Hair: a complementary source of bioanalytical information in forensic toxicology

An LC-MS/MS method for the determination of drugs of abuse included THC-COOH, EtG, and NPS, using a single hair extraction sample

Hair analysis plays an important role in the determination of drugs of abuse in both forensic and clinical toxicology investigations. The analysis of different substances often requires the use of different sample preparation methods, thereby increasing the amount of hair sample and time required. In the present study, a fast method involving a combination of a single 25 mg hair extraction procedure and four liquid chromatography-tandem mass spectrometry methods using the same chromatographic phases and column was developed and validated. The target was the identification and quantification of various commonly abused drugs and their metabolites, including amphetamines, cocaine, opioids, cannabinoids, THC-COOH and EtG, and more than 140 new psychoactive substances, including synthetic cannabinoids, phenethylamines, synthetic opioids, methylphenidate, cathinone, piperidine, and tryptamines.

Analytical techniques for screening of cannabis and derivatives from human hair specimens

Cannabis and associated substances are some of the most frequently abused drugs across the globe, mainly due to their anxiolytic and euphorigenic properties. Nowadays, the analysis of hair samples has been given high importance in forensic and analytical sciences and in clinical studies because they are associated with a low risk of infection, do not require complicated storage conditions, and offer a broad window of non-invasive detection. Analysis of hair samples is very easy compared to the analysis of blood, urine, and saliva samples. This review places particular emphasis on methodologies of analyzing hair samples containing cannabis, with a special focus on the preparation of samples for analysis, which involves screening and extraction techniques, followed by confirmatory assays. Through this manuscript, we have presented an overview of the available literature on the screening of cannabis using mass spectroscopy techniques. We have presented a detailed overview of the advantages and disadvantages of this technique, to establish it as a suitable method for the analysis of cannabis from hair samples.

Microextraction by Packed Sorbent as a Clean-up Approach for the Determination of Ketamine and Norketamine in Hair by Gas Chromatography--Tandem Mass Spectrometry

The use of new psychoactive substances has been increasing and constitutes a social and public health problem, and hence, toxicological analysis has become of utmost importance for the detection of such substances. In this article, we present the development and full validation of a simple, user and environmentally friendly, cheap and suitable method for the determination of ketamine and its main metabolite norketamine in hair samples. The procedure included using a miniaturized procedure-microextraction by packed sorbent with mixed-mode sorbent-for sample clean-up. Organic solvents use was minimal, and it was possible to obtain a linear method (0.05-10 ng/mg for both analytes). The extraction efficiency ranged from 32 to 61%, which did not impair sensitivity. The method proved to be selective, precise, accurate and suitable for routine analysis for the determination of said compounds in 50-mg hair samples.

Analysis of Cannabinoids in Biological Specimens: An Update

Cannabinoids are still the most consumed drugs of abuse worldwide. Despite being considered less harmful to human health, particularly if compared with opiates or cocaine, cannabis consumption has important medico-legal and public health consequences. For this reason, the development and optimization of sensitive analytical methods that allow the determination of these compounds in different biological specimens is important, involving relevant efforts from laboratories. This paper will discuss cannabis consumption; toxicokinetics, the most detected compounds in biological samples; and characteristics of the latter. In addition, a comprehensive review of extraction methods and analytical tools available for cannabinoid detection in selected biological specimens will be reviewed. Important issues such as pitfalls and cut-off values will be considered.

Detection of mescaline in human hair samples by UPLC-MS/MS: Application to 19 authentic forensic cases

Mescaline, a natural alkaloid found in the peyote cactus (Lophophora williamsii) in the Americas, has gradually become a drug of abuse in China because of its psychedelic properties. Its intake may lead to hallucinations and confusion or even be life-threatening. Mescaline is classified as a class Ⅰ psychotropic drug in China, which means its use in medicine or scientific research is under strict control of the government. However, studies on surveillance of mescaline abuse in the Chinese population are lacking. A rapid and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the determination and quantification of mescaline in hair. The method had good linearity in the range from 10 to 1000 pg/mg, with the limit of detection (LOD) of 3 pg/mg and the limit of quantitation (LOQ) of 10 pg/mg. The total runtime was 5 min. Acceptable intraday and interday precision (RSD < 15%) and accuracy (bias, -11.2% ∼ 6.8%) were achieved. The recovery was 85.0-101.0%, and the matrix effect was 92.0-105.0%. The validated method was successfully applied to 19 real forensic cases. The concentrations of mescaline in hair ranged from 10 to 784 pg/mg. The method has the benefits of simple sample preparation, high sensitivity, and short running time, making it suitable for large-scale quantitative surveillance analysis of mescaline in forensic toxicology.

Trends in microextraction approaches for handling human hair extracts - A review

The complementary role of hair in testing scenarios has expanded across the spectrum of toxicological and clinical monitoring investigations and, over the last 20 years, hair analysis has gained increasing attention and recognition. Moreover, a great deal of attention has been paid to the miniaturisation of extraction procedures, minimising/eliminating toxic organic solvents consumption, making them user-friendly and rapid, in addition to maximising extraction efficiency. The aim of this work is to provide a critical review of the advances observed over the last 5 years in the use of miniaturised approaches for sample clean-up and drug pre-concentration in hair analysis. There have been major improvements in some well-established microextraction approaches, such as liquid phase microextraction, mainly through the use of supramolecular and ionic liquids. In addition, new developments have also been reported in solid phase microextraction, driven by d-SPE applications. In the last 5 years, a total of 69 articles have been published using some type of microextraction technique for hair specimens, thus justifying the relevance of a critical review of innovations, improvements and trends related to these miniaturised approaches for sample preparation.

Detection of amfepramone and its metabolite cathinone in human hair: Application to a uthentic cases of amfepramone use

In recent years, overseas anti-obesity drugs including amfepramone have flowed into China through the internet or personal import by travelers. Amfepramone is controlled in China and is not available as a pharmaceutical product. It is obtainable either through the internet or imported by individuals across the border. The abuse of amfepramone is causing serious health problems. A method for the detection and quantification of amfepramone and its metabolite cathinone in human hair was developed and fully validated using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Approximately 10 mg of hair was weighed and pulverized with extraction solvent (a mixture of methanol: acetonitrile: 2 mM ammonium formate [pH 5.3] [25:29:46, v/v/v]). The limit of detection (LOD) and the limit of quantitation (LOQ) were 5 and 10 pg/mg, respectively. The method was linear over a concentration range from 10 to 10,000 pg/mg. The accuracy varied from -9.3% to 2.3%, with acceptable intra- and inter-day precision. The validated method was successfully applied to 17 authentic cases. The amfepramone concentrations ranged from 11.7 to 209 pg/mg, with a median of 30.2 pg/mg, and the hair cathinone concentrations ranged from 11.9 to 507 pg/mg, with a median of 54.0 pg/mg. This is the first report of amfepramone concentrations in human hair from amfepramone users. Cathinone can be incorporated into hair after amfepramone use.

Effect of growth and parturition on hair cortisol in Holstein cattle

The effect of growth and parturition on hair cortisol concentrations of cattle was investigated. Plasma, saliva, and hair (black and white from the shoulders and hip) samples were collected from calves at 6 and 24 weeks old and from dairy cattle at the dry (1 and 2 months prepartum) and lactation (10, 50, 150, and 250 days postpartum) periods. Plasma and saliva cortisol concentrations were lower in 24-week-old calves than those of 6-week-old calves, and hair cortisol concentrations decreased regardless of color and position. In 6-week-old calves, hair cortisol concentrations differed between sampling positions, but this difference was not observed in 24-week-old calves. Plasma and saliva cortisol concentrations increased before parturition until 10 days postpartum then decreased until 50 days postpartum. The same trend was observed in the cortisol concentrations of white hair. Contrarily, cortisol concentrations in black hair remained unchanged and was lower than that in white hair. Hair cortisol concentration can vary greatly depending on the location on the body, hair color, cattle age, or parturition. When this method is used, all of the above factors must be considered.

Recent Developments in the Determination of Biomarkers of Tobacco Smoke Exposure in Biological Specimens: A Review

Environmental tobacco smoke exposure (ETS) and smoking have been described as the most prevalent factors in the development of certain diseases worldwide. According to the World Health Organization, more than 8 million people die every year due to exposure to tobacco, around 7 million due to direct ETS and the remaining due to exposure to second-hand smoke. Both active and second-hand exposure can be measured and controlled using specific biomarkers of tobacco and its derivatives, allowing the development of more efficient public health policies. Exposure to these compounds can be measured using different methods (involving for instance liquid- or gas-chromatographic procedures) in a wide range of biological specimens to estimate the type and degree of tobacco exposure. In recent years, a lot of research has been carried out using different extraction methods and different analytical equipment; this way, liquid-liquid extraction, solid-phase extraction or even miniaturized procedures have been used, followed by chromatographic analysis coupled mainly to mass spectrometric detection. Through this type of methodologies, second-hand smokers can be distinguished from active smokers, and this is also valid for e-cigarettes and vapers, among others, using their specific biomarkers. This review will focus on recent developments in the determination of tobacco smoke biomarkers, including nicotine and other tobacco alkaloids, specific nitrosamines, polycyclic aromatic hydrocarbons, etc. The methods for their detection will be discussed in detail, as well as the potential use of threshold values to distinguish between types of exposure.

Development and validation of a liquid chromatography-tandem mass spectrometry method for quantifying delamanid and its metabolite in small hair samples

New all-oral regimens for rifampin-resistant tuberculosis (RR-TB) are being scaled up globally. Measurement of drug concentrations in hair assesses long-term drug exposure. Delamanid (DLM) is likely to be a key component of future RR-TB treatment regimens, but a method to describe its quantification in hair via liquid chromatography-tandem mass spectrometry (LC-MS/MS) has not previously been described. We developed and validated a simple, fast, sensitive, and accurate LC-MS/MS method for quantifying DLM and its metabolite DM-6705 in small hair samples. We pulverized and extracted two milligrams of hair in methanol at 37 °C for two hours, and diluted 1:1 with water. A gradient elution method eluted DLM, DM-6705, and the internal standard OPC 14714 within 3 min, bringing overall analysis time to 5.5 min. The method has limits of detection (LOD) of 0.0003 ng/mg for DLM and 0.003 ng/mg for DM-6705. The established linear dynamic ranges are 0.003-2.1 ng/mg and 0.03-21 ng/mg for DLM and DM-6705, respectively. Eleven of 12 participant hair samples had concentrations within DLM's linear dynamic range, while all 12 samples had concentrations within the quantifiable range for DM-6705. The ranges of concentrations observed in these clinical samples for DLM and DM-6705 were 0.004-0.264 ng/mg hair and 0.412-12.041 ng/mg hair respectively. We demonstrate that while DLM was detected in hair at very low levels, its primary metabolite DM-6705 had levels approximately 100 times higher. Measuring DM-6705 in hair may accurately reflect long-term adherence to DLM-containing regimens for drug-resistant TB.

Human exposure to PCBs, PBDEs and bisphenols revealed by hair analysis: A comparison between two adult female populations in China and France

Humans are exposed to various anthropogenic chemicals in daily life, including endocrine-disrupting chemicals (EDCs). However, there are limited data on chronic, low-level exposure to such contaminants among the general population. Here hair analysis was used to investigate the occurrence of four polychlorinated biphenyls (PCBs), seven polybrominated diphenyl ethers (PBDEs) and two bisphenols (BPs) in 204 Chinese women living in the urban areas of Baoding and Dalian and 311 pregnant French women. All the PCBs and PBDEs tested here were more frequently detected in the hair samples of the French women than in those of the Chinese women. In both cohorts, PCB 180 and BDE 47 were the dominant PCB and PBDE congener, respectively. PCB 180 was found in 82% of the French women and 44% of the Chinese women, while the corresponding values of BDE 47 were 54% and 11%, respectively. A discriminant analysis further demonstrated the difference in PCBs and PBDEs exposure profile between the two cohorts. These results demonstrate that hair analysis is sufficiently sensitive to detect exposure to these pollutants and highlight differences in exposure between populations even at environmental levels. Although BPA and BPS were found in 100% of the hair samples in both cohorts, the French women had significantly higher levels of BPA and BPS than the Chinese women. The median concentrations of BPA were one order of magnitude higher than BPS in both the Chinese (34.9 versus 2.84 pg/mg) and the French women (118 versus 8.01 pg/mg) respectively. Our results suggest that both French and Chinese populations were extensively exposed to BPA and BPS.

New miniaturized clean-up procedure for hair samples by means of microextraction by packed sorbent: determination of cocaine and metabolites

Cocaine is still one of the most commonly used illicit substances worldwide, with an estimated 4 million users in Europe in the last year. Hair samples have been widely used for the determination of episodic or repeated consumption of this substance, but the use of miniaturized techniques for hair sample clean-up has been challenging due to the sample complexity. Despite hair's complex matrix, MEPS provides a method that is fast, reduces the volume of extraction solvents used, and offers low-cost options (since extraction beds may be reused several times). Microextraction by packed sorbent using a mixed-mode sorbent was optimized for hair sample clean-up in order to determine cocaine, benzoylecgonine, ecgonine methyl ester, norcocaine, cocaethylene and anhydroecgonine methyl ester by gas chromatography coupled to tandem mass spectrometry. The method was fully validated according to internationally accepted criteria, presenting good linearity between the limits of quantification (0.01-0.15) and 5 ng/mg. Precision and accuracy resulted in coefficients of variation typically lower than 15%, with mean relative errors within ±15% for all compounds, except for the limit of quantification (±20%). The present work describes the first application of microextraction by packed sorbent for the concentration of cocaine and metabolites extracted from hair samples. Graphical abstract.

Determination of ketamine, methamphetamine and 3,4-methylenedioxymethamphetamine in human hair by flash evaporation-gas chromatography/mass spectrometry

A rapid and sensitive method utilizing flash evaporation-gas chromatography/mass spectrometry (FE-GC/MS) has been developed. The method is applicable to determine ketamine (KET), methamphetamine (MAMP) and 3,4-methylenedioxymethamphetamine (MDMA) in human hair. Cut and weighted hair (0.30 mg) was heated at the flash evaporation temperature of 350 °C. KET, MAMP and MDMA were released into a capillary column for GC/MS analysis and produced fragment ions in SIM mode. Validation of the method included evaluation of linearity, sensitivity, accuracy, precision and repeatability. Linearity ranged from 2 to 300 ng/mg for KET in hair and 2 to 200 ng/mg for MAMP and MDMA in hair with the correlation coefficients all greater than 0.998. Limits of detection were 0.7 ng/mg and limits of quantification were 2.0 ng/mg of hair for KET, MAMP and MDMA. The precision ranged from 1.57% to 7.75% for KET, 1.49% to 7.10% for MAMP and 1.84% to 8.31% for MDMA. The recovery ranged from 102.1% to 110.9% for KET, 99.3% to 108.0% for MAMP and 89.5% to 112.6% for MDMA. Six authentic hair samples from known drug abusers and three drug-free hair samples from volunteers who had never used drugs were successfully analyzed. Compared with traditional time-consuming and hair-comsuming pretreatment method, FE-GC/MS was a faster, simpler and low sample consumption method for the determination of KET, MAMP and MDMA in human hair.

Simultaneous Quantitative Determination of Amphetamines, Opiates, Ketamine, Cocaine and Metabolites in Human Hair: Application to Forensic Cases of Drug Abuse

A method using liquid chromatography-tandem mass spectrometry (LC-MS/MS) to simultaneously quantify amphetamines, opiates, ketamine, cocaine, and metabolites in human hair is described. Hair samples (50 mg) were extracted with methanol utilizing cryogenic grinding. Calibration curves for all the analytes were established in the concentration range 0.05-10 ng/mg. The recoveries were above 72%, except for AMP at the limit of quantification (LOQ), which was 48%. The accuracies were within ±20% at the LOQ (0.05 ng/mg) and between -11% and 13.3% at 0.3 and 9.5 ng/mg, respectively. The intraday and interday precisions were within 19.6% and 19.8%, respectively. A proficiency test was applied to the validated method with z-scores within ±2, demonstrating the accuracy of the method for the determination of drugs of abuse in the hair of individuals suspected of abusing drugs. The hair concentration ranges, means, and medians are summarized for abused drugs in 158 authentic cases.

A review of bioanalytical techniques for evaluation of cannabis (Marijuana, weed, Hashish) in human hair

Cannabis products (marijuana, weed, hashish) are among the most widely abused psychoactive drugs in the world, due to their euphorigenic and anxiolytic properties. Recently, hair analysis is of great interest in analytical, clinical, and forensic sciences due to its non-invasiveness, negligible risk of infection and tampering, facile storage, and a wider window of detection. Hair analysis is now widely accepted as evidence in courts around the world. Hair analysis is very feasible to complement saliva, blood tests, and urinalysis. In this review, we have focused on state of the art in hair analysis of cannabis with particular attention to hair sample preparation for cannabis analysis involving pulverization, extraction and screening techniques followed by confirmatory tests (e.g., GC–MS and LC–MS/MS). We have reviewed the literature for the past 10 years’ period with special emphasis on cannabis quantification using mass spectrometry. The pros and cons of all the published methods have also been discussed along with the prospective future of cannabis analysis.

Cannabis and Its Secondary Metabolites: Their Use as Therapeutic Drugs, Toxicological Aspects, and Analytical Determination

Although the medicinal properties of Cannabis species have been known for centuries, the interest on its main active secondary metabolites as therapeutic alternatives for several pathologies has grown in recent years. This potential use has been a revolution worldwide concerning public health, production, use and sale of cannabis, and has led inclusively to legislation changes in some countries. The scientific advances and concerns of the scientific community have allowed a better understanding of cannabis derivatives as pharmacological options in several conditions, such as appetite stimulation, pain treatment, skin pathologies, anticonvulsant therapy, neurodegenerative diseases, and infectious diseases. However, there is some controversy regarding the legal and ethical implications of their use and routes of administration, also concerning the adverse health consequences and deaths attributed to marijuana consumption, and these represent some of the complexities associated with the use of these compounds as therapeutic drugs. This review comprehends the main secondary metabolites of Cannabis, approaching their therapeutic potential and applications, as well as their potential risks, in order to differentiate the consumption as recreational drugs. There will be also a focus on the analytical methodologies for their analysis, in order to aid health professionals and toxicologists in cases where these compounds are present.

Opioid Use in Pregnant Women and Neonatal Abstinence Syndrome-A Review of the Literature

Opiate use during pregnancy has been an increasing problem over the last two decades, making it an important social and health concern. The use of such substances may have serious negative outcomes in the newborn, and clinical and cognitive conditions have been reported, including neonatal abstinence syndrome, developmental problems, and lower cognitive performance. These conditions are common when opiates are used during pregnancy, making the prescription of these kinds of drugs problematic. Moreover, the mother may develop opiate addiction, thus, increasing the likelihood of the infant being born with any of those conditions. This paper reviews the use of opiates during pregnancy and focuses mainly on the neonatal abstinence syndrome. First, the commonly prescribed opiates will be identified, namely those usually involved in cases of addiction and/or neonatal abstinence syndrome. Second, published approaches to deal with those problems will be presented and discussed, including the treatment of both the mother and the infant. Finally, we will outline the treatments that are safest and most efficient, and will define future goals, approaches, and research directions for the scientific community regarding this problem.

Synthetic cannabinoids in biological specimens: a review of current analytical methods and sample preparation techniques

Synthetic cannabinoids are a new class of chemical drugs capable of modifying human behavior. These products do not contain cannabis, but produce similar effects after consumption. The fact that they are easily accessed, and are many times considered to be harmless, justifies their widespread use among young people. This fact, together with the difficulty in their detection by routine drug tests, makes it extremely important to develop new procedures able to detect and monitor their consumption. The aim of this work is to perform a critical review regarding the human biological samples that can be used for the determination of synthetic cannabinoids, paying special attention to analytical methods and sample preparation techniques. The reviewed articles deal with the determination of synthetic cannabinoids in the context of forensic and toxicological analysis.

Toxicological hair analysis: Pre-analytical, analytical and interpretive aspects

Background and aims Hair analysis for drug detection is one of the widely accepted imperative techniques in the field of forensic toxicology. The current study was designed to investigate the efficacy of chromatography for detection of drugs of abuse in hair. Method A comprehensive review of articles from last two decades on hair analyses via PubMed and similar resources was performed. Issues concerning collection, decontamination and analytical techniques are summarised. Physiochemical nature of hair, mechanism of drug incorporation and its stability in hair are briefly discussed. Furthermore, various factors affecting results and interpretation are elucidated. Result A hair sample is chosen over traditional biological samples such blood, urine, saliva or tissues due to its inimitable ability to provide a longer time frame for drug detection. Its collection is almost non-invasive, less cumbersome and does not involve any specialised training/expertise. Recent advances in analytical technology have resulted in better sensitivity, reproducibility and accuracy, thus providing a new arena of scientific understanding and test interpretation. Conclusion Though recent studies have yielded many insights into drug binding and drug incorporation in hair, the major challenge in hair analysis lies in the interpretation of results, which may be affected by external contamination and thus lead to false-positives. Therefore, there is a need for more sensitive and selective analysis methods to be developed in order to minimise factors that induce the effect of melanin, age and so on, and this would certainly provide a new dimension to hair analysis and its applications.

Facial preservation following extreme mummification: Shrunken heads

Shrunken heads are a mummification phenomenon unique to South America. Ceremonial tsantsa are ritually reduced heads from enemy victims of the Shuar, Achuar, Awajún (Aguaruna), Wampís (Huambisa), and Candoshi-Shapra cultures. Commercial shrunken heads are comparatively modern and fraudulently produced for the curio-market, often using stolen bodies from hospital mortuaries and graves. To achieve shrinkage and desiccation, heads undergo skinning, simmering (in water) and drying. Considering the intensive treatments applied, this research aims to identify how the facial structure can alter and impact identification using post-mortem depiction. Sixty-five human shrunken heads were assessed: 6 ceremonial, 36 commercial, and 23 ambiguous. Investigations included manual inspection, multi-detector computerised tomography, infrared reflectography, ultraviolet fluorescence and microscopic hair analysis. The mummification process disfigures the outer face, cheeks, nasal root and bridge form, including brow ridge, eyes, ears, mouth, and nose projection. Melanin depletion, epidermal degeneration, and any applied staining changes the natural skin complexion. Papillary and reticular dermis separation is possible. Normal hair structure (cuticle, cortex, medulla) is retained. Hair appears longer (unless cut) and more profuse following shrinkage. Significant features retained include skin defects, facial creases, hairlines and earlobe form. Hair conditions that only affect living scalps are preserved (e.g. nits, hair casts). Ear and nose cartilage helps to retain some morphological information. Commercial heads appear less distorted than ceremonial tsantsa, often presenting a definable eyebrow shape, vermillion lip shape, lip thickness (if mouth is open), philtrum form, and palpebral slit angle. Facial identification capabilities are considered limited, and only perceived possible for commercial heads.

Stress assessment using hair cortisol of kangaroos affected by the lumpy jaw disease

The aim of this study was to objectively assess stress of kangaroos affected by lumpy jaw disease (LJD) using plasma and hair cortisol concentrations. The plasma and hair samples were collected from kangaroos with LJD and healthy controls. Collected hair samples were extracted with methanol after washing with isopropanol, following which they were processed with the cortisol enzyme immunoassay kit. The plasma cortisol concentration of LJD animals tended to be higher than that of the control. Ventral hair cortisol, but not dorsal hair, of LJD animals was significantly higher than that of the control. In conclusion, stress in kangaroos infected with LJD could be assessed by measuring ventral hair cortisol.

Monitoring of adherence to headache treatments by means of hair analysis

Purpose

The aim of this study was to evaluate the potential of hair analysis to monitor medication adherence in headache patients undergoing chronic therapy. For this purpose, the following parameters were analyzed: the detection rate of 23 therapeutic drugs in headache patients’ hair, the degree of agreement between the self-reported drug and the drug found in hair, and whether the levels found in hair reflected the drug intake reported by the patients.

Methods

The study included 93 patients suffering from primary headaches declaring their daily intake of at least one of the following drugs during the 3 months before the hair sampling: alprazolam, amitriptyline, citalopram, clomipramine, clonazepam, delorazepam, diazepam, duloxetine, fluoxetine, flurazepam, levomepromazine, levosulpiride, lorazepam, lormetazepam, mirtazapine, paroxetine, quetiapine, sertraline, topiramate, trazodone, triazolam, venlafaxine, and zolpidem.

A detailed pharmacological history and a sample of hair were collected for each patient. Hair samples were analyzed by liquid chromatography-electrospray tandem mass spectrometry, using a previously developed method.

Results

All 23 drugs were detected in the examined hair samples. The agreement between the self-reported drug and the drug found in hair was excellent for most analytes (P < 0.001, Cohen’s kappa); a statistically significant relationship (P < 0.05, linear regression analysis) between dose and hair level was found for amitriptyline, citalopram, delorazepam, duloxetine, lorazepam, and venlafaxine.

Conclusions

Hair analysis proved to be a unique matrix to document chronic drug use in headache patients, and the level found for each individual drug can represent a reliable marker of adherence to pharmacological treatments.

Electronic supplementary material

The online version of this article (doi:10.1007/s00228-016-2163-5) contains supplementary material, which is available to authorized users.

Salvia divinorum: toxicological aspects and analysis in human biological specimens

The identification and quantitation of the main psychoactive component of Salvia divinorum (salvinorin A) in biological specimens are crucial in forensic and clinical toxicology. Despite all the efforts made, its uncontrolled abuse has increased quickly, exposing its users' health to serious risks both in the short and long term. The use of alternative biological matrices in toxicological analyzes can be advantageous as complementary postmortem samples, or in situations when neither blood nor urine can be collected; they may be useful tools in those determinations, providing important information about prior exposure. The aim of this article is to present a brief summary of legal aspects of Salvia divinorum and salvinorin A, including the methods used for the determination of the latter in biological matrices.

Hair analysis for detection of triptans occasionally used or overused by migraine patients-a pilot study

Purpose

The aim of this study is to evaluate the detection rate of almotriptan, eletriptan, frovatriptan, sumatriptan, rizatriptan, and zolmitriptan in the hair of migraineurs taking these drugs; the degree of agreement between type of self-reported triptan and triptan found in hair; if the concentrations in hair were related to the reported cumulative doses of triptans; and whether hair analysis was able to distinguish occasional use from the overuse of these drugs.

Methods

Out of 300 headache patients consecutively enrolled, we included 147 migraine patients who reported to have taken at least one dose of one triptan in the previous 3 months; 51 % of the patients overused triptans. A detailed pharmacological history and a sample of hair were collected for each patient. Hair samples were analyzed by liquid chromatography-electrospray tandem mass spectrometry (LC-MS/MS) by a method that we developed.

Results

All the triptans could be detected in the hair of the patients. The agreement between type of self-reported triptan and type of triptan found in hair was from fair to good for frovatriptan and zolmitriptan and excellent for almotriptan, eletriptan, sumatriptan, and rizatriptan (P < 0.01, Cohen’s kappa). The correlation between the reported quantities of triptan and hair concentrations was statistically significant for almotriptan, eletriptan, rizatriptan, and sumatriptan (P < 0.01, Spearman’s rank correlation coefficient). The accuracy of hair analysis in distinguishing occasionally users from overusers was high for almotriptan (ROC AUC = 0.9092), eletriptan (ROC AUC = 0.8721), rizatriptan (ROC AUC = 0.9724), and sumatriptan (ROC AUC = 0.9583).

Conclusions

Hair analysis can be a valuable system to discriminate occasional use from triptan overuse.

Electronic supplementary material

The online version of this article (doi:10.1007/s00228-016-2074-5) contains supplementary material, which is available to authorized users.

Assessing cocaine abuse using LC-MS/MS measurements in biological specimens

Cocaine use is still a problem in today's world, and this has several implications on human activities. Indeed, important problems related to cocaine derive from its use in situations where concentration and focus skills are necessary, namely while driving and/or working. The need of analytical methods for drug analysis in specimens of biological origin for proper documentation of human exposure is increasing. While GC-MS-based procedures represented the state-of-the-art of analytical techniques a few years ago, there is a growing trend for their replacement by LC-MS/MS, which can be justified by the increased sensitivity presented by these new technologies. This paper will review recently published papers on the use of LC-MS/MS-based procedures for cocaine measurement in biological specimens.

Review: Drug concentrations in hair and their relevance in drug facilitated crimes

Segmental hair analysis can provide valuable retrospective information on the history of drug exposure in victims of drug facilitated crimes (DFC). This is now possible with availability of sensitive tandem MS techniques such as GC-MS/MS and LC-MS/MS allowing drugs to be detected at pg/mg concentrations after a single dose. In this review hair concentrations of 35 psychoactive drugs given in 20 controlled dose studies are reviewed and compared to the 25 different drugs detected in reported case work. The most common drugs were the benzodiazepines and related hypnotics, gamma-hydroxybutyrate (GHB), ketamine and methamphetamine. Those concentrations reported in DFC were mostly similar or higher than that seen in controlled dose studies. The factors that affecting interpretation of segmental hair results including hair color, growth rates, sample preparation and surface contamination are discussed.

Determination of cocaine in abuser hairs by CE: monitoring compliance to a detoxification program

Background: Segmental hair analysis was performed to verify the cocaine withdrawal and compliance to the therapy of four cocaine abusers that were following a drug detoxification program. Results/methodology: Cocaine and its major metabolite, benzoylecgonine, were preconcentrated and determined by in-line SPE and CE with prior isolation of the analytes from the hair matrix by an overnight acidic incubation procedure. The LODs obtained for hair samples were 0.02 ng/mg for cocaine and 0.1 ng/mg for benzoylecgonine. Conclusion: Our results showed that the established method, in conjunction with a segmental hair analysis, is suitable for determining drug abuse histories, being very useful in forensic toxicological laboratories as well as in rehabilitation and addiction treatment programs.

Recent trends in analytical methods and separation techniques for drugs of abuse in hair

Hair analysis of drugs of abuse has been a subject of growing interest from a clinical, social and forensic perspective for years because of the broad time detection window after intake in comparison to urine and blood analysis. Over the last few years, hair analysis has gained increasing attention and recognition for the retrospective investigation of drug abuse in a wide variety of contexts, shown by the large number of applications developed. This review aims to provide an overview of the state of the art and the latest trends used in the literature from 2005 to the present in the analysis of drugs of abuse in hair, with a special focus on separation analytical techniques and their hyphenation with mass spectrometry detection. The most recently introduced sample preparation techniques are also addressed in this paper. The main strengths and weaknesses of all of these approaches are critically discussed by means of relevant applications.

Role of LC-MS/MS in hair testing for the determination of common drugs of abuse and other psychoactive drugs

Hair testing has been used in toxicological investigations for the last two decades, but only recently a remarkable extension of hair analysis to a variety of application fields was observed, besides drug abuse recognition. The dramatic improvements of LC-MS/MS instrumentation make the detection of tiny amounts of almost whatever drug in hair possible, even after single-dose intake. The progresses observed during the last 5 years in the detection of psychoactive substances in hair are reviewed herein. The literature is partitioned according to the target compounds, namely traditional drugs of abuse, new psychoactive substances and pharmaceutical psychoactive substances. The LC-MS/MS methods presented are addressed to determine a single class of drugs, with the primary aim of accurate quantitation, or to perform multiclass analysis, for rapid and effective screening protocols.

Stress, the HPA axis, and nonhuman primate well-being: A review

Numerous stressors are routinely encountered by wild-living primates (e.g., food scarcity, predation, aggressive interactions, and parasitism). Although many of these stressors are eliminated in laboratory environments, other stressors may be present in that access to space and social partners is often restricted. Stress affects many physiological systems including the hypothalamic-pituitary-adrenocortical (HPA) axis, which is the focus of this review. The glucocorticoid, cortisol, is the ultimate output of this system in nonhuman primates, and levels of this hormone are used as an index of stress. Researchers can measure cortisol from several sampling matrices that include blood, saliva, urine, faeces, and hair. A comparison of the advantages and disadvantages of each sampling matrix is provided to aid researchers in selecting an optimal strategy for their research. Stress and its relationship to welfare have been examined in nonhuman primates using two complimentary approaches: comparing baseline cortisol levels under different conditions, or determining the reactivity of the system through exposure to a stressor. Much of this work is focused on colony management practices and developmental models of abnormal behaviour. Certain colony practices are known to increase stress at least temporarily. Both blood sampling and relocation are examples of this effect, and efforts have been made to reduce some of the more stressful aspects of these procedures. In contrast, other colony management practices such as social housing and environmental enrichment are hypothesized to reduce stress. Testing this hypothesis by comparing baseline cortisol levels has not proved useful, probably due to "floor" effects; however, social buffering studies have shown the powerful role of social housing in mitigating reactions of nonhuman primates to stressful events. Models of abnormal behaviour come from two sources: experimentally induced alterations in early experience (e.g., nursery rearing), and the spontaneous development of behavioural pathology (e.g., self-injurious behaviour). Investigators have often assumed that abnormal behaviour is a marker for stress and thus such monkeys are predicted to have higher cortisol levels than controls. However, an emerging finding is that monkeys with abnormal behaviour are more likely to show a pattern of lowered cortisol concentrations which may reflect either an altered set point or a blunting of the stress response system. These findings parallel human clinical studies demonstrating that neuropsychiatric disorders may be associated with either increased or decreased activity of the HPA system, depending on the aetiology and manifestation of the disorder and their potential influence in provoking allostatic shifts in system functioning.

Persistent organochlorine contaminants in hair samples of Northern Poland population, 1968-2009

The concentrations of persistent chlorinated organic pollutants were determined in hair samples (n=40) collected from inhabitants of Northern Poland in 1968, 1989 and 2009 using gas chromatography ion-trap tandem mass spectrometry (GC-MS/MS). Among the analytes were β- and γ-isomers of hexachlorocyclohexane (β- and γ-HCH), dichlorodiphenyltrichloroethane (p,p'-DDT) and its metabolites (p,p'-DDE, o,p'-DDD, o,p'-DDT and p,p'-DDD) and 6 polychlorinated biphenyl (PCB) congeners (IUPAC Nos. 28, 52, 101, 138, 153 and 180). The following: p,p'-DDE, o,p'-DDT, p,p'-DDT and PCB congeners: 28, 52 and 101 could be quantified in all samples. Overall total organochlorines level was found to decrease in that order: 1968>1989>2009. The most significant time-dependent decrease was noticed for sum of mean values, ∑DDTs (1658, 143.9 and 36.5 ng g(-1)) and ∑PCBs (42.2, 29.4 and 14.9 ng g(-1)) while ∑HCHs (β-HCH and γ-HCH) were present at comparable levels (22.2, 9.8 and 12.6 ng g(-1)) in 1968, 1989 and 2009 respectively. The highest concentrations of DDTs were found in samples from 1968. Despite the long storage time of samples, metabolites either parent compound p,p'-DDT are still present in those samples at very high concentrations. p,p'-DDE as the predominant and stable metabolite of DDT was detected in every sample in the highest concentration. A significant, continuous decrease of total concentration of all studied PCB congeners was observed over the studied period of time. Current results confirm previous reports of other authors upon the utility of hair as an alternative matrix for evaluation of human exposure to persistent organic pollutants.

Minireview: Hair cortisol: a novel biomarker of hypothalamic-pituitary-adrenocortical activity

Activity of the hypothalamic-pituitary-adrenocortical (HPA) axis is commonly assessed by measuring glucocorticoids such as cortisol (CORT). For many years, CORT was obtained primarily from blood plasma or urine, whereas later approaches added saliva and feces for noninvasive monitoring of HPA functioning. Despite the value of all these sample matrices for answering many research questions, they remain limited in the temporal range of assessment. Plasma and saliva are point samples that vary as a function of circadian rhythmicity and are susceptible to confounding by environmental disturbances. Even urine and feces generally assess HPA activity over a period of only 24 h or less. We and others have recently developed and validated methods for measuring the concentration of CORT in the body hair of animals (e.g. rhesus monkeys) and scalp hair of humans. CORT is constantly deposited in the growing hair shaft, as a consequence of which such deposition can serve as a biomarker of integrated HPA activity over weeks and months instead of minutes or hours. Since the advent of this methodological advance, hair CORT has already been used as an index of chronic HPA activity and stress in human clinical and nonclinical populations, in a variety of laboratory-housed and wild-living animal species, and in archival specimens that are many decades or even centuries old. Moreover, because human hair is known to grow at an average rate of about 1 cm/month, several studies suggest that CORT levels in hair segments that differ in proximity to the scalp can, under certain conditions, be used as a retrospective calendar of HPA activity during specific time periods preceding sample collection.

Toxicological analysis of blood and urine samples from female victims of alleged sexual assault

BACKGROUND

The toxicological analysis of blood and urine samples from victims of alleged sexual assault represents a crucial part of the forensic evidence when this crime is investigated.

MATERIAL AND METHODS

We searched a national forensic toxicology database (TOXBASE) to find cases registered as sexual assault, rape, including date-rape that the police had requested the analysis of ethanol and other drugs. Between 2008 and 2010, N = 1460 such cases met this criteria. After immunological screening of urine or blood samples, all positive results were verified by more specific analytical methods, such as gas chromatography-mass spectrometry (GC-MS) for illicit drugs. A large number of prescription drugs and their metabolites were determined by capillary GC with nitrogen-phosphorous (N-P) detector. GC with flame ionization detector (FID) was used to analyze ethanol and gamma-hydroxybutyrate (GHB) in blood at limits of quantitation (LOQ) of 0.1 g/L and 8 mg/L, respectively.

RESULTS

The average age (± standard deviation) of all victims was 24 ± 10.3 years and 72% were between 15 and 29 years. Ethanol and other drugs were not detected in 31% of cases (N = 459). Blood-ethanol was positive in N = 658 cases at mean, median and highest concentrations of 1.23 g/L, 1.22 g/L and 4.3 g/L, respectively. Ethanol plus drugs were present in N = 188 cases (13%) and one or more other drugs alone in N = 210 cases (14%). Cannabis (marijuana) and amphetamines were the major illicit drugs, whereas diazepam, alprazolam, zopiclone as well as newer antidepressants were the major prescription drugs identified.

CONCLUSIONS

The mean age of victims of sexual assault in Sweden, the proportion of drug positive to drug negative cases, the predominance of ethanol positive cases as well as the types of other drugs showed a remarkably good agreement in two studies spanning a period of 8 years.

Bioanalytical procedures and recent developments in the determination of opiates/opioids in human biological samples

The use and abuse of illegal drugs affects all modern societies, and therefore the assessment of drug exposure is an important task that needs to be accomplished. For this reason, the reliable determination of these drugs and their metabolites in biological specimens is an issue of utmost relevance for both clinical and forensic toxicology laboratories in their fields of expertise, including in utero drug exposure, driving under the influence of drugs and drug use in workplace scenarios. Most of the confirmatory analyses for abused drugs in biological samples are performed by gas chromatographic-mass spectrometric methods, but use of the more recent and sensitive liquid chromatography-(tandem) mass spectrometry technology is increasing dramatically. This article reviews recently published articles that describe procedures for the detection of opiates in the most commonly used human biological matrices, blood and urine, and also in unconventional ones, e.g. oral fluid, hair, and meconium. Special attention will be paid to sample preparation and chromatographic analysis.