Drug Testing Methods for Attention Deficit Hyperactivity Disorder Prescription Drug Abuse

Attention deficit/hyperactivity disorder (ADHD) medication abuse, frequently by teens and young adults, has resulted in an increase in emergency room visits. A January 2006 Food and Drug Administration advisory panel recommended that ADHD medication carry a warning of increased potential for cardiac problems, such as hypertension, cardiac arrest and stroke. The possibility of experiencing medical problems may be exacerbated by using ADHD medications improperly, or in combination with other drugs.

Ritalin is the ADHD prescription drug that is most frequently abused. It is a CNS stimulant that is chemically known as methylphenidate, which when metabolized by the liver, forms ritalinic acid (RA) i.e. when someone pops in a pill of Ritalin, within the liver this methylphenidate is converted or metabolized into ritalinic acid as a primary metabolite. Now, both methylphenidate and its metabolite ritalinic acid can be used for diagnostic purposes. Various diagnostic techniques have been developed over last few decades for drug identification and quantification purposes; some of the most common have been briefly mentioned below:

- Liquid/Gas Chromatography
- Mass Spectrometry
- Enzyme Linked Immunoassays

Liquid/Gas Chromatography: Chromatography is a process used for separating mixtures by virtue of differences in their absorbency. Most frequently employed methods for chemical compound separation and subsequent identification include gas chromatography (GC) and high-performance liquid chromatography (HPLC). HPLC employs incompressible silica or alumina •µ-beads as the stationary phase and pressures of up to a few thousand psi over the sample which most frequently is urine.

Mass Spectrometry: Developments of technology and methodology in the field of mass spectrometry have been rapid over the last seven years and are providing highly sensitive and accurate strategies for drug detection purposes. In this, a spectroscope is used for obtaining a mass spectrum by deflecting ions into a thin slit and measuring the ion current with an electrometer. Usually, selected reaction monitoring (SRM) as well as an electro-spray ionization source (EIS) are used to detect both urinary methylphenidate and the more prevalent metabolite which is ritalinic acid in this case. The major advantage of MS analysis is that this ionization technique tolerates a reasonable amount of impurities in the sample to be analyzed and many different samples can be processed rapidly in an automated manner and these can be kept on the target for several days without compromising the quality of the analysis, allowing easy re-analysis when required.

Enzyme linked immunoassays: ELISA uses antibodies that are covalently linked to a "reporter enzyme" such as alkaline phosphatase or horseradish peroxidase, enzymes whose products are readily detected, often just by a color change. The serum or urine to be tested is placed along with a solution of antibodies covalently linked to a reporter enzyme. If methylphenidate or ritalinic acid is present, the specific antibodies will adhere to them. The presence and quantity of bound antibody are then determined by adding the substrate for reporter enzyme and quantitative analysis can be done on the basis of intensity of the developed color.

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