Sweat Testing in Opioid Users with a Sweat Patch

Kintz, Pascal; Tracqui, A.; Mangin, Patrice; Edel, Yves

doi:10.1093/jat/20.6.393

Cited by 104 publications

(71 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although urine drug screening collection procedures attempt to ensure specimen integrity, some patients demonstrate considerable ingenuity in their efforts to defeat the testing process. [1][2][3][4] Possible methods of avoiding detection of drug misuse include diversion, excessive water consumption, ingesting diuretics such as herbal teas, and substitution of someone else's urine. Individuals who divert pain medication for illegitimate resale often reserve a few pills to be taken before a physician visit so the medication will appear in their urine ensuring that the physician will extend the prescription, and therefore will allow continued diversion of the medication.…”

Section: Discussionmentioning

confidence: 99%

Quantification of a Methadone Metabolite (EDDP) in Urine: Assessment of Compliance

Larson¹,

Richards²

2009

Clinical Medicine & Research

View full text Add to dashboard Cite

Objective: To investigate the possibility of utilizing the ratio of the methadone metabolite, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), to urine creatinine to develop a regression model that would predict drug adherence in patients prescribed methadone for either pain management or drug addiction.Design: Retrospective study. Setting:Marshfield Clinic-Lakeland Center, one of 41 regional centers that make up Marshfield Clinic, a large, private, multi-specialty healthcare institution in central Wisconsin. Participants:Patients receiving methadone treatment for substance abuse or chronic pain. Group 1 was an initial pilot group consisting of 7 patients who were followed for a 4-month period. Group 2 consisted of 33 patients who were followed over a 28-month period.Methods: Age, gender, weight, height, methadone dosage, quantitative urine creatinine and EDDP levels, reported compliance/non-compliance, and relevant clinical cofactors were retrospectively abstracted from the patients' medical records. Log-log regression analyses were used to model EDDP and the EDDP/creatinine ratio from urine screening results as functions of methadone dose, and in the larger cohort (group 2), body size, gender and age. The coefficient of determination adjusted for the number of predictor terms (R adj 2 ) was reported as a measure of model fit.Results: For group 1 data, there was a significant positive relation (P<0.001) but also substantial variability (R adj 2 = 0.49). Adjustment for creatinine through the EDDP/creatinine ratio provided a tighter relation (R adj 2 = 0.95). Similarly, for group 2 data, there was a significant positive relation (P=0.001) and substantial variability (R adj 2 = 0.53). Adjustment for creatinine through EDDP/creatinine ratios provided a substantially stronger relation (R adj 2 = 0.73). Gender and age showed no evidence of association with the EDDP/creatinine ratio (P=0.60 and P=0.51, respectively). Body size was significant in the model, both when measured by body surface area and by lean body weight, and improved the prediction when added to our model (R adj 2 = 0.80). Conclusion:For the first time, urine analyses may be used to monitor methadone over-or under-use in a clinical setting, regardless of the state of patient hydration or the manipulation of a sample by addition of another substance, such as bleach, soap, or even methadone, which could render an appropriate sample inappropriate or an inappropriate sample appropriate. A similar approach may prove useful for other drug treatments, allowing for more accurate monitoring of commonly abused prescription medications.

show abstract

Section: Discussionmentioning

confidence: 99%

Quantification of a Methadone Metabolite (EDDP) in Urine: Assessment of Compliance

Larson¹,

Richards²

2009

Clinical Medicine & Research

View full text Add to dashboard Cite

show abstract

“…Ampules of AMP, MAMP, MDMA, MDEA, MDA, HMMA (1 mg/mL in methanol) and the internal standards AMP-d 11 , MAMP-d 14 , MDMA-d 5 , MDA-d 5 and MDEA-d 6 (100 mcg/mL in methanol) were purchased from Cerilliant Corporation (Round Rock TX, USA). HMA was obtained from Lipomed Inc. (Cambridge, MA, USA).…”

Section: Chemicals and Reagentsmentioning

confidence: 99%

“…Sweat has been investigated as an alternate biological matrix for monitoring drug use [2][3][4][5][6][7][8]. Sweat patches are a convenient and tamper-evident means of collecting sweat.…”

Section: Introductionmentioning

confidence: 99%

“…Detection of 3,4-Methylenedioxymethamphetamine (MDMA) and metabolites is important in forensic toxicology for workplace drug testing, criminal justice, drug abuse treatment and sport doping control programs. Although sympathomimetic amphetamines have been reported in human perspiration [10], little is known about MDMA and metabolite disposition in sweat [5,7,8]. Proposed SAMHSA requirements for a positive sweat test include an amphetamines screen 25 ng/patch, and a confirmation cutoff of ≥25 ng/patch for MDMA, 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxyethylamphetamine (MDEA), methamphetamine (MAMP) and/or amphetamine (AMP).…”

Section: Introductionmentioning

confidence: 99%

“…Generally, lipophilic (less polar) compounds have a greater ability to cross biological membranes. Sweat wipes [24,25] and sweat patches [5,8,26] have been analyzed for sympathomimetic amines. Although some methods simultaneously quantified MDMA, MDA, MDEA, MAMP and AMP [5,24,25] in sweat; no method to date has included HMMA and HMA.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Development and validation of a disk solid phase extraction and gas chromatography–mass spectrometry method for MDMA, MDA, HMMA, HMA, MDEA, methamphetamine and amphetamine in sweat

Martinis

Barnes

Scheidweiler

et al. 2007

Journal of Chromatography B

View full text Add to dashboard Cite

We describe the development and validation of a method for the simultaneous quantification of 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), 3-hydroxy-4-methoxymethamphetamine (HMMA), 3-hydroxy-4-methoxyamphetamine (HMA), 3,4-methylenedioxyethylamphetamine (MDEA), methamphetamine (MAMP) and amphetamine (AMP) in sweat. Drugs were eluted from PharmChek ™ sweat patches with sodium acetate buffer, extracted with disk solid phase extraction and analyzed using GC/MS-EI with selected ion monitoring. Limits of quantification (LOQ) for MDMA, MDEA, MAMP and AMP were 2.5 ng/patch, and 5 ng/patch for MDA, HMA and HMMA. This fully validated procedure was more sensitive than previously published analytical methods and permitted the simultaneous analysis of multiple amphetamine analogs in human sweat.

show abstract

Liquid chromatography?mass spectrometry in forensic toxicology

Bocxlaer¹,

Clauwaert²,

Lambert³

et al. 2000

Mass Spectrom. Rev.

115

View full text Add to dashboard Cite

Liquid chromatography—mass spectrometry has evolved from a topic of mainly research interest into a routinely usable tool in various application fields. With the advent of new ionization approaches, especially atmospheric pressure, the technique has established itself firmly in many areas of research. Although many applications prove that LC—MS is a valuable complementary analytical tool to GC—MS and has the potential to largely extend the application field of mass spectrometry to hitherto “MS‐phobic” molecules, we must recognize that the use of LC—MS in forensic toxicology remains relatively rare. This rarity is all the more surprising because forensic toxicologists find themselves often confronted with the daunting task of actually searching for evidence materials on a scientific basis without any indication of the direction in which to search. Through the years, mass spectrometry, mainly in the GC—MS form, has gained a leading role in the way such quandaries are tackled. The advent of robust, bioanalytically compatible combinations of liquid chromatographic separation with mass spectrometric detection really opens new perspectives in terms of mass spectrometric identification of difficult molecules (e.g., polar metabolites) or biopolymers with toxicological relevance, high throughput, and versatility. Of course, analytical toxicologists are generally mass spectrometry users rather than mass spectrometrists, and this difference certainly explains the slow start of LC—MS in this field. Nevertheless, some valuable applications have been published, and it seems that the introduction of the more universal atmospheric pressure ionization interfaces really has boosted interests. This review presents an overview of what has been realized in forensic toxicological LC—MS. After a short introduction into LC—MS interfacing operational characteristics (or limitations), it covers applications that range from illicit drugs to often abused prescription medicines and some natural poisons. As such, we hope it can act as an appetizer to those involved in forensic toxicology but still hesitating to invest in LC—MS. © 2000 John Wiley & Sons, Inc., Mass Spec Rev 19: 165–214, 2000

show abstract

Sweat Testing in Opioid Users with a Sweat Patch

Cited by 104 publications

References 11 publications

Quantification of a Methadone Metabolite (EDDP) in Urine: Assessment of Compliance

Quantification of a Methadone Metabolite (EDDP) in Urine: Assessment of Compliance

Development and validation of a disk solid phase extraction and gas chromatography–mass spectrometry method for MDMA, MDA, HMMA, HMA, MDEA, methamphetamine and amphetamine in sweat

Liquid chromatography?mass spectrometry in forensic toxicology

Contact Info

Product

Resources

About