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Presumptive drug screening enables timely procurement of search and arrest warrants and represents a crucial first step in crime scene analysis. Screening also reduces the burden on forensic laboratories which often face insurmountable backlogs. In most scenarios, on-site presumptive drug screening relies on chemical field tests for initial identification.

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When faced with increasing drug-related deaths and decline in practicing forensic pathologists, the need to quickly identify toxicology-related deaths is evident in order to appropriately triage cases and expedite turnaround times. Lateral flow immunoassays conducted pre-autopsy offer quick urine drug screen (UDS) results in minutes and are used to inform the need for autopsy. Over 1000 medicolegal cases were reviewed to compare UDS results to laboratory enzyme-linked immunosorbent assay (ELISA) blood results to evaluate how well autopsy UDS predicted laboratory findings.

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Venlafaxine is an antidepressant belonging to the class of serotonin-norepinephrine reuptake inhibitors that are US Food and Drug Administration-approved to treat and manage symptoms of depression, anxiety, and other mood disorders in adults. We describe an adolescent patient who likely had a false-positive phencyclidine result detected with an 11-panel urine drug screen in an outpatient setting of long-term use of therapeutic venlafaxine extended release for the treatment of recurrent major depressive disorder and generalized anxiety disorder. We believe that this may be the first published case report to characterize this phenomenon in a young patient in the absence of an acute overdose.

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Article Synopsis
  • Pets can be exposed to illegal drugs either accidentally, intentionally, or through malicious means, with rising concerns due to increased drug use in humans.
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Phencyclidine false positive due to lamotrigine.

Am J Emerg Med

March 2023

Division of Medical Toxicology, Department of Emergency Medicine, Washington University School of Medicine, MSC 8072-17-5001, 660 S. Euclid Avenue, Saint Louis, MO 63110-1010, United States of America. Electronic address:

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