ABSTRACT
There is a wide disparity in the emphasis placed on toxicology testing in modern hospitals. Some hospitals have extensive toxicology testing with relatively sophisticated instruments that are dedicated to the detection and measurement of poisons. Many others do little or no testing for poisons except for those toxins that are very common or a part of routine medical practice. This latter group of laboratories would test, for example, for digoxin, a cardioactive drug that is often involved in overdoses. Such labs might also test for the most common drugs of abuse. These tests would be urine-based, qualitative, and usually less than 100% specific. Why is there little uniformity among healthcare institutions in regard to the extent of their test menus? This is, to some extent, a function of the specific mission of the medical center. For example, an urban institution located where drug abuse is a severe problem would be more likely to develop elaborate toxicology laboratory facilities. Further, the directors of laboratory facilities do not always agree on what the precise role of drug testing should be. Opinions differ. Some pathologists and laboratory scientists have great faith in the ability of the toxicology laboratory to help the attending physician. Other laboratory directors are of the opinion that limited medical resources are better directed at other areas.
