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de Jong LAA, Kloost T, Olyslager EJH, Böttcher M, Wieferink JA, Vossenberg P, Belgers M, Beurmanjer H, de Haan HA. Towards adherence monitoring using breath or oral fluid as a matrix in a methadone maintenance treatment program for patients with a chronic heroin use disorder: Issues and interpretation of the results. J Anal Toxicol 2023; 47:842-849. [PMID: 37639616 DOI: 10.1093/jat/bkad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/13/2023] [Accepted: 08/28/2023] [Indexed: 08/31/2023] Open
Abstract
Urine has been the preferred matrix for monitoring heroin and methadone adherence due to its large detection window. Drawbacks such as privacy concerns and adulteration however require other matrices. The study aims to determine if oral fluid and exhaled breath are suitable alternatives for heroin and methadone monitoring and to assess the detection time in exhaled breath. Forty-three participants, all on methadone and heroin-assisted treatment, were studied. Participants were monitored after the first and right before the second dosage of heroin. At both time points, oral fluid and exhaled breath samples were collected with urine at the second time point. All samples were screened for opiates, methadone and other drugs using immunoassay and LC-MS-MS. At the second time point, 98% of oral fluid samples and all exhaled breath samples tested positive for 6-monoacetylmorphine (6-MAM). Regarding morphine detection, the findings were reversed (100% in oral fluid, 98% in exhaled breath). Methadone-related results were 100% positive across all matrices, as expected. Notable is the detection of the heroin marker acetylcodeine in oral fluid and exhaled breath samples, which resulted in relatively low negative predictive value (average 54.6%). Oral fluid and exhaled breath are suitable alternatives for heroin and methadone maintenance monitoring. Clinicians should consider ease of collection, adulteration risk, costs, turn-around time and the substance of interest while choosing a matrix. In addition, even in cases when medicinal heroin is used, medical professionals should be aware of the presence of acetylcodeine in these alternate matrices.
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Affiliation(s)
- Lutea A A de Jong
- Department of Clinical Pharmacy, Expert center Gelre-iLab, Gelre Hospitals, P.O. Box 9014, Apeldoorn 7300 DS, The Netherlands
| | - Tim Kloost
- Department of Clinical Pharmacy, Expert center Gelre-iLab, Gelre Hospitals, P.O. Box 9014, Apeldoorn 7300 DS, The Netherlands
| | - Erik J H Olyslager
- Department of Clinical Pharmacy, Expert center Gelre-iLab, Gelre Hospitals, P.O. Box 9014, Apeldoorn 7300 DS, The Netherlands
| | - Michael Böttcher
- Department of Toxicology, MVZ Medizinische Labore Dessau Kassel GmbH, Bauhüttenstr. 6, Dessau-Roßlau 06847, Germany
| | - Jan A Wieferink
- Department of Clinical Pharmacy, Expert center Gelre-iLab, Gelre Hospitals, P.O. Box 9014, Apeldoorn 7300 DS, The Netherlands
| | - Peter Vossenberg
- Tactus Addiction Treatment Center, P.O. Box 154, Deventer 7400 AD, The Netherlands
| | - Maarten Belgers
- IrisZorg, Institute for Addiction Care and Sheltered Housing, Mr. B.M. Teldersstraat 7, Arnhem 6842 CT, The Netherlands
| | - Harmen Beurmanjer
- Novadic-Kentron Addictioncare, Hogedwarsstraat 3, Vught AE 5261, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, Nijmegen 6500 HE, The Netherlands
| | - Hein A de Haan
- Tactus Addiction Treatment Center, P.O. Box 154, Deventer 7400 AD, The Netherlands
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Al-Asmari AI, Alharbi H, Al-Zahrani AE, Zughaibi TA. Heroin-Related Fatalities in Jeddah, Saudi Arabia, between 2008 and 2018. TOXICS 2023; 11:248. [PMID: 36977013 PMCID: PMC10099738 DOI: 10.3390/toxics11030248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
To date, epidemiological studies have not evaluated heroin-related deaths in the Middle East and North African regions, especially Saudi Arabia. All heroin-related postmortem cases reported at the Jeddah Poison Control Center (JPCC) over a 10-year period (21 January 2008 to 31 July 2018) were reviewed. In addition, liquid chromatography electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) was utilized to determine the 6-monoacetylmorphine (6-MAM), 6-acetylcodeine (6-AC), morphine (MOR), and codeine contents in unhydrolyzed postmortem specimens. Ninety-seven heroin-related deaths were assessed in this study, and they represented 2% of the total postmortem cases at the JPCC (median age, 38; 98% male). In the blood, urine, vitreous humor, and bile samples, the median morphine concentrations were 280 ng/mL, 1400 ng/mL, 90 ng/mL, and 2200 ng/mL, respectively; 6-MAM was detected in 60%, 100%, 99%, and 59% of the samples, respectively; and 6-AC was detected in 24%, 68%, 50%, and 30% of the samples, respectively. The highest number of deaths (33% of total cases) was observed in the 21-30 age group. In addition, 61% of cases were classified as "rapid deaths," while 24% were classified as "delayed deaths." The majority (76%) of deaths were accidental; 7% were from suicide; 5% were from homicide; and 11% were undetermined. This is the first epidemiological study to investigate heroin-related fatalities in Saudi Arabia and the Middle East and North African region. The rate of heroin-related deaths in Jeddah remained stable but increased slightly at the end of the study period. Most patients were heroin-dependent abusers and from the middle-aged group. The availability of urine, vitreous humor, and bile specimens provided valuable information regarding the opioids that were administered and the survival time following heroin injection.
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Affiliation(s)
- Ahmed I. Al-Asmari
- Laboratory Department, Ministry of Health, King Abdul-Aziz Hospital, Jeddah 21442, Saudi Arabia
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Hassan Alharbi
- Poison Control and Forensic Chemistry Center, Ministry of Health, Jeddah 21176, Saudi Arabia
| | | | - Torki A. Zughaibi
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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3
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Bollini SM, Banks JF, Hobbs GA. Urine Thebaine Determination by Liquid Chromatography Tandem Mass Spectrometry After Poppy Seed Consumption. Drug Test Anal 2022; 14:1539-1546. [PMID: 35478494 DOI: 10.1002/dta.3274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/25/2022] [Accepted: 04/12/2022] [Indexed: 11/11/2022]
Abstract
Laboratories are challenged to distinguish whether a positive urine morphine result is due to heroin use or possible poppy seed consumption. Thebaine is an opium alkaloid that has been shown to be present in the urine of individuals who have consumed poppy seeds, as well as those who have used opium. It is not present in heroin. We present a sensitive, specific liquid chromatography tandem mass spectrometry (LC-MS/MS) assay for thebaine. We show that thebaine is detectable after consumption of two different poppy seed-containing products for up to 72 hours in urine. We discuss limitations of the assay and suggest how the test might best be used.
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Buchweitz JP, Zyskowski J, Lehner AF. Heroin Fatality in a Feline: A Case Report with Postmortem Liver Concentrations. J Anal Toxicol 2021; 46:e36-e41. [PMID: 33475731 DOI: 10.1093/jat/bkab011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 11/12/2022] Open
Abstract
A case of feline intoxication and fatality with the illicit drug heroin is described. A five-year-old castrated male domestic short hair cat was recently diagnosed with an active pneumonitis and left at home for a couple days under the care of another resident. Upon return, the owner found his cat dead with strong suspicion of foul-play. The cat was necropsied by a local veterinary clinic to retrieve the liver for diagnostic toxicology. The postmortem liver sample screened positive for 6-acetylmorphine and 6-acetylcodeine by gas chromatography mass spectrometry (GC-MS). Deconvolution techniques were applied to chromatograms and revealed the additional presence of morphine and mirtazapine. Subsequent quantitation of mirtazapine, heroin, morphine, 6-acetylmorphine, 6-acetylcodeine was performed by gas chromatography tandem quadrupole mass spectrometry (GC-MS/MS). Although companion animal fatalities arising from toxicities are a likely consequence of drug abuse in a home, this is the first reported case of a malicious feline fatality resulting from heroin with quantitation of heroin metabolites.
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Affiliation(s)
- John P Buchweitz
- Michigan State University Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, 4125 Beaumont Rd, Lansing, MI 48910, USA.,Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, 784 Wilson Rd, East Lansing, MI 48824, USA
| | - Justin Zyskowski
- Michigan State University Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, 4125 Beaumont Rd, Lansing, MI 48910, USA
| | - Andreas F Lehner
- Michigan State University Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, 4125 Beaumont Rd, Lansing, MI 48910, USA
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5
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Al-Asmari AI. Postmortem Liver and Kidney Tissue Concentrations of Heroin Biomarkers and Their Metabolites in Heroin-Related Fatalities*†. J Forensic Sci 2020; 65:2087-2093. [PMID: 33460103 DOI: 10.1111/1556-4029.14537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 01/23/2023]
Abstract
A method was developed and validated for analyzing 6-monoacetylmorphine, morphine, 6-acetylcodeine, and codeine in routine postmortem liver and kidney specimens using liquid chromatography-tandem mass spectrometry. Samples were prepared with a Stomacher instrument followed by solid-phase extraction. All calibration curves [0.5-1000 ng/g] were linear with coefficients of determination greater than 0.99 and limits of quantification of 1.0 ng/g. Within-run precision ranged between 2.0% and 8.0%, between-run precision ranged between 1.0% and 9.0%, and accuracy ranged between -5.0% and +3.0%. Matrix effects ranged from -18% to +9%. After matrix effects were excluded, analytical recoveries ranged from 76% to 94%. The distributions of 6-monoacetylmorphine, morphine, 6-acetylcodeine, and codeine were investigated in 31 postmortem cases in which heroin was the primary cause of death. In the current study, the median free morphine ratios were calculated for liver to blood and kidney to blood, which were 2.2 and 4.0, respectively. The current report highlights the importance of testing multiple specimens, including liver and kidney, in heroin-related deaths, especially if no blood samples are available. Furthermore, this work presents new information regarding the distribution of heroin metabolites in liver and kidney.
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Affiliation(s)
- Ahmed I Al-Asmari
- Laboratory Department, King Abdul-AzizHospital-Jeddah Health Affair, Ministry of Health, P.O. BOX 4670, Jeddah, Makkah AL-Mukharmah, 21442, Saudi Arabia
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6
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Semi-quantitative analysis of drugs of abuse in human urine by end-point dilution flow immunochromatographic assay. JPC-J PLANAR CHROMAT 2020. [DOI: 10.1007/s00764-020-00041-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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7
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Al‐Asmari AI. Postmortem Fluid Concentrations of Heroin Biomarkers and Their Metabolites. J Forensic Sci 2019; 65:570-579. [DOI: 10.1111/1556-4029.14200] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/06/2019] [Accepted: 09/06/2019] [Indexed: 11/28/2022]
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8
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Mthembi PM, Mwenesongole EM, Cole MD. Chemical profiling of the street cocktail drug 'nyaope' in South Africa using GC-MS II: Stability studies of the cannabinoid, opiate and antiretroviral components during sample storage. Forensic Sci Int 2019; 300:187-192. [PMID: 31128330 DOI: 10.1016/j.forsciint.2019.04.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 01/30/2023]
Abstract
Nyaope is a mixture of low grade heroin, cannabis products, antiretroviral drugs and other materials added as bulking agents. It is a highly physically additive mixture which is smoked by users. As part of the development of a method for the analysis and profiling of nyaope this study evaluates the stability of the cannabinoid, opiate and antiretroviral components of nyaope during storage following seizure. Conditions used were those typically used for storage of drug seizures: in a desiccator in a refrigerator, in a desiccator in the dark at room temperature, in a desiccator in daylight at room temperature and ambient room temperature in the dark in a cabinet used for storage of drug seizures. Street samples of cannabis (Δ9-tetrahydrocannabinol) and heroin were mixed with efavirenz and nevirapine tablets to mimic a nyaope sample. The samples were homogenized and transferred into glass bottles and extracted with tertiary butyl alcohol (tBuOH) and analysed by gas chromatography - mass spectrometry (GC-MS) after the powdered drugs had been stored for intervals of 0 and 24 h under each storage condition. The data obtained indicates that the target drug components in nyaope samples decompose and that for comparison purposes the drug extracts should be prepared in tBuOH immediately after seizure because of the decomposition of the drug components during storage prior to extraction and analysis. The implications of this work are that law enforcement agencies dealing with nyaope and wanting to compare drug samples may need to change their practice around how the drug is handled after seizure but prior to analysis.
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Affiliation(s)
- P M Mthembi
- Department of Genetics, University of the Free State, P.O. Box 339, Bloemfontein, 9300, South Africa; South African Police Services Forensic Science Laboratory, Chemistry Section, Private Bag X620, Pretoria, 0001, South Africa.
| | - E M Mwenesongole
- Department of Genetics, University of the Free State, P.O. Box 339, Bloemfontein, 9300, South Africa; Department of Chemical and Forensic Sciences, Botswana International University of Science and Technology, Palapye, Botswana
| | - M D Cole
- Faculty of Science & Technology, Anglia Ruskin University, Cambridge, United Kingdom
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Thaulow CH, Øiestad ÅML, Rogde S, Karinen R, Brochmann GW, Andersen JM, Høiseth G, Handal M, Mørland J, Arnestad M, Øiestad EL, Strand DH, Vindenes V. Metabolites of Heroin in Several Different Post-mortem Matrices. J Anal Toxicol 2018; 42:311-320. [DOI: 10.1093/jat/bky002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cecilie Hasselø Thaulow
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Åse Marit Leere Øiestad
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Sidsel Rogde
- Department of Forensic Sciences, Section of Forensic Pathology and Clinical Forensic Medicine, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, N-0318 OSLO, Norway
| | - Ritva Karinen
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Gerd Wenche Brochmann
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Jannike Mørch Andersen
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Gudrun Høiseth
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Marte Handal
- Department of Mental Disorders, Norwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 OSLO, Norway
| | - Jørg Mørland
- Norwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 OSLO, Norway
- Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, N-0318 OSLO, Norway
| | - Marianne Arnestad
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Elisabeth Leere Øiestad
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
- School of Pharmacy, University of Oslo, PO Box 1068 Blindern, N-0316 Oslo, Norway
| | - Dag Helge Strand
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
| | - Vigdis Vindenes
- Department of Forensic Sciences, Section of Forensic Toxicology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, N-0318 OSLO, Norway
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10
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Leung KW, Wong ZC, Ho JY, Yip AW, Cheung JK, Ho KK, Duan R, Tsim KW. Surveillance of drug abuse in Hong Kong by hair analysis using LC-MS/MS. Drug Test Anal 2017; 10:977-983. [DOI: 10.1002/dta.2345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 11/10/2017] [Accepted: 11/10/2017] [Indexed: 12/19/2022]
Affiliation(s)
- K. Wing Leung
- Division of Life Science and Center for Chinese Medicine, Division of Life Science; The Hong Kong University of Science and Technology; Clear Water Bay Hong Kong China
| | - Zack C.F. Wong
- Division of Life Science and Center for Chinese Medicine, Division of Life Science; The Hong Kong University of Science and Technology; Clear Water Bay Hong Kong China
| | - Janet Y.M. Ho
- Division of Life Science and Center for Chinese Medicine, Division of Life Science; The Hong Kong University of Science and Technology; Clear Water Bay Hong Kong China
| | - Ada W.S. Yip
- Division of Life Science and Center for Chinese Medicine, Division of Life Science; The Hong Kong University of Science and Technology; Clear Water Bay Hong Kong China
| | - Jerry K.H. Cheung
- Division of Life Science and Center for Chinese Medicine, Division of Life Science; The Hong Kong University of Science and Technology; Clear Water Bay Hong Kong China
| | - Karen K.L. Ho
- Division of Life Science and Center for Chinese Medicine, Division of Life Science; The Hong Kong University of Science and Technology; Clear Water Bay Hong Kong China
| | - Ran Duan
- Division of Life Science and Center for Chinese Medicine, Division of Life Science; The Hong Kong University of Science and Technology; Clear Water Bay Hong Kong China
| | - Karl W.K. Tsim
- Division of Life Science and Center for Chinese Medicine, Division of Life Science; The Hong Kong University of Science and Technology; Clear Water Bay Hong Kong China
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11
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Du P, Zhou Z, Bai Y, Xu Z, Gao T, Fu X, Li X. Estimating heroin abuse in major Chinese cities through wastewater-based epidemiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 605-606:158-165. [PMID: 28666170 DOI: 10.1016/j.scitotenv.2017.05.262] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 05/26/2017] [Accepted: 05/29/2017] [Indexed: 06/07/2023]
Abstract
Heroin consumption in major cities across China was estimated for the first time via wastewater-based epidemiology. Influent and effluent wastewater samples were collected from 49 wastewater treatment plants (WWTPs) in 24 major cities that cover all the geographic regions of the country. Concentrations of morphine, 6-acetylmorphine, and codeine were measured. Near complete removal of morphine by wastewater treatment processes was observed, whereas removal rates of codeine were slightly lower. Morphine loads were much higher than codeine loads at most WWTPs in China, a trend opposite to that in many European countries. In addition, morphine and codeine loads were strongly correlated at most WWTPs, indicating morphine and codeine in wastewater were predominantly from the same source, street heroin. At WWTPs in Guangzhou and Shenzhen, codeine loads were considerably higher than morphine loads, consistent with previous reports of codeine abuse (e.g., as cough syrup) among middle and high school students in Guangdong province. Heroin consumption was derived based on morphine loads and taking into account therapeutic use of morphine and codeine, as well as contribution of codeine and acetylcodeine in street heroin. Highest heroin consumption was observed in northwestern and southwestern China. The average heroin consumption of the sampled cities was 64.6±78.7mg/1000inh/d. The nation-wide average heroin consumption was much lower than that of methamphetamine, consistent with seizure data and numbers of registered heroin and methamphetamine users in China.
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Affiliation(s)
- Peng Du
- Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, 100871 Beijing, China
| | - Zilei Zhou
- Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, 100871 Beijing, China
| | - Ya Bai
- Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, 100871 Beijing, China
| | - Zeqiong Xu
- Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, 100871 Beijing, China
| | - Tingting Gao
- Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, 100871 Beijing, China
| | - Xiaofang Fu
- Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, 100871 Beijing, China
| | - Xiqing Li
- Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, 100871 Beijing, China.
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12
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Maas A, Madea B, Hess C. Confirmation of recent heroin abuse: Accepting the challenge. Drug Test Anal 2017; 10:54-71. [DOI: 10.1002/dta.2244] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/30/2017] [Accepted: 06/30/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Alexandra Maas
- Department of Forensic Toxicology; University Bonn, Institute of Forensic Medicine; Bonn Germany
| | - Burkhard Madea
- Department of Forensic Toxicology; University Bonn, Institute of Forensic Medicine; Bonn Germany
| | - Cornelius Hess
- Department of Forensic Toxicology; University Bonn, Institute of Forensic Medicine; Bonn Germany
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13
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Gracia-Lor E, Castiglioni S, Bade R, Been F, Castrignanò E, Covaci A, González-Mariño I, Hapeshi E, Kasprzyk-Hordern B, Kinyua J, Lai FY, Letzel T, Lopardo L, Meyer MR, O'Brien J, Ramin P, Rousis NI, Rydevik A, Ryu Y, Santos MM, Senta I, Thomaidis NS, Veloutsou S, Yang Z, Zuccato E, Bijlsma L. Measuring biomarkers in wastewater as a new source of epidemiological information: Current state and future perspectives. ENVIRONMENT INTERNATIONAL 2017; 99:131-150. [PMID: 28038971 DOI: 10.1016/j.envint.2016.12.016] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 12/12/2016] [Accepted: 12/16/2016] [Indexed: 05/19/2023]
Abstract
The information obtained from the chemical analysis of specific human excretion products (biomarkers) in urban wastewater can be used to estimate the exposure or consumption of the population under investigation to a defined substance. A proper biomarker can provide relevant information about lifestyle habits, health and wellbeing, but its selection is not an easy task as it should fulfil several specific requirements in order to be successfully employed. This paper aims to summarize the current knowledge related to the most relevant biomarkers used so far. In addition, some potential wastewater biomarkers that could be used for future applications were evaluated. For this purpose, representative chemical classes have been chosen and grouped in four main categories: (i) those that provide estimates of lifestyle factors and substance use, (ii) those used to estimate the exposure to toxicants present in the environment and food, (iii) those that have the potential to provide information about public health and illness and (iv) those used to estimate the population size. To facilitate the evaluation of the eligibility of a compound as a biomarker, information, when available, on stability in urine and wastewater and pharmacokinetic data (i.e. metabolism and urinary excretion profile) has been reviewed. Finally, several needs and recommendations for future research are proposed.
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Affiliation(s)
- Emma Gracia-Lor
- Research Institute for Pesticides and Water, Universitat Jaume I, Castellon, Spain; IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Department of Environmental Health Sciences, Milan, Italy.
| | - Sara Castiglioni
- IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Department of Environmental Health Sciences, Milan, Italy.
| | - Richard Bade
- Research Institute for Pesticides and Water, Universitat Jaume I, Castellon, Spain.
| | - Frederic Been
- Toxicological Center, University of Antwerp, 2610 Wilrijk, Belgium.
| | - Erika Castrignanò
- Deparment of Chemistry, Faculty of Science, University of Bath, Bath BA2 7AY, UK.
| | - Adrian Covaci
- Toxicological Center, University of Antwerp, 2610 Wilrijk, Belgium.
| | - Iria González-Mariño
- IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Department of Environmental Health Sciences, Milan, Italy.
| | - Evroula Hapeshi
- NIREAS-International Water Research Center, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus.
| | | | - Juliet Kinyua
- Toxicological Center, University of Antwerp, 2610 Wilrijk, Belgium.
| | - Foon Yin Lai
- Toxicological Center, University of Antwerp, 2610 Wilrijk, Belgium.
| | - Thomas Letzel
- Analytical Group, Chair of Urban Water Systems Engineering, Technical University of Munich, Germany.
| | - Luigi Lopardo
- Deparment of Chemistry, Faculty of Science, University of Bath, Bath BA2 7AY, UK.
| | - Markus R Meyer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Saarland University, 66421 Homburg, Germany.
| | - Jake O'Brien
- National Research Center for Environmental Toxicology, The University of Queensland, Coopers Plains, QLD 4108, Australia.
| | - Pedram Ramin
- Dept. of Environmental Engineering, Technical University of Denmark, Denmark.
| | - Nikolaos I Rousis
- IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Department of Environmental Health Sciences, Milan, Italy.
| | - Axel Rydevik
- Deparment of Chemistry, Faculty of Science, University of Bath, Bath BA2 7AY, UK.
| | - Yeonsuk Ryu
- Ecotoxicology and Risk Assessment, Norwegian Institute for Water Research, Oslo, Norway.
| | - Miguel M Santos
- CIMAR/CIIMAR, LA-Interdisciplinary Centre for marine and Environmental Research, University of Porto, Portugal; FCUP-Dept of Biology, Faculty of Sciences, University of Porto, Rua do Campo Alegre, 4169-007 Porto, Portugal.
| | - Ivan Senta
- Rudjer Boskovic Institute, Zagreb, Croatia.
| | - Nikolaos S Thomaidis
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece.
| | - Sofia Veloutsou
- Analytical Group, Chair of Urban Water Systems Engineering, Technical University of Munich, Germany.
| | - Zhugen Yang
- Division of Biomedical Engineering, School of Engineering, University of Glasgow, G128LT Glasgow, United Kingdom.
| | - Ettore Zuccato
- IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Department of Environmental Health Sciences, Milan, Italy.
| | - Lubertus Bijlsma
- Research Institute for Pesticides and Water, Universitat Jaume I, Castellon, Spain.
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14
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Chen P, Braithwaite RA, George C, Hylands PJ, Parkin MC, Smith NW, Kicman AT. The poppy seed defense: a novel solution. Drug Test Anal 2013; 6:194-201. [DOI: 10.1002/dta.1590] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 10/31/2013] [Accepted: 11/04/2013] [Indexed: 11/07/2022]
Affiliation(s)
- P. Chen
- Division of Analytical and Environmental Sciences (Department of Forensic and Analytical Science); FWB, King's College London; SE1 9NH, UK
| | - R. A. Braithwaite
- Division of Analytical and Environmental Sciences (Department of Forensic and Analytical Science); FWB, King's College London; SE1 9NH, UK
| | - C. George
- Division of Analytical and Environmental Sciences (Department of Forensic and Analytical Science); FWB, King's College London; SE1 9NH, UK
| | - P. J. Hylands
- Institute of Pharmaceutical Science; FWB, King's College London; SE1 9NH, UK
| | - M. C. Parkin
- Division of Analytical and Environmental Sciences (Department of Forensic and Analytical Science); FWB, King's College London; SE1 9NH, UK
| | - N. W. Smith
- Division of Analytical and Environmental Sciences (Department of Forensic and Analytical Science); FWB, King's College London; SE1 9NH, UK
| | - A. T. Kicman
- Division of Analytical and Environmental Sciences (Department of Forensic and Analytical Science); FWB, King's College London; SE1 9NH, UK
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15
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Abstract
Urine is recognized as the prime matrix for drug test screening with well-established methods and testing protocols. Its major limitation is with regard to the inconvenience of sample collection and lack of integrity due to adulteration, dilution, drug spiking or sample exchange. The question is whether oral fluid, with its apparent better sample integrity, can replace urine for drug screening. This review examines the sample integrity problems and the advantages and limitations of oral fluid and urine in drug screening programmes. The variety of sample collection devices for oral fluid is shown to be a problem with recovery and detection for some drugs. This is examined in relation to the pharmacokinetics of drug metabolism and excretion in this matrix. Buccal contamination with drugs in oral fluid may also cause problems with interpretation. The clinical advantages of oral fluid analysis compared with urine testing are highlighted. Parent drugs are often found in oral fluid where only their metabolites may be found in urine, for example the benzodiazepines. 6-Monoacetylmorphine, an indicative marker of heroin, has a high prevalence in oral fluid from users of this drug but its detection in urine is limited due to its short half-life. Advances in analytical techniques, particularly chromatography linked to tandem mass spectrometry, are helping to promote oral fluid analysis. However, the lack of concordance studies examining both urine and oral fluid drug levels and kinetics in the clinical setting is of some concern.
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Affiliation(s)
- Keith R Allen
- Department of Specialist Laboratory Medicine, Leeds Teaching Hospitals, Britannia House, Morley, Leeds LS27 0DQ, UK
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16
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Concheiro M, Shakleya DM, Huestis MA. Simultaneous analysis of buprenorphine, methadone, cocaine, opiates and nicotine metabolites in sweat by liquid chromatography tandem mass spectrometry. Anal Bioanal Chem 2011; 400:69-78. [PMID: 21125263 PMCID: PMC3717346 DOI: 10.1007/s00216-010-4392-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 10/07/2010] [Accepted: 10/25/2010] [Indexed: 01/09/2023]
Abstract
A liquid chromatography tandem mass spectrometry method for buprenorphine (BUP), norbuprenorphine (NBUP), methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), cocaine, benzoylecgonine, ecgonine methyl ester (EME), morphine, codeine, 6-acetylmorphine, heroin, 6-acetylcodeine, cotinine, and trans-3'-hydroxycotinine quantification in sweat was developed and comprehensively validated. Sweat patches were mixed with 6 mL acetate buffer at pH 4.5, and supernatant extracted with Strata-XC-cartridges. Reverse-phase separation was achieved with a gradient mobile phase of 0.1% formic acid and acetonitrile in 15 min. Quantification was achieved by multiple reaction monitoring of two transitions per compound. The assay was a linear 1-1,000 ng/patch, except EME 5-1,000 ng/patch. Intra-, inter-day and total imprecision were <10.1%CV, analytical recovery 87.2-107.7%, extraction efficiency 35.3-160.9%, and process efficiency 25.5-91.7%. Ion suppression was detected for EME (-63.3%) and EDDP (-60.4%), and enhancement for NBUP (42.6%). Deuterated internal standards compensated for these effects. No carryover was detected, and all analytes were stable for 24 h at 22 °C, 72 h at 4 °C, and after three freeze/thaw cycles. The method was applied to weekly sweat patches from an opioid-dependent BUP-maintained pregnant woman; 75.0% of sweat patches were positive for BUP, 93.8% for cocaine, 37.5% for opiates, 6.3% for methadone and all for tobacco biomarkers. This method permits a fast and simultaneous quantification of 14 drugs and metabolites in sweat patches, with good selectivity and sensitivity.
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Affiliation(s)
- Marta Concheiro
- Servicio de Toxicología Forense, Dpto. Anatomía Patológica y Ciencias Forenses, Facultad de Medicina, Universidad de Santiago de Compostela, C/San Francisco s/n, 15782, Santiago de Compostela (A Coruña), Spain
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Boulevard, Suite 200, Room 05A721, Baltimore, MD 21224, USA
| | - Diaa M. Shakleya
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Boulevard, Suite 200, Room 05A721, Baltimore, MD 21224, USA
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Boulevard, Suite 200, Room 05A721, Baltimore, MD 21224, USA
- Chemistry and Drug Metabolism, Biomedical Research Center (BRC), National Institute on Drug Abuse, NIH, 251 Bayview Blvd., Suite 200, Room 05A721, Baltimore, MD 21224, USA
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17
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Berset JD, Brenneisen R, Mathieu C. Analysis of llicit and illicit drugs in waste, surface and lake water samples using large volume direct injection high performance liquid chromatography--electrospray tandem mass spectrometry (HPLC-MS/MS). CHEMOSPHERE 2010; 81:859-866. [PMID: 20801487 DOI: 10.1016/j.chemosphere.2010.08.011] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 08/02/2010] [Accepted: 08/03/2010] [Indexed: 05/29/2023]
Abstract
Llicit and illicit drugs represent a recent group of emerging contaminants and have been found in the aquatic environment. A HPLC-MS/MS method was developed using direct injection (DI) of larger volumes and a polar endcapped reversed-phase (RP) column to measure drug components in water samples belonging to the cocaine group, opiates, amphetamine-like stimulants and metabolites thereof. After validation, including sensitivity, linearity, recovery, precision and matrix effect studies, most drugs could be detected with limits of quantitation (LOQ) of 20 ng L(-1) in wastewater (WW) and 0.2 ng L(-1) in surface water. The major substances found in influents and effluents were cocaine (COC), benzoylecgonine (BE), morphine (MO), methadone (MD) and its main metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) with concentrations up to 2 μg L(-1), followed by codeine (COD) and the amphetamines which ranged between 20 and 400 ng L(-1). Except for MO, COD and EDDP levels were generally lower in the effluents. River and lake water contained trace amounts of mainly BE, MD and EDDP from the high pg L(-1) to the low ng L(-1) level. Monitoring COC and BE levels over 11 consecutive days in influents and effluents suggests a consumption preference on week-end days. Finally, measuring an influent after a major music event revealed that sewage treatment plants (STPs) are exposed, for a limited period of time, to high concentration peaks of COC and BE as well as amphetamine-like stimulants such as ecstasy (MDMA).
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Affiliation(s)
- Jean-Daniel Berset
- Water and Soil Protection Laboratory (WSPL), Environmental Organic Chemistry Group (EOCG), Office of Water and Waste (OWW), Schermenweg 11, 3014 Bern, Switzerland.
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18
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Abstract
The interpretation of toxicological findings is critical for the thorough investigation of the use and abuse of psychoactive substances. A positive analytical result for a sample taken could usually result in criminal proceedings and a punitive outcome for the defendant whose sample was analysed. The detection of markers of illicit opiate misuse is important both in the management of substance misuse and in the postmortem identification of illicit opiate use. The aim of this study was to emphasise the role of opiate biomarkers available at the laboratory and in the clinical environment. Urine remains the biological tool of choice for qualitative detection of illicit drug use in a clinical setting, while quantitative accuracy remains strictly the domain of blood. Accurate interpretation of the screening tests within a clinical setting alongside other relevant information remains the key to the usefulness of any test. Moreover, the finding of a morphine/codeine concentration ratio in blood exceeding unity is a strong evidence that the person had used heroin, as opposed to having taken a prescription analgesic drug containing codeine.
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Affiliation(s)
- M Stefanidou
- Department of Forensic Medicine and Toxicology, Medical School, University of Athens, Athens, Greece.
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19
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Duxbury K, Romagnoli C, Anderson M, Watts R, Waite G. Development of a clinically relevant liquid chromatography tandem mass spectrometry assay for 13 drugs of abuse in urine, designed to meet the needs of the service users. Ann Clin Biochem 2010; 47:415-22. [DOI: 10.1258/acb.2010.010049] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background The clinical requirements of the users of assay results must be at the centre of assay development. We aimed to develop a single liquid chromatography tandem mass spectrometry (LC-MS/MS) assay for drugs of abuse in urine that would meet the needs of our service users and replace the multiple screening and confirmatory techniques previously in use. Methods After discussion with our users, it was decided that 13 drugs and metabolites should be measured in our panel: morphine, codeine, norcodeine, dihydrocodeine, 6-monoacetylmorphine, acetyl codeine, methadone and its metabolite, buprenorphine and its metabolite, amphetamine, benzoylecgonine and cotinine. Urine samples were prepared by the addition of internal standard, enzymatic hydrolysis and solid-phase extraction. Chromatography conditions were optimized so that the analytes were separated within a run time of 6 min. Optimal parent to daughter m/z ion transitions were chosen for all drugs and daughter ion ratios were used. Results The LC-MS/MS assay was successfully validated with acceptable precision and lower limits of quantification for all drugs. No matrix effects were seen. The results produced by the LC-MS/MS assay compared well with the previous combination of techniques in use. Conclusions We have developed and validated a fit-for-purpose LC-MS/MS assay for 13 drugs of abuse in urine that obviates the need for multiple screening and confirmatory analytical techniques.
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Affiliation(s)
- K Duxbury
- Department of Clinical Biochemistry, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK
| | - C Romagnoli
- Department of Clinical Biochemistry, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK
| | - M Anderson
- Department of Clinical Biochemistry, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK
| | - R Watts
- Waters Corporation, MS Technologies Centre, Atlas Park, Simonsway, Manchester, M22 5PP, UK
| | - G Waite
- Department of Clinical Biochemistry, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK
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20
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Abstract
Seeds of the opium poppy plant are legally sold and widely consumed as food. Due to contamination during harvesting, the seeds can contain morphine and other opiate alkaloids. The objective of this study is to review the toxicology of poppy seed foods regarding influence on opiate drug tests. Computer-assisted literature review resulted in 95 identified references. Normal poppy seed consumption is generally regarded as safe. During food processing, the morphine content is considerably reduced (up to 90%). The possibility of false-positive opiate drug tests after poppy food ingestion exists. There are no unambiguous markers available to differentiate poppy food ingestion from heroin or pharmaceutical morphine use. This is also a problem in heroin-assisted maintenance programs. A basic requirement in such substitution programs is the patients' abstinence from any other drugs, including additional illicit heroin. Also a lack of forensic ingestion trials was detected that consider all factors influencing the morphine content in biologic matrices after consumption. Most studies did not control for the losses during food processing, so that the initial morphine dosage was overestimated. The large reduction of the morphine content during past years raises questions about the validity of the "poppy seed defence." However, a threshold of food use that would not lead to positive drug tests with certainty is currently unavailable. Research is needed to prove if the morphine contents in today's foods still pose the possibility of influencing drug tests. Future trials should consider processing-related morphine losses.
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21
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22
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Musshoff F, Trafkowski J, Lichtermann D, Madea B. Comparison of urine results concerning co-consumption of illicit heroin and other drugs in heroin and methadone maintenance programs. Int J Legal Med 2009; 124:499-503. [PMID: 19672612 DOI: 10.1007/s00414-009-0361-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 06/15/2009] [Indexed: 11/26/2022]
Abstract
Urine samples of patients from a heroin maintenance program (HMP) and a methadone maintenance program (MMP) were chromatographically analyzed 1 month before and 6 and 12 months into treatment for the presence of classical markers of heroin use as well as for the presence of markers for illicit heroin abuse. Furthermore, the samples were immunochemically tested for cannabinoids, cocaine metabolites, amphetamine, methylendioxyamphetamines and benzodiazepines. A co-consumption of illicit heroin (HER) in the HMP was determined to be 50% but was significantly lower compared to the MMP with a co-use of 71%. The incidence was high because not only acetylcodeine (AC) as a very specific marker was considered but also other marker substances for illicit HER use. Amphetamines played only a minor part in both collectives, and the proportion of HER and methadone patients using cocaine was similar and decreased during treatment. Also, the benzodiazepine use decreased, and cannabis use was high in both collectives during treatment. Considering only the AC in the present study, a co-use of illicit HER in the HMP was similar to previous reports concerning HER-assisted treatment programs. If additional marker substances were examined, the suspicion of a co-use of illicit HER is markedly enhanced.
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Affiliation(s)
- Frank Musshoff
- Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, 53111, Bonn, Germany.
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23
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Trathen B, Paterson S, Cordero R, Luty J. Validity of noscapine and papaverine metabolites as markers of heroin misuse in the context of diamorphine treatment. A survey of urine samples from non‐substance misusing patients prescribed diamorphine. JOURNAL OF SUBSTANCE USE 2009. [DOI: 10.1080/14659890802581628] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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24
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Bourgine J, Ma LL, Le Boisselier R, Paillet-Loilier M, Albessard F, Lelong-Boulouard V, Vigneau C, Jolliet P, Debruyne D, Coquerel A. Comparaison des données analytiques et anamnestiques des consommations de drogues et psychotropes chez des usagers d’opiacés en traitement de substitution. Étude de faisabilité. Therapie 2009; 64:269-77. [DOI: 10.2515/therapie/2009043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Guthery B, Bassindale A, Pillinger CT, Morgan GH. The detection of various opiates and benzodiazepines by comprehensive two-dimensional gas chromatography/time-of-flight mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2009; 23:340-348. [PMID: 19125414 DOI: 10.1002/rcm.3883] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A technique using comprehensive two-dimensional gas chromatography/time-of-flight mass spectrometry (GC x GC/TOFMS) is applied to qualitative and quantitative drug testing. Human serum was 'spiked' with known quantities of benzodiazepines and a 'street heroin' mixture including some of the major metabolites and impurities. The sample components were extracted from the matrix by solid-phase extraction (SPE). Constituents containing polar hydroxyl and/or secondary amine groups were derivatised with N-methyl-N-(tert-butyldimethyl)trifluoroacetamide (MTBSTFA) to improve the chromatographic performance. An orthogonal separation of the matrix constituents was achieved by coupling a DB-5ms (5% phenyl) to a BPX50 (50% phenyl) GC column. The eluant was focused onto the second column by a twin-stage cryo-modulator. Rapid 6 s modulation times were achieved by transfer from a 30 m x 0.25 mm (length x internal diameter) to a 2 m x 0.1 mm column. TOFMS with rapid spectral acquisition (< or =500 spectra/s) was employed in the mass range m/z 40-650. A clean mass spectrum was obtained for each analyte using mass spectral deconvolution software. The sensitivity and repeatability of the method were evaluated by the preparation of calibration standards for two benzodiazepines, flunitrazepam and its major metabolite 7-aminoflunitrazepam (7-amino-FN), in the concentration range 5-1000 ng/mL. The limits of detection (LODs) and limits of quantitation (LOQs), calculated by repeat injections (x10) of the lowest standard, were 1.6 and 5.4 ng/mL (flunitrazepam); 2.5 and 8.5 ng/mL (7-amino-FN), respectively. There is scope to extend this protocol to screen a large number of drugs and metabolites stored in a library database.
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Affiliation(s)
- Bill Guthery
- Planetary and Space Sciences Research Institute, The Open University, Milton Keynes, UK.
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26
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Soltaninejad K, Faryadi M, Akhgari M, Bahmanabadi L. Chemical profile of counterfeit buprenorphine vials seized in Tehran, Iran. Forensic Sci Int 2007; 172:e4-5. [PMID: 17646070 DOI: 10.1016/j.forsciint.2007.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2007] [Accepted: 06/10/2007] [Indexed: 10/23/2022]
Abstract
Buprenorphine, commonly known by the trademark Temgesic, is one of the most popular drugs of abuse among the opioid-addicted young individuals in Iran. Temgesic, Bungesic, etc. are the most popular and important illicit opioid drugs in Tehran's illicit drugs black market, and are now among the most widely abused by opioid addicts. Because of this, counterfeiting of this drug has increased in Tehran. In this study, the qualitative analysis of counterfeit buprenorphine by gas chromatography-mass spectrometry (GC-MS) and high performance liquid chromatography (HPLC) demonstrates the presence of diacetylmorphine, acetylcodeine and pheniramine, as well as the absence of buprenorphine. In conclusion, due to the absence of quality control and difficulties in differentiating counterfeit buprenorphine from genuine products, the use of counterfeit buprenorphine leads the opioid abusers to health risks.
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27
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Soltaninejad K, Faryadi M, Akhgari M, Bahmanabadi L. Chemical profile of counterfeited buprenorphine vials seized in Tehran, Iran. Forensic Sci Int 2007. [DOI: https://doi.org/10.1016/j.forsciint.2007.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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28
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Abstract
AbstractLinear-dichroic infrared spectra (IR-LD) of 3-ethoxy-4-(N-norcodeino-)cyclobutene-1,2-dione (1) and codeine dihydrogenphosphate (Codeinum phosphoricum) (2), oriented as solid suspensions in nematic liquid crystals, have been measured. IR characteristic band assignments were made, and used in stereo-structural predictions. The results were compared with crystallographic structures of similar organic systems, and found to be in good agreement.
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29
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Trafkowski J, Madea B, Musshoff F. The Significance of Putative Urinary Markers of Illicit Heroin Use After Consumption of Poppy Seed Products. Ther Drug Monit 2006; 28:552-8. [PMID: 16885724 DOI: 10.1097/00007691-200608000-00011] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
After consumption of poppy seeds various substances were detected in urine or blood samples using an immunoassay and a sophisticated liquid chromatographic-tandem mass spectrometric procedure. These compounds are widely considered to be putative markers of heroin (HER) abuse whereas acetylcodeine was regarded as a marker for illicit preparations ("street HER"). Besides positive urinary opiate immunoassay results during a 48 hours monitoring period, peak concentrations of morphine (MOR), codeine and their glucuronides appeared 4 to 8 hours after ingestion of poppy seeds, and concentrations of total MOR higher than 10 microg/mL were observed. Also, in serum samples taken up to 6 hours after consumption, MOR glucuronides were found. Free MOR was only detected in traces (1 to 3 ng/mL) within 2 hours of consumption. In addition, 3 of 6 onsite opiate sweat tests revealed positive results 6.5 hours after ingestion. Furthermore, it was demonstrated that neither noscapine (NOS) nor papaverine (PAP) was detectable in urine or blood samples after the consumption of poppy seeds containing up to 94 microg NOS and up to 3.3 mug PAP. NOS and PAP were rapidly metabolized, whereas desmethylpapaverine and, especially, its glucuronide were found in urine samples of poppy seed consumers even 48 hours after consumption. According to these results PAP metabolites should not be regarded as markers of illicit HER abuse. In conclusion, only acetylcodeine can be regarded as a specific marker but has the problem of a short half-life. Therefore, we suggest that NOS and PAP, but not their metabolites, might be used cautiously as additional markers of illicit HER abuse as they have not been detected after oral intake of poppy seeds in normal doses. But it must be kept in mind that in some cases poppy seeds with an unusually high content of these alkaloids could be available, and that these substances are also agents in some pharmaceuticals.
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Affiliation(s)
- Jens Trafkowski
- Institute of Forensic Medicine, University Bonn, Stiftsplatz 12, 53111 Bonn, Germany
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30
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Kolev T, Ivanova B, Bakalska R. 6-O-acetylcodeine and its hydrogensquarate: Linear-dichroic infrared (IR-LD) spectroscopy. J Mol Struct 2006. [DOI: 10.1016/j.molstruc.2006.01.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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31
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Paterson S, Lintzeris N, Mitchell TB, Cordero R, Nestor L, Strang J. Validation of techniques to detect illicit heroin use in patients prescribed pharmaceutical heroin for the management of opioid dependence. Addiction 2005; 100:1832-9. [PMID: 16367984 DOI: 10.1111/j.1360-0443.2005.01225.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The clinical implementation and evaluation of heroin substitution programmes have been confounded by the lack of objective and validated biomarkers for illicit heroin use in patients prescribed pharmaceutical heroin. This study examined the capacity to detect illicit heroin use by gas chromatography-mass spectrometry (GC-MS) analysis of urine samples for the presence of opium impurities common to illicit, but not pharmaceutical heroin. AIMS To characterize the diagnostic properties of the metabolites of noscapine and papaverine in comparison to morphine as a gold-standard marker of illicit heroin use; and to examine the relationships between the self-reported time since most recent heroin use and the detection of these opioids in urine. DESIGN A cross-sectional study of 52 opioid-dependent patients in treatment (not prescribed heroin), who self-reported illicit heroin use within the preceding 2 weeks. Self-report data regarding recent drug use and a urine sample were collected. GC-MS analyses of urines were conducted and reported by laboratory staff blinded to self-report data. FINDINGS The metabolites of papaverine (hydroxypapaverine and dihydroxypapeverine) were found to have high sensitivity, specificity and negative predictive values as markers for illicit heroin use compared to the 'gold-standard' morphine. Other opioids, including 6-mono-acetylmorphine (6-MAM), codeine and noscapine metabolites (e.g. meconine) were less adequate in detecting heroin use. CONCLUSIONS GC-MS detection of papaverine metabolites in urine appears to be suitable method of identifying illicit heroin use for clinical and research purposes.
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Affiliation(s)
- S Paterson
- Toxicology Unit, Imperial College London, UK
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32
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Al-Amri AM, Smith RM, El-Haj BM, Juma'a MH. The GC–MS detection and characterization of reticuline as a marker of opium use. Forensic Sci Int 2004; 142:61-9. [PMID: 15272474 DOI: 10.1016/j.forsciint.2004.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Reticuline (a precursor of opium alkaloids) was detected and characterised as its trimethylsilyl ethers, acetyl esters and methyl ethers by GC-EIMS and GC-CIMS in opium and the urine of opium users after hydrolysis by acid or beta-glucuronidase as coextractive of morphine. Because this compound cannot be detected in heroin and poppy seeds, it is suggested as a differentiating marker between opium and heroin use, opium and poppy seeds use, or opium and "pharmaceutical" codeine use in cases when opiate use has been confirmed by detection of morphine and codeine in the urine. As well as being a constituent of opium, reticuline in the urine of opium users may also result from the metabolic demethylation of the three other benzyltetrahydroisoquinoline opium alkaloids: codamine, laudanosine and laudanine.
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Affiliation(s)
- A M Al-Amri
- Sharjah Police Forensic Science Laboratory, P.O. Box 29, Sharjah, United Arab Emirates
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33
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Al-Amri AM, Smith RM, El-Haj BM, Juma'a MH. The GC–MS detection and characterization of reticuline as a marker of opium use. Forensic Sci Int 2004; 140:175-83. [PMID: 15036439 DOI: 10.1016/j.forsciint.2003.10.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2003] [Indexed: 11/16/2022]
Abstract
Reticuline (a precursor of opium alkaloids) was detected and characterised as its trimethylsilyl ethers, acetyl esters and methyl ethers by GC-EIMS and GC-CIMS in opium and the urine of opium users after hydrolysis by acid or beta-glucuronidase as coextractive of morphine. Because this compound cannot be detected in heroin and poppy seeds, it is suggested as a differentiating marker between opium and heroin use, opium and poppy seeds use, or opium and "pharmaceutical" codeine use in cases when opiate use has been confirmed by detection of morphine and codeine in the urine. As well as being a constituent of opium, reticuline in the urine of opium users may also result from the metabolic demethylation of the three other benzyltetrahydroisoquinoline opium alkaloids: codamine, laudanosine and laudanine.
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Affiliation(s)
- A M Al-Amri
- Sharjah Police Forensic Science Laboratory, P.O. Box 29, Sharjah, United Arab Emirates
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Concentrations of Unconjugated Morphine, Codeine and 6-Acetylmorphine in Urine Specimens from Suspected Drugged Drivers. J Forensic Sci 2002. [DOI: 10.1520/jfs15258j] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Ceder G, Jones AW. Concentration Ratios of Morphine to Codeine in Blood of Impaired Drivers as Evidence of Heroin Use and not Medication with Codeine. Clin Chem 2001. [DOI: 10.1093/clinchem/47.11.1980] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background: Both the illicit drug heroin and the prescription drug codeine are metabolized to morphine, which tends to complicate interpretation of opiate-positive samples. We report here the concentrations of morphine and codeine, the morphine/codeine ratios, and 6-acetylmorphine (6-AM) in blood specimens from individuals arrested for driving under the influence of drugs (DUID) in Sweden. The results were compared with positive findings of 6-AM in urine as evidence of heroin intake.
Methods: In 339 DUID suspects, both blood and urine specimens were available for toxicologic analysis. In another 882 cases, only blood was available. All specimens were initially analyzed by immunoassay, and the positive results were verified by isotope-dilution gas chromatography–mass spectrometry. In routine casework, the limits of quantification (LOQs) for unconjugated opiates were 5 ng/g for blood and 20 μg/L for urine.
Results: The median concentration of morphine in blood was 30 ng/g with 2.5 and 97.5 percentiles of 5 and 230 ng/g, respectively (n = 979). This compares with a median codeine concentration of 20 ng/g and 2.5 and 97.5 percentiles of 5 and 592 ng/g, respectively (n = 784). The specific metabolite of heroin, 6-AM, was identified in only 16 of 675 blood specimens (2.3%). This compares with positive findings of 6-AM in 212 of 339 urine samples (62%) from the same population of DUID suspects. When 6-AM was identified in urine, the morphine/codeine ratio in blood was always greater than unity (median, 6.0; range, 1–66). In 18 instances, 6-AM was present in urine, although morphine and codeine were below the LOQ in blood. The morphine/codeine ratio in blood was greater than unity in 85% of DUID cases when urine was not available (n = 506), and the median morphine and codeine concentrations were 70 ng/g and 10 ng/g, respectively. When morphine/codeine ratios in blood were less than unity (n = 76), the median morphine and codeine concentrations were 10 ng/g and 180 ng/g, respectively.
Conclusions: Only 2.3% of opiate-positive DUID suspects were verified as heroin users on the basis of positive findings of 6-AM in blood. A much higher proportion (62%) were verified heroin users from 6-AM identified in urine. When urine was not available for analysis, finding a morphine/codeine concentration ratio in blood above unity suggests heroin use and not medication with codeine. This biomarker indicated that 85% of opiate-positive DUID blood samples were from heroin users.
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Affiliation(s)
- Gunnel Ceder
- Department of Forensic Chemistry, University Hospital, 581 85 Linköping, Sweden
| | - Alan Wayne Jones
- Department of Forensic Chemistry, University Hospital, 581 85 Linköping, Sweden
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