Pathology’s Dr. Martin Bluth tackles lab’s helpful role in drug addiction for clinical review

January 11, 2017

“Toxicology and Drug Testing,” the latest installment of the Clinics in Laboratory Medicine review series released by the medical publishing house Elsevier, is edited and co-written by Wayne State University School of Medicine Professor of Pathology Martin Bluth, M.D., Ph.D., a recognized expert in clinical pathology who Elsevier requested to explore the subject for its December 2016 issue.

“This important and timely work has been matured to address the ever-increasing concern of opioid and drug abuse, and the clinical and economic toll this epidemic continues to wreak on our nation,” Dr. Bluth said. “It serves to reduce the confusion of laboratory testing approaches that health care providers wrestle with on a routine basis by highlighting the value and utility the clinical lab and toxicology testing provides to clinicians for appropriate patient management.”

Opioids refer to addictive medications that relieve pain by switching off pain receptors in the brain, and can include prescription medications such as hydrocodone, oxycodone, morphine, codeine as well as illicit drugs such as heroin.

The review, available at, explores 13 subject areas, which address general topics including “Narcotic Analgesics and Common Drugs of Abuse: Clinical Correlations and Laboratory Assessment,” “Common Interferences in Drug Testing,” in addition to specific specialties including “Toxicology in Pain Management,” “Toxicology in Reproductive Endocrinology,” “Ketamine: A Cause of Urinary Tract Dysfunction” and “Drug Toxicities of Common Analgesic Medications in the Emergency Department”, among others.

“How does the physician know where the patient before him lies on the spectrum of ‘patient to addict’ without the aid of a crystal ball?” writes Dr. Bluth in the review’s preface, “Drug Testing and Toxicology: Redefining the Plague of Darkness.”

“The clinical laboratory… can provide objective drug compliance and monitoring assistance to aid the physician in managing the patient. The application of toxicology and drug monitoring to one’s practice can be very helpful in aiding the physician in answering two basic questions as he or she assesses the patient: Is the patient taking what has been prescribed? Is the patient taking something else?” he asked.

Dr. Bluth, who serves on the Michigan State Medical Society Committee on Health Care Quality, Efficiency and Economics and its Opioid Prescription Stewardship Task Force, took on the editing project for physicians to better understand the rubric of toxicology and drug testing, and how it relates to various clinic specialties.

“It brings clinical toxicology assessment to the forefront and edifies the inextricable benefit and ancillary objective clinical laboratory support that drug testing offers to clinical decision-making with respect to pain management, drug choice administration and metabolism, testing types and their appropriate utilization, interpretation and understanding, as well as dispelling myths and clarifying limitations in the field,” he said.

Elsevier’s Clinics in Laboratory Medicine review series represents state-of-the-art understanding of clinical management in various medical disciplines.

Dr. Bluth is chief medical officer for Consolidated Laboratory Management Systems, medical director of Pathology Laboratories for Michigan Surgical Hospital and national medical director for the martial arts therapy nonprofit program Kids Kicking Cancer.

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