{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:41:25Z","timestamp":1791664885938,"version":"4.3.4"},"reference-count":127,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Toxicology testing for drugs associated with scenarios such as recreational use or substance use disorder can be performed in support of the emergency department (ED) for specific patient populations such as pediatrics and trauma. These compounds were historically referred to as drugs of abuse (DOA); although the word \u201cabuse\u201d is recognized as potentially stigmatizing, no replacement terminology for DOA has emerged in current guidelines. This document refers to these compounds as drugs or substances of misuse, and acknowledges the need for less-stigmatizing language that more fully encompasses the range of uses for these drugs. This literature-driven, consensus guidance document provides recommendations primarily targeted to US hospital-based laboratories performing urine drug testing (UDT) in support of the ED. Indications for ordering UDT and related testing in both pediatric and adult populations are summarized. Further, recommendations are made for testing that should be available at all facilities with rapid turnaround, and how to perform and report testing. The advantages and disadvantages of immunoassays and mass spectrometry, as well as common challenges, are reviewed. Indications for mass-spectrometry assays and more extensive testing (e.g., novel psychoactive substances) are also provided. Future directions for improvements in laboratory technology to improve the utility of this testing are outlined. All laboratories should collaborate with ED leadership, medical toxicologists and poison control centers to optimize and update test menus to reflect local drug use patterns, ensure test methodologies and results meet clinical needs, and educate clinical staff regarding assay limitations and accurate test interpretation.<\/jats:p>","DOI":"10.1093\/jalm\/jfaf172","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T12:39:51Z","timestamp":1760618391000},"page":"155-180","source":"Crossref","is-referenced-by-count":4,"title":["ADLM Guidance Document on Laboratory Testing for Drugs of Misuse to Support the Emergency Department"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0769-7165","authenticated-orcid":false,"given":"Christine L H","family":"Snozek","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona , Phoenix, AZ ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0856-8402","authenticated-orcid":false,"given":"Matthew D","family":"Krasowski","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Iowa Hospitals and Clinics , Iowa City, IA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M","family":"Colby","sequence":"additional","affiliation":[{"name":"Premier Biotech Labs LLC , Minneapolis, MN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamisha L","family":"Johnson-Davis","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Utah Health , Salt Lake City, UT ,","place":["United States"]},{"name":"ARUP Institute for Clinical and Experimental Pathology , Salt Lake City, UT ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca E","family":"Bruccoleri","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Clinical Pharmacology, Vanderbilt University Medical Center , Nashville, TN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy E","family":"Melanson","sequence":"additional","affiliation":[{"name":"Department of Pathology Brigham & Women\u2019s Hospital, Harvard University Medical School , Boston, MA ,","place":["United 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