FROM THE BENCH
MNDOSA Methodology
MDH PHL is providing laboratory analysis
support for MNDOSA. Utilizing LC-QQQ
(Agilent 6460) technology, they have
developed three methods that look
for over 200 different drugs of abuse.
The multi-drug panel includes the
most commonly abused drugs of abuse
(amphetamine, methamphetamine,
cocaine, etc.), the designer drug panel
targets the synthetic cannabinoids and
cathinones, and the opiate panel targets
the synthetic opiates. Each sample
analyzed for the program is extracted
three times and spiked with method-
specific internal standards to aid in proper
identification. The drug panels were
purchased from PinPoint Testing LLC and
supplied to MDH in 96 well plates.
While specimens are dedicated for
public health surveillance use only and
laboratory test results are not included
in the patient’s medical record, MDH
followed CLIA requirements in completing
the method validations. To complete
the validations, MDH chemist Matt
Wogen spent months optimizing the LC
separation, MS parameters and extraction
efficiency for each matrix, compound
and internal standard. Due to the large
number of compounds of interest, over
100,000 different peaks were processed.
With the changing landscape of synthetic
drugs, there is a consistent need to update
the panel of compounds, requiring regular
revalidation of the methods.
Reporting and Collaboration
MNDOSA data collection began in
November 2017; preliminary data were
first presented to the advisory group
and MNDOSA partners in February
2018. The MNDOSA team at MDH
provides quarterly aggregate reports
with preliminary data to all members
of the advisory group on a quarterly
basis, as well as weekly hospital-specific
reports to each participating hospital.
According to Environmental Laboratory
Section manager Paul Moyer, MS, who
oversees the area performing the
testing at Minnesota’s state laboratory,
collaboration across divisions within
the state health department has proven
critical to development of the pilot.
Particularly vital are connections with
the Injury and Violence Prevention
Section. Moyer recommends that other
laboratories make time to meet with their
colleagues in Injury Prevention to discuss
opioid and substances of abuse. “These
individuals have a potential interest in
accurate data on the effects of chemical
exposure. At the very least, it will be
useful to have met each other. You never
know what will happen down the line.”
@APHL
• Determine the burden of substance use/
overdoses associated with recreational
drug use in select emergency
departments and hospitals in Minnesota
• Identify clusters of drug overdoses
• Identify substances causing clusters,
unusual or atypical clinical presentation
and severe illnesses to inform
approaches to treatment and prevention
• Describe the populations most affected to
focus and guide prevention efforts
MNDOSA has applied for additional
funding to continue and expand the pilot
to additional hospitals. As well as the
hospitals in Duluth, the pilot includes a
Twin Cities Level I trauma center, and
more hospitals are expected to participate
in the coming months. MNDOSA plans
to evaluate pilot data against other data
sources and assess the feasibility of
expanding to other parts of the state. n
For more information about MNDOSA,
contact project coordinator Terra Wiens
or Paul Moyer.
Thus far, MNDOSA stakeholders are
excited about the potential for further
analyses. The data have already enabled
them to see demographic characteristics
and suspected substances.
PublicHealthLabs
MNDOSA Objectives:
APHL.org
Fall 2018 LAB MATTERS
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