Alternative Specimens—Sweat

Abstract

Drugs are incorporated into sweat by passive diffusion and transdermal migration. The proof of principle of drug testing in sweat has been developed in the past 25 years. Numerous devices and approaches have been developed for the collection of sweat. The potential application of sweat analysis for on‐site drug testing at the roadside is limited by the nonavailability of adequate analytical devices. Their major limitation is the lack of sensitivity to some drug classes, an aspect that has been improving over the years. Adequate analytical methodology has been developed for drug analysis both in sweat patches and skin swabs. Immunoassays directed at the detection of parent drugs combined with highly sensitive chromatographic coupled to mass spectrometry analytical methods is the most common analytical approach. In particular, the sweat patch drug testing approach has been proven to be an alternative to urine testing in substance abuse treatment and probation programs. Some of the advantages include a wider detection window, easier sample collection, and reduced opportunities for sample tampering. There are still some pending studies on environmental skin contamination, drug absorption/loss through patch membrane, and drug reabsorption from patches that limit the routine application of drug testing in sweat to some extent.

Sweat testing for the detection of atomoxetine from paediatric patients with attention deficit/ hyperactivity disorder: application to clinical practice

“…[12] Sweat is the other alternative matrix that may provide additional information on drug use and misuse since the detection window of drugs in sweat is the time the sweat patch is worn, supplying cumulative drug use data from patch application until removal. [14,15] The development of the sweat patch technology has been an important step forward in facilitating sample collection. Because the patches can be worn for up to 1 week, and no drug degradation seems to occur during this time interval, the window of drug detection can be longer than the one provided by urine testing.…”

“…Because the patches can be worn for up to 1 week, and no drug degradation seems to occur during this time interval, the window of drug detection can be longer than the one provided by urine testing. [15] Testing in sweat could be used as a non-invasive alternative to blood testing not only for purposes of drug monitoring, [16] and pharmacokinetic [8,17] studies, but also for monitoring recent use of ATX in children, adolescents, and young adults to evaluate drug compliance and associate with eventually observed clinical outcomes.…”