abuse. The testing procedure is fully automated in order to make
drug testing as efficient and cost-effective as possible. Modern testing instruments like the cobas
8000 modular analyzer series from Roche are capable of screening a several hundred of samples
within a short time period.
Reference:
1) United Nations (2012). World Drug Report. United Nations Office on Drugs and Crime,
Vienna/Austria.