Biomarkers of opiate use

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.

True‐Positive Drugs of Abuse Test Results Due to Use of Prescriptions and Nonprescription Drugs

“…The tea bags usually contain approximately 1 g of plant material, usually dried raw coca leaves that are also a natural source of cocaine. Urinary samples were collected at 2,5,8,15,21,24,43, and 68 hours after drinking the tea. When the tea was prepared, 1 cup of Peruvian coca tea had an average of 4.14 mg of cocaine, whereas 1 cup of Bolivian tea had an average of 4.29 mg of cocaine.…”

“…Stefanidou et al reported that a morphine -tocodeine ratio in blood exceeding 1 is strong evidence that the person had abused heroin as opposed to taking a prescription medication containing codeine (21) . However, the illicit use of heroin also results in confi rmation of morphine in urine because heroin is fi rst metabolized to 6 -monoacetyl morphine and then into morphine, whereas the marker compound 6 -monoacetyl morphine may not be confi rmed in the urine of an illicit user of heroin because this compound can be detected only for a short time in heroin after heroin abuse.…”

Direct and efficient liquid chromatographic‐tandem mass spectrometric method for opiates in urine drug testing – importance of 6‐acetylmorphine and reduction of analytes

“…[1,2] Heroin itself is rarely found in urine or other body fluids, and is mainly excreted in the urine as free and conjugated morphine. [3,4] In addition, since illicit heroin contains acetylcodeine, codeine may also occur in urine after heroin intake. [3,4] In addition, since illicit heroin contains acetylcodeine, codeine may also occur in urine after heroin intake.…”

“…[3,4] In addition, since illicit heroin contains acetylcodeine, codeine may also occur in urine after heroin intake. [4,7] Morphine and codeine undergoes glucuronidation as major metabolic pathways leading to formation and excretion in urine of morphine-3-glucuronide (M3G), morphine-6glucuronide (M6G), codeine-6-glucuronide (CG) by action of UDP glucuronyltransferase (UGT) [1] , especially the UGT2B7 [8,9] and the UGT2B1 isoforms. [4,7] Morphine and codeine undergoes glucuronidation as major metabolic pathways leading to formation and excretion in urine of morphine-3-glucuronide (M3G), morphine-6glucuronide (M6G), codeine-6-glucuronide (CG) by action of UDP glucuronyltransferase (UGT) [1] , especially the UGT2B7 [8,9] and the UGT2B1 isoforms.…”

“…[4] This is best done based on accurate and precise quantification of morphine and codeine and taking absolute morphine concentration and ratio to codeine into consideration. [4] This is best done based on accurate and precise quantification of morphine and codeine and taking absolute morphine concentration and ratio to codeine into consideration.…”