Simultaneous Liquid Chromatography-Mass Spectrometry Quantification of Urinary Opiates, Cocaine, and Metabolites in Opiate-Dependent Pregnant Women in Methadone-Maintenance Treatment

Abstract

Opiates, cocaine, and metabolites were quantified by liquid chromatography–mass spectrometry (LC–MS) in 284 urine specimens, collected thrice weekly, to monitor possible drug relapse in 15 pregnant heroin-dependent women. Opiates were detected in 149 urine specimens (52%) with limits of quantification (LOQ) of 10–50 μg/L. Morphine, morphine-3-glucuronide, and/or morphine-6-glucuronide were positive in 121 specimens; 6-acetylmorphine, a biomarker of heroin ingestion, was quantifiable in only 7. No heroin, 6-acetylcodeine, papaverine, or noscapine were detected. One hundred and sixty-five urine specimens (58%) from all 15 participants were positive for one or more cocaine analytes (LOQ 10–100 μg/L). Ecgonine methylester (EME) and/or benzoylecgonine were the major cocaine biomarkers in 142. Anhydroecgonine methylester, a biomarker of smoked cocaine, was positive in six; cocaethylene and/or ecgonine ethylester, biomarkers of cocaine and ethanol co-ingestion, were found in 25. At the current Substance Abuse Mental Health Services Administration cutoffs for total morphine (2000 μg/L), codeine (2000 μg/L), 6-acetylmorphine (10 μg/L), and benzoylecgonine (100 μg/L), 16 opiate- and 29 cocaine-positive specimens were identified. Considering 100 μg/L EME as an additional urinary cocaine biomarker would identify 51 more positive cocaine specimens. Of interest is the differential pattern of opiate and cocaine biomarkers observed after LC–MS as compared to gas chromatography–mass spectrometry analysis.

The Ability of Bacterial Cocaine Esterase to Hydrolyze Cocaine Metabolites and Their Simultaneous Quantification Using High-Performance Liquid Chromatography-Tandem Mass Spectrometry

“…Most drug screening assays include cocaine and at least one major metabolite, usually benzoylecgonine, and an increasing number of these screens are now performed using LC-MS/MS technology (Dams et al, 2007;Badawi et al, 2009;Shakleya et al, 2010;Wang et al, 2010). Whereas the methods have been well documented (Dams et al, 2007;Badawi et al, 2009;Shakleya et al, 2010;Wang et al, 2010), the goal of a screen is to incorporate as many compounds as possible into a single assay. Comprehensive screens may even require the use of expensive ultra-performance liquid chromatography instrumentation (Badawi et al, 2009) to achieve sufficient resolution of all components.…”

Maternal Hair Analysis for the Detection of Illicit Drugs, Medicines, and Alcohol Exposure During Pregnancy

“…NAS is developed in the newborn as a consequence of withdrawal from chronic exposure during gestation, and its principal symptoms are irritability, autonomic dysfunction, respiratory symptoms, and gastrointestinal signs. [15][16][17] Among the different maternal and neonatal matrices, the ones with the longest window of detection are meconium and maternal and neonatal hair. Maternal interview is often used to detect drug consumption throughout pregnancy; however, it is well known that it is a subjective measure of drug exposure and underreport is common.…”

Analysis of Drugs of Abuse in Biological Specimens

“…Shakleya et al 30) reported that opiates, cocaine, and their metabolites were quantified by LC-MS in 284 urine specimens collected thrice weekly, to monitor possible drug relapse in 15 drug-dependent pregnant women. As a result, 165 urine specimens (58%) from all the 15 subjects were positive for one or more cocaine analytes.…”