Ejaz Hassan Khan, Sameena Ghayur, Farooq Ahmad Khan, Asma Shaukat.
Drug abuse testing: A clinico-pathological study of opiates and cannabinoids addiction.
Pak J Pathol Jan ;7(4):19-25.

Analytical procedures are now available which can provide accurate and precise drug analysis which is vital in two major fields i.e. therapeutic drugs and drugs of abuse testing. A clinicopathological study was planned to evaluate the usefulness of cannabinoids and opiates testing out of drugs of abuse. The analytical performance of the methods, establishment of quality control, validity of therapeutic ranges, clinical presentation, duration of addiction in case of addicts and their urinary metabolite, effect of opiate addiction on different parameters of semen analysis and on testosterone, FSH, LH and prolactin levels were main aspects of the study. Our results showed that the fluorescent polarization immunoassay was an accurate and precise method and met all requirements of good quality control. A large number of patients addicted with opiates or cannabinoids had been taking these drugs of abuse for more than two years at the time of diagnosis. About 25% of cannabinoid addicts had urinary metabolite levels of more than 2000 ng/ml. They commonly presented with euphoria, anxiety, loss of concentration and disorientation in space and time. Half of opiate addicts had urinary opiate levels of more than 5000 ng/ml. They commonly presented with gastrointestinal complaints, polyuria, confusion dizziness, reduced sexual ability and blurred vision. There was no effect of opiate addiction or of its treatment on serum testosterone, FSH or LH levels. However treatment of opiate addicts resulted in hyperprolactinaemia. Opiate addicts also had abnormalities in semen analysis including low volume, oligospermia and decreased sperm motility.

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