Drug abuse has been part of our society for centuries, but the technology to test body fluids for drugs has only been available for less than 50 yr. Testing for illicit drugs first began in Vietnam (1). In the late 1960s, an unusually large number of soldiers began returning home from Southeast Asia as heroin addicts. Identifying these GIs proved difficult. The unpopularity of the Vietnam War was already a public relations disaster for the Nixon administration, and sending our soldiers home as heroin addicts was another war tragedy that the Administration did not want. White House staffers began to look for tools that could be used to rapidly screen thousands of GIs before they returned to the United States. The search ended in 1970, when SYVA Company, a small research organization located in Palo Alto, California, developed a rapid test system capable of detecting opiates in urine. The system used an innovative homogeneous methodology based on the tumbling action of free radicals in solution. This technology was known commercially as free radical assay technique (FRAT) (2). The test was conducted by using an electron spin resonance spectrometer to measure the action of the free radicals. The equipment to conduct this test was somewhat cumbersome, but it was quickly deployed to Vietnam and became an effective screening tool. The FRAT technology had a short but successful commercial life and was replaced 2 yr later by a more robust technology from SYVA known as enzyme-multiplied immunoassay technique (EMIT) (3). This new system utilized an enzymatic reaction that was measured on a simple spectrophotometer. EMIT became the gold standard for the next generation of successful drug-testing methodologies. Other screening technologies followed from Roche, Abbott, and Microgenics. Each of these new technologies further refined the screening tools to identify drug users by testing their body fluids. These technologies will be discussed in more detail in Chapter 3.
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