INDIANAPOLIS -- With a single drop of blood, hospitals and law enforcement may soon be able to detect concentrations of synthetic illicit drugs.
Modern street drugs found on the market such as Spice and K2 do not show up in regular urine drug screenings, and people continue to overdose on them. The drugs usually are not detected until after a person dies or authorities intercept the transportation of them. One IUPUI professor and his team are working to change that.
Dr. Nicholas Manicke, and Indiana University-Purdue University Indianapolis chemistry and chemical biology assistant professor, has developed a cartridge that can test blood for these hard-to-detect compounds in a short period of time. The cartridge, about the size of a fingertip, separates the drug from the droplet of blood so it can be identified with a mass spectrometer, an instrument used to identify the kinds of particles present in a given substance.
The roots of the project date back to before Manicke even started working at the university.
“I started working on this when I was a post-doc at Purdue in West Lafayette, so that would have been four or five years ago,” he said.
The original focus of the studies was on clinical applications.
“We wanted to develop a method to measure concentration of pharmaceuticals in blood and the reason is for this application called therapeutic drug monitoring,” Manicke said. “Let’s say a cancer patient takes a chemotherapeutical drug or some other type of cancer medication and the doctor, in many ways, has to guess at the right dose. There are a lot of variables that go into dosing a patient, such as age or body weight. It would be nice if we could actually measure the amount of drug that is actively circulating in that patient’s blood so then that physician can adjust the dosage up or down to individualize it to that patient.”
Manicke found that the illicit drug problem was also something important to address. Since then, the methods have been developed and evolved over time.
Manicke’s team really started working on detecting illicit drugs about 2.5 years ago for a project supported by the National Institute of Justice to develop a drug screening method for typical or synthetic illicit drugs. Now, they are trying to identify newer drugs on the market that do not show up in a regular drug test.
“These newer synthetic drugs like Spice and K2, and also fentanyl analogs, which are causing a lot of the opiate- and heroin-related overdoses, are at very low concentrations, much lower than many of the traditional drugs we started off with,” Manicke said. “Because the concentrations in the blood are so much lower, it really took a completely different approach to detect the low amounts.”
Greta Ren, a chemistry graduate student at IUPUI, has dedicated much of her time to working on the project, Manicke said.
“It’s very different working with research that’s applicable to everyday life, when my undergrad research was fixing problems that might happen years from now or things that were way more abstract,” she said. “In the news I see all of the time that someone has overdosed on this, and I could be changing something immediately.”
Wren makes the devices using a 3-D printing facility at Herron School of Art and Design, and also tests the samples returned to the laboratory from the emergency rooms at Indiana University Health Methodist Hospital and Eskenazi Health. The hospitals began collecting samples for the project at the beginning of this summer.
“Even just knowing what drugs to look for when we get into analyzing these samples is a difficult question because Greta and I have looked into literature, but by the time a scientist writes a paper and publishes it — it could be a year old,” Manicke said. “A year could change a lot in the types of drugs that show up here, so we have to find other ways to identify what we might see.”
Dr. Daniel Rusyniak, a professor of emergency medicine and an adjunct professor of pharmacology/toxicology and neurology at the IU School of Medicine and medical director of the Indiana Poison Center, has been working to collect these samples for the project.
He said they are currently in the process of ensuring the device works and the illicit drugs can be detected accurately, but in the future he knows this research has the potential to help patients, clinicians and even policymakers.
“If somebody comes into your emergency department and has an overdose and it involves one of these newer synthetic drugs, there’s really no way to know what they took,” Rusyniak said.
For the most part, the names of the street drugs are the same, but a drug like heroin could be made up of 30 to 50 different compounds and Spice could be any one of 200 different compounds, he continued. Instead of taking a sample and sending it to another state for results, which could take weeks, this mass spectrometry technology could speed up the process and make it more cost-efficient.
“It holds the promise that some point in the future we may be able to do this type of testing in the hospital,” Rusyniak said. “So now when I have somebody come in who has overdosed, I can send off a sample, find out within an hour or so what the compound is that they’ve used, and if it’s something new I can then alert public health officials. They can make sure the information is shared within the community that there is this chemical being sold that is causing this problem.
“Law enforcement could be notified as well to be on the lookout for that particular compound or product. The ability to get the real-time results in the future would be really advantageous to both the people taking care of the patient and also public heath officials.”
Sample collection at the two Indianapolis hospitals will continue over the course of two years, while researchers continue to test and analyze the drug compounds. Both Manicke and Rusyniak hope research hospitals will be able to implement their own testing of patients in the not-so-distant future.