Pain medicine specialist receives award for new advances in oral fluid testing

This year's Eastern Pain Society Scientific meeting was held at Mount Sinai Beth Israel Medical Center in New York City in late October and is one of the largest meetings of pain physicians and fellows in the tri-state area. At the meeting, Naum Shaparin, MD, a pain medicine specialist at Montefiore Hospital, was presented an award as one of the top new studies that was presented during the annual conference.

A poster presentation titled, "Prescription Compliance Monitoring of Plasma Oxycodone, Hydrocodone, and Morphine Concentration Ranges in Patients at Steady State from Measured Oral Fluid Levels," which focuses on the development of dose correlations using oral fluid testing on patients undergoing chronic oxycodone therapy, was delivered by Shaparin. In the study, oral fluid results were compared to blood results to create an algorithm to perform oral fluid dose correlations.

"Much attention has been given to developing better ways to monitor opiate use in the pain management and primary care medical fields. Patients prescribed chronic opiates are at risk of abuse and toxicity," said Richard Stripp, PhD, chief scientific officer with Sterling Healthcare Services, and one of the coauthors of this study. "It has become more and more important to document appropriate drug concentration ranges in patients to ensure proper therapeutic levels of the drug and to ensure patient compliance."

"It would be a big step forward in toxicology testing to provide physicians a powerful, simple, non-invasive tool for determining whether the medication levels are within the expected range for the particular patient," Stripp adds.

While traditional toxicology tests, such as urine drug screens, are ideal for detection of drugs of abuse and suitable for confirming whether a medication is present or absent in a patient, a more comprehensive test that indicates whether the drug concentrations are within the expected range based on dosing is highly desirable. Seeing how a dose compares with the quantitated results on the lab report enables clinicians to detect whether a patient is taking the correct dosage and whether that dosage is effective in the patient—considering genetics, metabolism, drug interactions, and more.

"The ability to relate a measured oral fluid concentration to a calculated steady state range in oral fluid is a novel and revolutionary approach to prescription pain medication monitoring in the clinical toxicology field," said Shaparin.