Screening for stimulant use in adult emergency department seizure patients

Objective: The objective of this study was to determine the prevalence of p ositive plasma drug screening for cocaine or amphetamine in adult emergency department seizure patients. Methods: This prospective study evaluated con secutive eligible seizure patients who had a plasma sample collected as par t of their clinical evaluation. Plasma was tested for amphetamine and the c ocaine metabolite benzoylecgonine using enzyme-mediated immunoassay methodo logy. Plasma samples with benzoylecgonine greater than 150 ng/mL or an amph etamine greater than 500 ng/mL were defined as positive. Patient demographi cs, history of underlying drug or alcohol-related seizure disorder, estimat ed time from seizure to sample collection, history or suspicion of cocaine or amphetamine abuse, results of clinical urine testing for drugs of abuse, and assay results were recorded without patient identifiers. Results: Four teen of 248 (5.6%, 95% CI 2.7%-8.5%) plasma samples were positive by immuno assay testing for benzoylecgonine and no samples (0%, 95% CI 0-1.2%) were p ositive for amphetamine, Positive test results mere more common in patient visits where there was a history or suspicion of cocaine or amphetamine abu se (p < 0.0005), Conclusions: During this study period, routine plasma scre ening for cocaine and amphetamines in adult seizure patients had a low yiel d, As a result, routine plasma screening would yield few cases of stimulant drug in which there was neither a history nor suspicion of drug abuse in t his population.