1
|
Furo H, Whitted M, Lin T, Zhou YY, Abdelsayed S, Brimhall BB, Elkin PL. Buprenorphine, Norbuprenorphine, and Naloxone Levels in Adulterated Urine Samples: Can They be Detected When Buprenorphine/Naloxone Film is Dipped into Urine or Water? SUBSTANCE USE : RESEARCH AND TREATMENT 2024; 18:11782218231223673. [PMID: 38433747 PMCID: PMC10906499 DOI: 10.1177/11782218231223673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/13/2023] [Indexed: 03/05/2024]
Abstract
Reportedly, various urine manipulations can be performed by opioid use disorder (OUD) patients who are on buprenorphine/naloxone medications to disguise their non-compliance to the treatment. One type of manipulation is known as "spiking" adulteration, directly dipping a buprenorphine/naloxone film into urine. Identifying this type of urine manipulation has been the aim of many previous studies. These studies have revealed urine adulterations through inappropriately high levels of "buprenorphine" and "naloxone" and a very small amount of "norbuprenorphine." So, does the small amount of "norbuprenorphine" in the adulterated urine samples result from dipped buprenorphine/naloxone film, or is it a residual metabolite of buprenorphine in the patient's system? This pilot study utilized 12 urine samples from 12 participants, as well as water samples as a control. The samples were subdivided by the dipping area and time, as well as the temperature and concentration of urine samples, and each sublingual generic buprenorphine/naloxone film was dipped directly into the samples. Then, the levels of "buprenorphine," "norbuprenorphine," "naloxone," "buprenorphine-glucuronide" and "norbuprenorphine-glucuronide" were examined by Liquid Chromatography with tandem mass spectrometry (LC-MS/MS). The results of this study showed that high levels of "buprenorphine" and "naloxone" and a small amount of "norbuprenorphine" were detected in both urine and water samples when the buprenorphine/naloxone film was dipped directly into these samples. However, no "buprenorphine-glucuronide" or "norbuprenorphine-glucuronide" were detected in any of the samples. In addition, the area and timing of dipping altered "buprenorphine" and "naloxone" levels, but concentration and temperature did not. This study's findings could help providers interpret their patients' urine drug test results more accurately, which then allows them to monitor patient compliance and help them identify manipulation by examining patient urine test results.
Collapse
Affiliation(s)
- Hiroko Furo
- Department of Biomedical Informatics, State University of New York (SUNY) at Buffalo, Buffalo, NY, USA
- Department of Family Medicine, State University of New York (SUNY) at Buffalo, Buffalo, NY, USA
| | - Marisa Whitted
- Department of Pathology and Laboratory Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Tony Lin
- Department of Family Medicine, State University of New York (SUNY) at Buffalo, Buffalo, NY, USA
| | - Yi Y Zhou
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Sarah Abdelsayed
- Department of Family Medicine, State University of New York (SUNY) at Buffalo, Buffalo, NY, USA
| | - Bradley B Brimhall
- Department of Pathology and Laboratory Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Peter L Elkin
- Department of Biomedical Informatics, State University of New York (SUNY) at Buffalo, Buffalo, NY, USA
- Department of Veterans Affairs in Western New York, Bioinformatics Laboratory, Buffalo, NY, USA
- Faculty of Engineering, the University of Southern Denmark, Odense, Denmark
| |
Collapse
|
2
|
Fitzgerald RL. In Control? J Appl Lab Med 2023; 8:237-239. [PMID: 36645386 DOI: 10.1093/jalm/jfac134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/18/2022] [Indexed: 01/17/2023]
|