CLN Daily 2026
For patients presenting with suspected drug overdose or poisoning, every minute matters. Yet comprehensive toxicology testing often relies on liquid chromatography-mass spectrometry (LC-MS/MS), a highly accurate but time-intensive workflow requiring sample preparation before analysis.
The scientific session, “Alternative sampling for rapid toxicology screening by mass spectrometry,” moderated by William Clarke, PhD, MBA, DABCC, FADLM, will explore emerging technologies that could dramatically shorten turnaround time while preserving analytical confidence.
The session will highlight several innovative approaches that reduce or even eliminate traditional chromatographic separation. Rather than positioning these technologies as replacements for LC-MS/MS, the speakers will discuss how these methods may complement existing workflows by providing rapid screening in situations where timely clinical decisions are critical. Chromatographic methods will continue to provide definitive confirmation and quantitative analysis when needed.
The session will open with Clarke who will present the MassSpec Pen, a handheld ambient ionization platform being developed for rapid, non-invasive toxicology screening.
Originally designed for tissue analysis, the technology is now being adapted for clinical toxicology through direct sampling of biological specimens with minimal sample preparation. Coupled with High Resolution Mass Spectrometry (HRMS), the platform enables broad-spectrum detection of drugs and metabolites while preserving the analytical confidence of mass spectrometry.
Clarke will highlight the development of a modular, cart-based system and will present early clinical studies demonstrating proof of concept detection of drugs of abuse across multiple specimen types. While the findings will underscore the potential for bringing mass spectrometry closer to the patient, he will emphasize that additional optimization and larger validation studies will be required before the technology can complement routine LC-MS/MS testing.
Next, Joshua DeBord, PhD, will discuss work using direct analysis in real-time mass spectrometry (DART-MS), an ambient ionization technique capable of rapidly screening drugs with minimal sample preparation. By bypassing chromatography, DART-MS can significantly reduce analysis time while maintaining clinically useful specificity for many toxicology applications. The approach has shown promise for the rapid detection of opioids and benzodiazepines, potentially supporting faster clinical decision-making in emergency settings.
In the final presentation, Patrice Ohouo, PhD, NRCC, MLS(ASCP), will focus on desorption electrospray ionization mass spectrometry (DESI-MS), another ambient ionization technology that enables ultra-rapid detection of drug metabolites directly from biological samples. In addition to toxicology screening, DESI-MS offers opportunities for tissue imaging and spatial molecular analysis, suggesting broader applications in pathology and precision medicine.
Although each speaker will describe a different analytical approach, they all share a common goal for the session: moving mass spectrometry closer to the point of clinical decision-making by simplifying sample preparation and delivering actionable results more quickly.
As clinical toxicology continues to evolve, the technologies highlighted in this session point toward a future in which laboratories may be able to deliver comprehensive drug testing in minutes rather than hours.
While significant validation, implementation, and regulatory challenges remain, advances in alternative sampling and high-resolution mass spectrometry are bringing the field closer to faster, more flexible testing that can better support real-time patient care.