The Current Status of Sweat Testing For Drugs of Abuse: A Review

Abstract

Sweat is an alternative biological matrix useful to detect drugs of abuse intake. It is produced by eccrine and apocrine glands originating in the skin dermis and terminating in secretory canals that flow into the skin surface and hair follicles. Since many years it has been demonstrated that endogenous and exogenous chemicals are secreted in this biological sample hence its collection and analysis could show the past intake of xenobiotics. From the seventies the excretion of drugs of abuse has been investigated in human skin excretion; later in nineties forensic scientists began to experiment some techniques to trap sweat for analyses. Even if the use of skin excretions for drug testing has been restricted mainly by difficulties in sample recovery, the marketing of systems for the sample collection has allowed successful sweat testing for several drugs of abuse. In the recent years sweat testing developed a noninvasive monitoring of drug exposure in various contexts as criminal justice, employment and outpatient clinical settings. This paper provides an overview of literature data about sweat drug testing procedures for various xenobiotics especially cocaine metabolites, opiates, cannabis and amphetamines. Issues related to collection, analysis and interpretation of skin excretions as well as its advantages and disadvantages are discussed. Moreover the chance to apply the technique to some particular situation such as workplace drug testing, drivers, doping or prenatal diagnosis, the comparison between sweat and other non conventional matrices are also reviewed. According to literature data the analysis of sweat may be usefully alternative for verifying drug history and for monitoring compliance.

Hydrogel Micropatch and Mass Spectrometry–Assisted Screening for Psoriasis-Related Skin Metabolites

“…Because of the lack of a simple methodology, the detection and quantification of skin metabolites has not been favored in the clinical setting, with the exception of the diagnosis of cystic fibrosis in infants (12 ). Several methods for collecting small amounts of skin excretions have been proposed (cotton swab, wipe, skinpatch, and syringe), but all of them involve major inconveniences (13 ). Therefore, it would be helpful to develop and implement analytical methods for sampling and analyzing skin excretions that circumvent chromatographic separations (14,15 ).…”

Opening the toolbox of alternative sampling strategies in clinical routine: A key-role for (LC-)MS/MS

“…The main disadvantages of this sampling technique are the potential influence of external contamination of the skin or the sweat patches and the unknown sample volume (rendering interpretation of a quantitative result challenging), as sweat production may vary in function of physical activity or ambient temperature. Given the limited potential of sweat analysis in the routine clinical lab, the interested reader is referred to other recent reviews 23,24 .…”

Alternative Sampling Strategies for Cytochrome P450 Phenotyping

“…Several applications of sweat testing have been described, including measurement of chloride ions as a biomarker of cystic fibrosis [142] and detection of drugs of abuse in forensic toxicology, roadside and workplace drug testing [143][144][145].…”

“…Limitations of this sampling strategy are the potential influence of external contamination of the devices or the skin and the unknown collected volume, as sweat production may vary in function of ambient temperature or physical activity [145]. Delahunty et al suggested that sweat could potentially be used as an alternative for urine or plasma to estimate CYP1A2 activity.…”