Wednesday, January 3, 2018

Always confirm presumptive results. Always.

Baltimore police raided a grocery store at the beginning of December 2017 and seized 13.2 pounds of what they suspected was morphine and 16.5 pounds of what they suspected was fentanyl. Two individuals faced distribution of fentanyl and other related drug charges and then were held in jail without bail. Other items seized were vials, containers, tubes, capsules, and plastic bags.

Turns out that the drugs were neither morphine nor fentanyl. As reported by the Baltimore Sun, charges have been dropped in the case as the substances were not identified by the crime laboratory as morphine or fentanyl or illicit drugs or controlled substances. The story seems to still be developing and as reported, the police say they will provide more information Thursday (1/4/2018) as to the substance's identity.

Thoughts?

Now, I'm not sure in this case if presumptive field tests were used, but this is a good reminder to always confirm presumptive results prior to making any medical or legal decision. Field tests, color tests, reagent tests, point of care device tests, dipstick tests, laboratory immunoassay tests, and other similar tests are considered presumptive in nature. They are prone to false positive results (and false negative results too). Care must be taken in interpreting a presumptive test and if any important decision is to be made using the result, the result must be confirmed via an alternate more specific confirmatory method such as gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-tandem mass spectrometry (LC-MS/MS), which is not prone to false positives (or negatives).

Also, as to what the substance was? Maybe one of the many fentanyl analogs or designer opioids available in the wild these days? That's complete speculation, but if it was an analog, I wouldn't expect the police to drop charges. Maybe flour or sugar? Or some baking powder? This was a corner shop/grocery store after all. Who knows what the substance was. I guess we'll find out when the police let us know.

Stay tuned on this one.

In case you want to read about false positive results for amphetamines by a presumptive immunoassay test, read this (a little ditty...about immunoassays).


References

http://www.baltimoresun.com/news/maryland/crime/bs-md-ci-store-raid-folo-20171206-story.html

http://www.baltimoresun.com/news/maryland/crime/bs-md-ci-fentanyl-charges-dropped-20180103-story.html


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