Adults with opioid use disorder
The work began with Haass-Koffler talking with members of the engineering team about the challenges in measuring the presence of opioid substances in people with opioid use disorder. Blood testing for opioids generally requires substantial quantities of blood, which can be difficult to get from frequent opioid users who may have collapsed veins or other conditions. Urine tests, on the other hand, frequently produce inaccurate results.
Working closely with John Murphy, a research engineer at Brown, Fariha developed a fully automated liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay to detect opioid compounds from microsamples including serum or blood spots. They showed that the system is capable of accurately quantifying six different opioids — including buprenorphine, methadone, codeine, hydrocodone, morphine and oxycodone — using a small sample of just 20 microliters (less than a single drop) of serum.
Haass-Koffler then integrated the new diagnostic technique into an ongoing clinical trial. The trial, which assesses the use of oxytocin as a complement to opioid agonist therapy, leveraged the microsampling method to detect opioid use that traditional urine samples had missed. This enhanced detection capability provided critical insights, helping the research team demonstrate that administering oxytocin can be a valuable tool in reducing opioid use among people with opioid use disorder.
Detecting opioids in newborns
After developing a method for detecting opioids from small blood samples in adults, the researchers began thinking of other ways to apply it. Neonatal abstinence syndrome (NAS), in which babies are born with symptoms of opioid withdrawal, seemed like an obvious choice, they said.
Opioid use among expectant mothers is alarmingly high in the U.S — one recent study by the Centers for Disease Control and Prevention found that one in five pregnant women self-reported opioid misuse. Diagnosis of opioid exposure in newborns is currently made by assessing a baby’s symptoms and reviewing a mother’s opioid use history. There is currently no standard blood test for opioids in infants.
“The idea behind this work was to come up with a diagnostic method that’s more quantitative,” Fariha said.
The solution was a device that can extract potential opioid samples from dried blood spots, which are routinely gathered shortly after birth from a small prick on a baby’s heel. The device applies an electric field to a dried blood spot to draw up potential opioid compounds. Once the sample is prepared, it can be sent to a lab for analysis with a mass spectrometer, which are commonly used in neonatal testing.
The research showed that the technique can successfully detect a range of opioid substances including codeine, hydrocodone, morphine, methadone and oxycodone. And the technique is fully automated, making it easy to deploy at the clinical level, the researchers say.
Fariha said she’s hopeful that the technique can not only improve diagnosis of NAS, but also treatment. If clinicians know precisely how much opioid is present, they could potentially make more informed decisions about whether medication is necessary and in what amounts.
“At its core, this work is about more than automation,” Fariha said. “It’s about designing diagnostic tools that are precise, scalable and better aligned with the needs of real-world patients, especially in maternal and infant health.”
The researchers say both studies represent an effort to make diagnostics more useful, accessible and patient-centered.
“Diagnostics shouldn’t be locked inside centralized labs,” Fariha said. “I want to design systems that meet patients where they are — whether that’s a newborn in a NICU or a village clinic halfway around the world. As a Bangladeshi woman, I recognize the need for solutions with global translatability and impact, without requiring major infrastructural support.”
Clinical data used in the Scientific Reports study was supported by a Center of Biomedical Research Excellence grant from the National Institute of General Medical Sciences (P20 GM130414).
