Drug deposition in adipose tissue and skin: evidence for an alternative source of positive sweat patch tests

Levisky, Joseph A.; Bowerman, David L.; Jenkins, Werner W.; Karch, Steven B.

doi:10.1016/s0379-0738(00)00146-8

Cited by 43 publications

(19 citation statements)

References 13 publications

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“…The highest concentration of sweat glands resides in the hands, while the forehead contains the densest population of sebaceous glands (Levisky, Bowerman, Jenkins, & Karch, 2000). Both, however, are capable of delivering remnants of drug use to the skin's surface through either sweat or sebum (Joseph, Oyler, Wstadilc, Ohuoha, & Cone, 1998;Willis, Harris, & Moretz, 1973).…”

Section: Introductionmentioning

confidence: 99%

Utility of sweat patch testing for drug use monitoring in outpatient treatment for opiate dependence

Chawarski

Fiellin

O’Connor

et al. 2007

Journal of Substance Abuse Treatment

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We evaluated the utility of sweat testing for monitoring of drug use in outpatient clinical settings and compared sweat toxicology with urine toxicology and self-reported drug use during a randomized clinical trial of the efficacy of buprenorphine for treatment of opioid dependence in primary care settings. All study participants (N = 63) were opiate-dependent, treatment-seeking volunteers. The results based on toxicology tests obtained from 188 properly worn and unadulterated patches (out of 536 applied) show that the level of agreement between positive sweat test results and positive urine results was 33% for opiates and 92% for cocaine. The findings of this study, that there is a low acceptability of sweat patch testing by patients (only 54.3% were brought back attached to the skin) and that weekly sweat testing is less sensitive than weekly urine testing in detecting opiate use, suggest limited utility of sweat patch testing in outpatient clinical settings.

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Section: Introductionmentioning

confidence: 99%

Utility of sweat patch testing for drug use monitoring in outpatient treatment for opiate dependence

Chawarski

Fiellin

O’Connor

et al. 2007

Journal of Substance Abuse Treatment

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“…Although their experiments were not specifically designed to evaluate residual drug excretion in sweat, the question is raised. 33 More controlled administration studies are needed in chronic heavy users to differentiate new drug use from residual drug excretion.…”

Section: Discussionmentioning

confidence: 99%

Monitoring Pregnant Women's Illicit Opiate and Cocaine Use With Sweat Testing

Brunet

Barnes

Choo

et al. 2010

Therapeutic Drug Monitoring

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Dependence on illicit drugs during pregnancy is a major public health concern as there may be associated adverse maternal, fetal, and neonatal consequences. Sweat patches (n = 389) were collected from 39 pregnant volunteers who provided written informed consent for this Institutional Review Board-approved protocol and wore patches, replaced approximately weekly, from study entry until delivery. Patches were analyzed for opiates (heroin, 6-acetylmor-phine, 6-acetylcodeine, morphine and codeine) and cocaine (cocaine, benzoylecgonine, ecgonine methyl ester, anhydroecgonine methyl ester) by solid phase extraction and gas chromatography mass spectrometry. Seventy-one percent (276) of collected sweat patches were ≥5 ng per patch (limit of quantification) for one or more analytes. Cocaine was present in 254 (65.3%) patches in concentrations ranging from 5.2 to 11,835 ng per patch with 154 of these high enough to satisfy the proposed Substance Abuse and Mental Health Services Administration guidelines for a confirmatory drug test (25 ng per patch). Interestingly, 6-acetylmorphine was the most prominent opiate analyte documented in 134 patches (34.4%) with 11.3% exceeding the proposed opiate Substance Abuse and Mental Health Services Administration cut-off (25 ng per patch). Heroin was identified in fewer patches (77), but in a similar concentration range (5.3–345.4 ng per patch). Polydrug use was evident by the presence of both cocaine and opiate metabolites in 136 (35.0%) patches. Sweat testing is an effective method for monitoring abstinence or illicit drug use relapse in this high-risk population of pregnant opiate- and/or cocaine-dependent women.

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“…This result suggests that there are other sources of pad contamination besides those resulting from direct contact with airborne PAHs. Among these there are the use of dirty clothes,38 and the fact that since the bottom surface of the pad was in contact with the skin, a build-up of PAHs might arise from perspiration and/or diffusion from inside the body to the skin surface 39. Viewed in this context, the concentration of PAHs may represent a combination of current external exposure (air and clothing), and pre-existing skin contamination and excretion.…”

Section: Discussionmentioning

confidence: 99%