Given the limitations of self-reports on drug use, testing for drugs of abuse is important for most clinical and forensic toxicological situations, both for assessing the reality of the intoxication and for evaluation of the level of drug impairment. It is generally accepted that chemical testing of biological fluids is the most objective means of diagnosis of drug use. The presence of a drug analyte in a biological specimen can be used to document exposure. The standard in drug testing is the immunoassay screen, followed by the gas chromatographic-mass spectrometric confirmation conducted on a urine sample. In recent years, remarkable advances in sensitive analytical techniques have enabled the analysis of drugs in unconventional biological specimens such as hair. The advantages of this sample over traditional media, like urine and blood, are obvious: collection is noninvasive, relatively easy to perform, and in forensic situations it may be achieved under close supervision of law enforcement officers to prevent adulteration or substitution. The window of drug detection is dramatically extended to weeks, months or even years when testing hair. It seems that the value of alternative specimen analysis for the identification of drug users is steadily gaining recognition. This can be seen from its growing use in preemployment screening, in forensic sciences, in clinical applications and for doping control. Hair analysis may be a useful adjunct to conventional drug testing in urine. Methods for evading urinalysis do not affect hair analysis. The aim of this review is to document toxicological applications of hair analysis in drug detection.
Although considered as a new drug of abuse, gamma-hydroxybutyrate, or GHB, has been used clinically since the 1960s as an intravenous anesthetic. It was also investigated for treatment of insomnia, of alcohol and opiate withdrawal syndrome, and in cerebrovascular disorders. GHB is a substance naturally present within mammalian species. Properties of neurotransmitter or neuromodulator are generally given to this substance (1,2). Doses of 10 mg/kg cause amnesia; 20 to 30 mg/kg cause sleep; and doses of 50 mg/kg or higher produce anesthesia. Illicit use of GHB typically involves doses of 35 mg/kg (3). People exposed to GHB involve: bodybuilders who believe that the drug stimulates the release of growth hormone, even if this activity is still under debate (4); ravers or club attendees for its intoxicating effects, such as euphoria, reduced inhibitions, sedation, and muscle relaxation that can benefit after ecstasy abuse (5); drivers as a result of recreational abuse (6); and victims of drug-facilitated sexual assault (7). The purported enhancement of sexuality, coupled with a possible abrupt coma-inducing effect, ease of administration in spiked drinks, and potential amnesia have resulted in the use of GHB as an assault-related drug. GHB is also attractive to rapists as it is readily available (Internet, on the street, in dance clubs or fitness centers).
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