Tox Tuesday: Industry expert Alberto Salomone

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Alberto Salomone has been the president of the European Workplace Drug Testing Society (EWDTS) since 2015 and is the laboratory supervisor at the Centro Regionale Antidoping e di Tossicologia “A. Bertinaria” in Turin, Italy. Having received ISO 17025 accreditation in 2009, the lab performs over 300,000 tests per year for road and workplace drug testing, driving re-licensing and drug abuse history.

Salomone is regularly appointed as an expert by the prosecutors or counsels in Italy to provide chemical analysis and assessment within complex judicial cases on biological fluids, drug-facilitated crimes and post-mortem.

Here is what he had to say when we spoke to him regarding all things toxicology:

What are the current drug trends, in your view?

Salomone: For most European forensic laboratories, current drug trends mean “old drugs.” Every day we see cannabis and cocaine, and more rarely but constantly, heroin users. Other drugs such as amphetamine/methamphetamine and ketamine are sporadic and related to very specific contexts. This scenario hasn’t changed much in the last years for all drugs except for cannabis and its derivatives. In terms of quantitative results, it is not unusual to observe high concentrations of THC and its metabolites in biological samples. Actually, this is not surprising, since the majority of hashish and marijuana seized nowadays in the illicit market have a higher psychoactive content than in the past.

Salomone

Qualitatively speaking, we are also observing an increase in the number of positive results, because of two completely different reasons. First, more and more countries in Europe are legalizing cannabis for medical use. Second, non-medical products containing cannabidiol and low levels of THC are becoming available (e.g., in Switzerland and Italy), although it has not yet been exhaustively investigated whether the use of such products may produce a positive result for THC. Some definitive analytical evidence will be certainly needed in the future in all forensic situations, including workplace drug testing, in order to discriminate among the aforementioned product use.

What about new drugs?

Salomone: If we talk about upcoming drug trends, we of course should think “new drugs.” Two possible scenarios are likely to account for the intake of new psychoactive substances (NPS) by individuals, and specifically those involved in regular testing, for instance for driving re-licensing or in workplace drug testing. The first one suggests that certain classes of drug consumers will be deliberately induced to substitute the “old drugs” with the new synthetic substances, allowing them to avoid judicial sanctions. The second, different but equally worrying, is represented by the unknowing intake of NPS, to whom ecstasy and opioids users are especially exposed. Indeed, it has been proven that worldwide traffickers often replace MDMA and heroin with other chemicals (e.g. cathinones, fentanyl and analogues) and then sell the counterfeited products to unsuspecting drug users.

What difficulties do you see as an analyst?

Salomone: The intake of “new drugs” has posed a serious challenge in terms of analytical determination in biological samples since day one. The good news is that, today, a series of new elements has modified the perspective, thanks to the recent immunoassays, ultra-high performance liquid chromatography (UHPLC) tandem mass spectrometry and UHPLC–high resolution mass spectrometry instrumentation — which allows the detection of extremely large NPS panels within a single analytical test or run. As a matter of fact, several forensic and clinical laboratories are now offering screening and confirmation for different classes of new psychoactive substances. It is still plausible that the screening methods developed by the laboratories might miss a certain number of positive samples, because of the analytical challenges posed by the difficulties in identifying unscheduled compounds, the wide variations in chemical structure, and a lack of commercially available standards. However, the analytical capability is overall improving, and we should all address our efforts in this direction, thus to decrease the occurrence of false negative results in the forthcoming years.

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