Buprenorphine and nor‐buprenorphine levels in head hair samples from former heroin users under Suboxone® treatment

Abstract

In the current study, buprenorphine (BUP) and its major metabolite, nor-buprenorphine (NBUP), were determined in hair samples from former heroin users following Suboxone® treatment. Hair samples from 36 subjects were analyzed. The drugs of interest were isolated from hair by solid-liquid extraction with methanol and were determined by liquid chromatography-mass spectrometry, using an electrospray ionization interface. The analytical parameters of the method (such as linearity, limits of quantification, recovery, accuracy, and precision) were determined. The inter-quartile range of BUP levels was from 11.4 to 37.4 pg/mg (mean value 56.6 pg/mg) for the proximal hair segment, from 5.8 to 43.3 pg/mg for the middle hair segment (mean value 25.3 pg/mg), while a range from 4.3 to 33.9 pg/mg (mean value 105.2 pg/mg) for the distant to the root hair segment was determined. For NBUP the corresponding inter-quartile range was from 27.0 to 147.6 for the proximal segment (mean value 95.4 pg/mg), from 21.5 to 164.7 pg/mg for the middle segment (mean value 102.0 pg/mg) and from 20.4 to 103.6 pg/mg for the distant segment (mean value 156.8 pg/mg). The mean BUP/NBUP concentration ratio was 0.5. The daily dose of Suboxone® correlated significantly with BUP and NBUP levels in hair (p = 0.001 and p = 0.023) as well as with the BUP/NBUP ratio (p = 0.010). No significant correlation was found between the levels of BUP and NBUP and the duration of Suboxone® administration. The developed and validated method was successfully used for the determination of BUP and NBUP in hair samples collected from former heroin users under Suboxone® treatment.

Chiral analysis of amphetamines in hair by liquid chromatography–tandem mass spectrometry: compliance‐monitoring of attention deficit hyperactivity disorder (ADHD) patients under Elvanse® therapy and identification after controlled low‐dose application

“…Another major approach of a TDM concept is the quantitative compliance controlling. The implementation of this aspect of TDM by hair testing is controversially discussed and mostly criticized, as there are only a few selected drugs showing a sufficient correlation between the concentration in hair and drug dosage . Mostly, no evidence for a linear relationship between dosage and drug concentration in hair has been found .…”

“…The implementation of this aspect of TDM by hair testing is controversially discussed and mostly criticized, as there are only a few selected drugs showing a sufficient correlation between the concentration in hair and drug dosage. [25][26][27][28][29] Mostly, no evidence for a linear relationship between dosage and drug concentration in hair has been found. [30][31][32][33] In the present study no dose-response relationship was observed by correlating all concentration values to the selfdeclared administered dose.…”

Development of a sensitive untargeted liquid chromatography–high resolution mass spectrometry screening devoted to hair analysis through a shared MS2 spectra database: A step toward early detection of new psychoactive substances

“…26,30 However, this approach is time consuming (at least two MS2 cycles per m/z) and may miss numerous compounds presenting a weak intensity. NCE allows an adaptation of the collision energy according the mass of the ion.…”

“…Stepped NCE is often used in MS2 experiments to provide an appropriate fragmentation regardless molecule's mass. 26,30 However, this approach is time consuming (at least two MS2 cycles per m/z) and may miss numerous compounds presenting a weak intensity.…”

An overview of available drugs for management of opioid abuse during pregnancy

“…Because buprenorphine only partially binds the μ opioid receptor, the effects of this drug do not increase linearly with the dose and patients experience a “ceiling effect” as the activity of this drug plateaus above a certain concentration unlike the other opioid treatments. This ‘ceiling effect’ makes buprenorphine a safer choice than other full agonists at higher doses [ 26 ].…”