Identification and quantitation of alkaloids in coca tea

Window of detection of cocaine-related alkaloids in oral fluid collected with the FloqSwab™ after coca tea consumption

Coca tea is a popular drink in some countries of South America, where it is presented as a safe energy preparation, based on a limited total content of cocaine of ∼3-5 mg. Tea bags can be bought with no legal considerations in these countries both by locals and tourists, but its consumption can have consequences when consumed overseas. Driving under the influence of cocaine is banned in most of the places in the world and can be documented by oral fluid testing. A study was implemented with coca tea bags (Coca & Muna) purchased in Peru, after a French attorney-at-law contacted the laboratory to assess the involvement of coca tea in the positive oral fluid results of a driver. Ten healthy volunteers consumed 250 mL of coca tea containing 4.5 mg of cocaine. No volunteer reported any change in behavioral effects after consumption of the coca tea. Oral fluid was collected with a swab (FloqSwab™, Copan) over 8 h to follow the elimination of cocaine and its major metabolites (benzoylecgonine and ecgonine methylester). This is the procedure used by the French police. All samples were analyzed by UHPLC-MS-MS after Quantisal™ buffer desorption. As the device does not allow measurement of the amount of collected fluid, the results are qualitative. This is in accordance with the French law that requires a yes or no response about the presence of cocaine, with a minimum required performance level of 10 ng/mL of cocaine or benzoylecgonine. Parent cocaine was identified for 30-120 min. Benzoylecgonine and ecgonine methylester were identified between 1 and 8 h, with a large inter-individual variation. Although it is generally accepted that a 4-5 mg cocaine dose has no significant pharmacological effect, the consumption of coca tea can lead to the suspension of a person's driving license due to a positive oral fluid test.

Cocaine: An Updated Overview on Chemistry, Detection, Biokinetics, and Pharmacotoxicological Aspects including Abuse Pattern

Cocaine is one of the most consumed stimulants throughout the world, as official sources report. It is a naturally occurring sympathomimetic tropane alkaloid derived from the leaves of Erythroxylon coca, which has been used by South American locals for millennia. Cocaine can usually be found in two forms, cocaine hydrochloride, a white powder, or ‘crack’ cocaine, the free base. While the first is commonly administered by insufflation (‘snorting’) or intravenously, the second is adapted for inhalation (smoking). Cocaine can exert local anaesthetic action by inhibiting voltage-gated sodium channels, thus halting electrical impulse propagation; cocaine also impacts neurotransmission by hindering monoamine reuptake, particularly dopamine, from the synaptic cleft. The excess of available dopamine for postsynaptic activation mediates the pleasurable effects reported by users and contributes to the addictive potential and toxic effects of the drug. Cocaine is metabolised (mostly hepatically) into two main metabolites, ecgonine methyl ester and benzoylecgonine. Other metabolites include, for example, norcocaine and cocaethylene, both displaying pharmacological action, and the last one constituting a biomarker for co-consumption of cocaine with alcohol. This review provides a brief overview of cocaine’s prevalence and patterns of use, its physical-chemical properties and methods for analysis, pharmacokinetics, pharmacodynamics, and multi-level toxicity.

Analysis of Erythroxylum coca Leaves by Imaging Mass Spectrometry (MALDI-FT-ICR IMS)

Matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI IMS) can determine the chemical identity and spatial distribution of several molecules in a single analysis, conserving its natural histology. However, there are no specific studies on the spatial distribution of alkaloids in Erythroxylum coca leaves by MALDI IMS, preserving the histology of the monitored compounds. Therefore, in this work, positive-ion mode MALDI Fourier-transform ion cyclotron resonance imaging mass spectrometry (MALDI(+)FT-ICR IMS) was applied to identify and analyze the distribution of alkaloids on the surface of coca leaves, evaluating the ionization efficiency of three matrices (α-cyano-4-hydroxycinnamic acid (CHCA), 2-mercaptobenzothiazole (MBT), and 2,5-dihydroxybenzoic acid (DHB)). The last was chosen as the best matrix in this study, and it was studied in five concentrations (0.5, 1.0, 2.0, 4.0, and 8.0 mg·mL^-1), where 2 mg·mL^-1 was the most efficient. The washing of coca leaves with the organic solvents (acetonitrile, methanol, toluene, and dichloromethane) tested did not improve the performance of the ionization process. Finally, a tissue section, 50 μm thick, was used to study the inner part of the leaf tissue, where alkaloids and flavonoid molecules were detected.

Analysis of Cocaine and its Metabolites in Urine After Consummation of Coca Tea by Five Subjects and Subsequent Hair Testing

Coca tea is a popular drink in some South American countries where it is reputed to have medicinal properties. This preparation is composed of natural cocaine alkaloids and therefore can be banned in some countries. During an anti-doping control in Peru, the urine of an athlete tested positive for benzoylecgonine, ecgonine methyl ester and cocaine (400 ng/mL, 180 ng/mL and 0.5 ng/mL, respectively). The athlete indicated that she had consumed a coca tea in the morning before the competition. As her lawyer contacted us to assess the scientific aspects of possible involvement of coca tea to explain the adverse analytical finding, a study was implemented with the same tea bags. Five volunteers from the laboratory consumed 250 mL of coca tea containing approximately 3.8 mg of cocaine. Urine (11 specimens for each subject) was collected over 3 days to follow the elimination of cocaine and metabolites (benzoylecgonine and ecgonine methyl ester). All samples were analyzed by UHPLC-MS/MS after alkaline extraction. Cocaine was identified for 20 hours, with concentrations ranging from 6 to 91 ng/mL. Benzoylecgonine and ecgonine methyl ester were identified for 70 hours and for 60 hours, respectively, with concentrations ranging from 6 to 3730 ng/mL and from 6 to 1738 ng/mL. The concentration profiles were identical for the five volunteers. This study supports the athlete's claims. In addition, the hair of the five subjects was collected a month later and all the hair tests were negative for cocaine using a limit of decision at 10 pg/mg. Although it is accepted that a 4 mg dose of cocaine has no significant pharmacological effect, the consummation of coca tea can lead to significant legal consequences since the measured urine concentrations sometimes cannot be considered incidental. Therefore, discrimination between coca tea consummation and recreational cocaine abuse relies primarily on hair analysis.

Do dried blood spots (DBS) have the potential to support result management processes in routine sports drug testing?

Dried blood spots (DBS) have been considered as complementary matrix in sports drug testing for many years. Especially concerning substances prohibited in-competition only, the added value of DBS collected concomitantly with routine doping control urine samples has been debated, and an increasing potential of DBS has been discussed in the scientific literature. To which extent and under which prerequisites DBS can contribute to enhanced anti-doping efforts is currently evaluated. As a proof-of-principle, two analytical applications, one targeting cocaine/benzoyl ecgonine and the other prednisone/prednisolone, are presented in this perspective to indicate potential added value but also presently existing limitations of the DBS approach.

Travel medicine, coca and cocaine: demystifying and rehabilitating Erythroxylum - a comprehensive review

Few travel health measures are as controversial as the use of coca leaves at high altitude; yet, there appears widespread ignorance among health professionals and the general public about coca, its origins as well as its interesting and often flamboyant history. Equally, the cultural and traditional significance to Andean people is not recognised. The coca leaves contain many alkaloids, one of which, cocaine, has gained notoriety as a narcotic, leading to the mistaken idea that coca equals cocaine. This article contrasts coca with cocaine in an attempt to explain the differences but also the reasons for this widespread misconception. By its very nature, there may never be scientific ‘proof’ that coca leaves do or do not work for travellers at altitude, but at least a solid knowledge of coca, and how it differs from cocaine, provides a platform for informed opinions and appropriate critical views on the current confusing and contradictory legal situation.

Erythroxylum in Focus: An Interdisciplinary Review of an Overlooked Genus

The genus Erythroxylum contains species used by indigenous people of South America long before the domestication of plants. Two species, E. coca and E. novogranatense, have been utilized for thousands of years specifically for their tropane alkaloid content. While abuse of the narcotic cocaine has impacted society on many levels, these species and their wild relatives contain untapped resources for the benefit of mankind in the form of foods, pharmaceuticals, phytotherapeutic products, and other high-value plant-derived metabolites. In this review, we describe the current state of knowledge of members within the genus and the recent advances in the realm of molecular biology and biochemistry.

Coca: The History and Medical Significance of an Ancient Andean Tradition

Coca leaf products are an integral part of the lives of the Andean peoples from both a cultural and traditional medicine perspective. Coca is also the whole plant from which cocaine is derived. Coca products are thought to be a panacea for health troubles in regions of South America. This review will examine the toxicology of whole coca and will also look at medicinal applications of this plant, past, present, and future.

Emerging pollutants in the Esmeraldas watershed in Ecuador: discharge and attenuation of emerging organic pollutants along the San Pedro-Guayllabamba-Esmeraldas rivers

Water quality characteristics and emerging organic pollutants were sampled along the San Pedro-Guayllabamba-Esmeraldas River and its main water pollution streams in the summer of 2013. The annual flow rate of the stream is 22 000 Mm(3) y(-1) and it collects the wastewater of Quito-Ecuador in the Andes and supplies drinking water to the city of Esmeraldas near the Pacific Ocean. The most persistent emerging pollutants were carbamazepine and acesulfame, which were found to be stable along the San Pedro-Guayllabamba-Esmeraldas River, whereas the concentration of most other organic emerging pollutants, such as caffeine, sulfamethoxazole, venlafaxine, O-desmethylvenlafaxine, and steroidal estrogens, was degraded to a large extent along the 300 km flow. The mass rate of the sum of cocaine and benzoylecgonine, its metabolite, was increased along the stream, which may be attributed to coca plantations and wild coca trees. This raises the possibility of using river monitoring as an indirect way to learn about changes in coca plantations in their watersheds. Several organic emerging pollutants, such as venlafaxine, carbamazepine, sulphamethoxazole, and benzoylecgonine, survived even the filtration treatment at the Esmeraldas drinking water system, though all except for benzoylecgonine are found below 20 ng L(-1), and are therefore not likely to cause adverse health effects. The research provides a way to compare drug consumption in a major Latin American city (Quito) and shows that the consumption of most sampled drugs (carbamazepine, venlafaxine, O-desmethylvenlafaxine, sulphamethoxazole, ethinylestradiol) was below their average consumption level in Europe, Israel, and North America.

Drug confirmation by mass spectrometry: Identification criteria and complicating factors

Drug confirmation by mass spectrometry coupled with chromatography is essential to toxicology, doping control, pain management, and workplace drug testing. High confidence in this technology is due to its superior specificity and sensitivity. However, there are challenges associated with drug confirmation, and proper setup and validation of these assays are important in assuring high-quality results. In this article, assay parameters required for drug confirmation are summarized based on recent scientific publications, various established guidelines, and our own practical experience. Factors affecting the result quality and correct results interpretation are critically reviewed. Several emerging technologies and their potential applications are briefly explored.

A rapid and simple determination of caffeine in teas, coffees and eight beverages

Caffeine was extracted and preconcentrated by the simple, fast and green method of dispersive liquid-liquid microextraction (DLLME) and analysed by gas chromatography-nitrogen phosphorus detection (GC-NPD). The influence of main parameters affecting the extraction efficiency investigated and optimised. Under the optimal conditions, the method was successfully applied to determination of caffeine in different real samples including five types of tea (green, black, white, oolong teas and tea bag), two kinds of coffee (Nescafe coffee and coffee), and eight beverages (regular Coca Cola, Coca Cola zero, regular Pepsi, Pepsi max, Sprite, 7up, Red Bull and Hype).The limit of detection (LOD) and limit of quantification (LOQ) were 0.02 and 0.05 μg mL(-1), respectively. Linear dynamic range (LDR) was 0.05-500 μg mL(-1) and determination coefficient (R(2)) was 0.9990. The relative standard deviation (RSD) was 3.2% (n=5, C=1 μg mL(-1)).

The use of coca: prehistory, history, and ethnography

The purpose of this article is to review the use of the natural mild stimulant coca, which is a story that originates with the prehistory of coca, evolves through its following historical uses, and leads up to the eventual development of cocaine. This discussion will begin with the botanical background of the coca plant, followed by a review of some of the prehistoric, historic and ethnographic evidence of coca use, which indicates the extensive antiquity and pervasiveness of coca use in South and Central America. The diverse roles that coca played among the Inca and other indigenous peoples led to the early adoption of coca in the West and, in turn, to the resultant discovery of cocaine and its assorted early applications, particularly for medicinal purposes.

Determination of essential oil composition from Osmanthus fragrans tea by GC-MS combined with a chemometric resolution method

The essential oils of the Osmanthus fragrans tea (OFT), Osmanthus fragrans (OF) and green tea (GT) had been extracted by steam distillation and analyzed by gas chromatography-mass spectrometry (GC-MS) with the help of heuristic evolving latent projections (HELP), an effective chemometric resolution method (CRM). The overlapping peak clusters were resolved into pure chromatograms and pure mass spectra with HELP. The qualitative analysis was performed by similarity searches in the National Institute of Standards and Technology (NIST) mass spectra database with the obtained pure mass spectrum of each component. Identification of some compounds was also assisted by comparison of temperature-programmed retention indices (PTRI) with authentic standards included in our own laboratory database under construction. The quantitative results were obtained by overall volume integration (OVI) method. A total of 67, 73 and 53 components in essential oils of the OFT, OF and GT were identified, accounting for 90.83%, 93.65% and 89.97% total contents of the essential oil of OFT, OF and GT, respectively.

Drugs of abuse: management of intoxication and antidotes

Illicit drug intoxications are an increasing public health problem for which, in most cases, no antidotes are clinically available. The diagnosis and treatment of these intoxications requires a trained clinician with experience in recognizing the specific signs and symptoms of intoxications to individual drugs as well as polydrug intoxications, which are more the rule than the exception. To make the diagnosis, the clinical observation and a urine toxicology test are often enough. Evaluating the blood levels of drugs is frequently not practical because the tests can be expensive and results may be delayed and unavailable to guide the establishment of a treatment plan. Other laboratory tests may be useful depending on the drug or drugs ingested and the presence of other medical complications. The treatment should be provided in a quiet, safe and reassuring environment. Vital signs should be closely monitored. Changes in blood pressure, respiratory frequency and temperature should be promptly treated, particularly respiratory depression (in cases of opiate intoxication) or hyperthermia (in cases of cocaine or amphetamine intoxication). Intravenous fluids should be administered as soon as possible. Other psychiatric and medical complication should receive appropriate symptomatic treatment. Research on immunotherapies, including vaccines, monoclonal and catalytic antibodies, seems to be a promising approach that may yield specific antidotes for drugs of abuse, helping to ameliorate the morbidity and mortality associated with illicit drug intoxications.

Can coca leaves contribute to improving the nutritional status of the Andean population?

BACKGROUND

Coca leaves (Erythroxylum coca) have been promoted as a food that could address the dietary deficiencies of the Andean population, but this is based on nutrient analyses of a small sample of leaves.

OBJECTIVE

We assessed the nutritional potential of eight samples of coca leaves grown in different regions of Peru.

METHODS

We used AOAC techniques to measure nutrients, nutrient inhibitors (phytate, polyphenols, oxalic acid, and fiber), and alkaloid concentrations, all expressed per 100 g dry weight (DW) of the ground leaves. Minerals were measured by inductively coupled lasma- mass spectrometry in n twondependent laboratories.

RESULTS

The leaves contained protein, , 20.28 g/1 0DW with lysine as the limiting amino acid; n-cbetarotene, 3.51 mg/100gDW ; vitamin E, 16.72 mg/100gDW ; trace amounts of vitamin D; calcium, 990.18 and 1033.17 mg/100 gDW at two different laboratories; iron, 29.16 and 29.16 mg/100 gDW; zinc, 2.71 and 2.63 mg/100 gDW; and magnesium, 225.19 and 196.69 mg/l001gDW Cocaine was the principal alkaloid, with a concentration of 0.56 g/100 gDW; other alkaloids were also identified. The results were compared with those for other edible leaves. The nutrient contributions of coca powder (5 g) and bread made with coca were compared with those of normal portions of alternative foods.

CONCLUSIONS

Two spoonfuls of coca leaf flour would satisfy less than 10% of dietary intakes for schoolchildren and adults for critical commonly deficient nutrients in the diet. Coca leaves do not provide nutritional benefits when eaten in the recommended quantities, and the presence of absorbable cocaine and other alkaloids may be potentially harmful; hence coca leaves cannot be recommended as a food.

Cross-cultural adaptation in urban ethnobotany: the Colombian folk pharmacopoeia in London

AIM OF THE STUDY

To investigate traditional health care practices and changes in medicinal plant use among the growing Colombian community in London.

MATERIALS AND METHODS

Ethnobotanical fieldwork consisted of qualitative, in-depth, semi-structured interviews with 23 Colombians living in London and botanical identification of 46 plant species actively used as herbal remedies. Subsequently, research data were compared with literature on ethnobotany and traditional herbal medicine in the home country, using a framework on cross-cultural adaptation, adjusted for the purpose of this study.

RESULTS

Similarities and discrepancies between data and literature are interpreted as potential indicators of continuity and loss (or deculturation) of traditional remedies, respectively. Remedies used in London that are not corroborated by the literature suggest possible newly acquired uses.

CONCLUSIONS

Cross-cultural adaptation related to health care practices is a multifaceted process. Persistence, loss and incorporation of remedies into the Colombian folk pharmacopoeia after migration are influenced by practical adaptation strategies as well as by symbolic-cultural motives of ethnic identity.

Coca tea consumption causes positive urine cocaine assay

BACKGROUND

Coca tea, derived from the same plant that is used to synthesize cocaine, is commonly consumed in South America and easily obtained in the United States.

OBJECTIVES

To determine whether consumption of coca tea would result in a positive urine toxicology screen for cocaine metabolites.

METHODS

Five healthy adult volunteers consumed coca tea and underwent serial quantitative urine testing for cocaine metabolites by fluorescence polarization immunoassay. The cutoff for a positive assay was chosen at 300 ng/ml, the National Institute on Drug Abuse standard.

RESULTS

Each participant's urine cocaine assay was positive (level exceeding 300 ng/ml) by 2 h after ingestion. Three out of five participants' samples remained positive at 36 h. Mean urine benzoylecgonine concentrations in all postconsumption samples was 1777 ng/ml (95% confidence interval: 1060-2495).

CONCLUSIONS

Coca tea ingestion resulted in a positive urine assay for cocaine metabolite. Healthcare professionals should consider a history of coca tea ingestion when interpreting urine toxicology results.

Cocaine distribution in wild Erythroxylum species

Cocaine distribution was studied in leaves of wild Erythroxylum species originating from Bolivia, Brazil, Ecuador, Paraguay, Peru, Mexico, USA, Venezuela and Mauritius. Among 51 species, 28 had never been phytochemically investigated before. Cocaine was efficiently and rapidly extracted with methanol, using focused microwaves at atmospheric pressure, and analysed without any further purification by capillary gas chromatography coupled to mass spectrometry. Cocaine was reported for the first time in 14 species. Erythroxylum laetevirens was the wild species with the highest cocaine content. Its qualitative chromatographic profile also revealed other characteristic tropane alkaloids. Finally, its cocaine content was compared to those of two cultivated coca plants as well as with a coca tea bag sample.

Non-Intentional Doping in Sports

Compulsory drug testing was introduced in 1968 by the International Olympic Committee. Since then, several doping cases have been reported in sports competition world wide. Positive results are based on the detection of prohibited substances, their metabolites and markers in biological (mainly urine) samples supplied by athletes. In some cases, the evidences were not contested and athletes admitted the use of banned substances. However, in other cases, athletes denied the use of doping to enhance performance and claimed to have inadvertently or passively absorbed the drug. Unfortunately, no current accepted analytical method is capable of distinguishing between a sample from a cheater and one from an athlete who was passively exposed to a doping agent. Athletes' allegations have included the passive inhalation of drug smoke (e.g. marijuana) or the ingestion of food or products sold as nutritional supplements that contained prohibited substances. In the scientific literature, several studies have been performed to investigate the possibility of an accidental exposure being the reason for the appearance of detectable quantities of banned substances in urine samples. Based on these studies, this article discusses those cases where the athlete's claims could be possible in generating a positive result in doping control and in which circumstances it would be improbable to happen.

Focused microwave-assisted extraction of cocaine and benzoylecgonine from coca leaves

Extraction of cocaine and benzoylecgonine from coca leaves was performed by focused microwave-assisted extraction (FMAE). Cocaine extraction was optimised with respect to the nature of the extracting solvent, the particle size distribution, the moisture of the sample, the applied microwave power and the radiation time. A central composite design was used to optimise the two latter parameters and to assess the robustness of the extraction method around the best conditions. FMAE generated extracts similar to those obtained by conventional solid-liquid extraction but in a more efficient manner, i.e. 30 s were sufficient to extract cocaine quantitatively from leaves. Analyses of cocaine and benzoylecgonine in coca leaves was carried out by capillary GC-FID and GC-MS for peak identification, as well as by capillary electrophoresis with UV detection.

The Possibilities of Hair Analysis in the Determination of Involuntary Doping in Sports

Although not yet fully recognised by international sporting committees, hair analysis in doping control may be a useful adjunct to drug testing of urine. It may permit access to retrospective information and the identification of banned substances, especially when exogenous abuse has to be distinguished from other forms of involuntary exposure to identical substances. Negative hair results coupled with positive urine samples may be used to draw conclusions of involuntary doping in sports whenever athletes claim not to have ingested any drug, identical substances are present in their environment or are normal constituents of food and beverages served to them immediately before the competition. Two cases are well described in the literature in which hair analyses were fundamental in documenting positive doping after urinalysis. In Brazil, 2 cases of athletes testing positive for banned substances caught our attention because of the possibility of involuntary doping; hair analysis, if performed, may have helped to clarify the results of the urinalysis. Despite the fact that it cannot be used for routine control and overrule positive urinalysis, hair analysis can detect long term exposure as well as those substances which are not excreted in urine. In the current International Olympic Committee (IOC) code, hair analysis is not yet considered useful even in special cases of doping control.