Comprehensive toxicological screening of common drugs of abuse, new psychoactive substances and cannabinoids in blood using supported liquid extraction and liquid chromatography-quadrupole time-of-flight mass spectrometry

Immunoassay (IA) is currently the most widely used technique for toxicological screening in drug-impaired driving investigations. However, practical limitations in the scope of testing, and the emergence of new psychoactive substances (NPSs), have highlighted the need for alternative approaches, particularly mass spectrometry-based screening. High-resolution mass spectrometry broadens the scope of testing to include NPSs and increases analyte specificity compared to IA. In addition, it provides a platform with increased flexibility and adaptability to incorporate emerging drugs of interest due to the transient drug market. In this study, a comprehensive screening procedure was developed to identify >200 drugs of interest, including cannabinoids and NPSs in whole blood. Supported liquid extraction and liquid chromatography-quadrupole time-of-flight mass spectrometry using All Ions data acquisition were used. The method was validated in accordance with published recommendations, and all compounds of interest were identified at recommended cutoffs for driving under the influence of drug investigations. Cannabinoids, including 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol, fentanyl analogs, buprenorphine, novel synthetic opioids and synthetic cannabinoids, were identified at low- to sub-nanogram/milliliter concentrations in whole blood using both positive and negative electrospray ionization acquisition methods.