Cocaine found in a child’s hair due to environmental exposure?

Psychotropic substances in house dusts: a preliminary assessment

Psychotropic substances (PSs) are known to affect air and waters, while scarce attention has been paid to their occurrence in settled dusts although they can reach important concentrations there; moreover, no procedures have been developed for this specific purpose. In this study, a list of PSs (i.e., nicotine, cotinine, caffeine, cocaine, cannabinol, Δ⁹-tetrahydrocannabinol, cannabidiol, amphetamine, heroin, and methadone) were characterized in dusts from Rome and Fiumicino international airport, Italy, and from Ouargla city, Algeria. The analytical procedure, based on ultra-sonic bath extraction, silica column chromatography, and GC-MSD analysis, provided good recovery, uncertainty, sensitivity, and lack of interferences for all substances except amphetamine. In NIST SRM-2585 house dust, nicotine, cotinine, caffeine, cocaine, and cannabinol accounted for ~5.95, 0.87, 4.17, 7.0, and 2.2 μg/g, respectively; on the other hand, methadone, tetrahydrocannabinol, cannabidiol, and heroin (all <0.025 μg/g) were below the detection limit of the method. Two sites at the Fiumicino airport were affected by different loads of PSs (e.g., 0.76 and 2.80 ng/m² of cocaine). In Ouargla, where dust was collected in a primary school and a dwelling, nicotine ranged from ~60 ± 50 to ~86 ± 89 ng/m², cocaine was absent, and cannabinoids (0.35 ± 0.43 ng/m² as total) were found only in the home. In Rome, nicotine, caffeine, cocaine, and cannabinol reached ca. 700, 1470, 0.82, and 2.4 ng/m², respectively, in a smokers' home, but they were ca. 1300, 25,000, 670, and 1700 ng/m² in a non-smoker home. In conclusion, all dusts revealed the presence of illicit PSs. Further studies are necessary to understand the links between the PS amounts in airborne particulates and in dusts, as well as the PS origin and fate in interiors.

The presence of licit and illicit drugs in police stations and their implications for workplace drug testing

The presence of licit and illicit drug residues on surfaces was studied in 10 police stations and a central drug evidence store in New South Wales, Australia, with the results compared to similar surfaces in four public buildings (to establish a community baseline). The results of almost 850 workplace surface swabs were also compared to the outcome of drug analysis in urine and hair samples volunteered by police officers. Surfaces were swabbed with alcohol and the swabs were extracted and analysed by LC-MS/MS. Low level concentrations of the more commonly used drugs were detected at four public sites and one restricted access police office facility. Surface swabs taken in 10 city and country police stations yielded positive results for a broader suite of drugs than at background sites however 75-93% of the positive drug results detected in police stations were below 40ng, which is only slightly greater than the largest background result measured in the current study. This study indicates that contamination issues are more likely to be focussed in higher risk areas in police stations, such as counters and balances in charge areas, and surfaces within drug safes although front reception counters also returned surface contamination. All 64 urine samples collected in this study were negative, while only 2 of the 11 hair samples collected from donors resulted in trace concentrations for cocaine, but not its metabolite benzoylecgonine. Positive hair samples were only obtained from police donors in very high risk jobs, indicating that the exposure risk is low. Minor changes to the materials used as work surfaces, and some procedural changes in police stations and large evidence stores are suggested to decrease the likelihood of drugs contaminating work surfaces, thereby reducing the potential exposure of police officers to drugs in the workplace.

Clinical Interpretation of Urine Drug Tests: What Clinicians Need to Know About Urine Drug Screens

Urine drug testing is frequently used in clinical, employment, educational, and legal settings and misinterpretation of test results can result in significant adverse consequences for the individual who is being tested. Advances in drug testing technology combined with a rise in the number of novel misused substances present challenges to clinicians to appropriately interpret urine drug test results. Authors searched PubMed and Google Scholar to identify published literature written in English between 1946 and 2016, using urine drug test, screen, false-positive, false-negative, abuse, and individual drugs of abuse as key words. Cited references were also used to identify the relevant literature. In this report, we review technical information related to detection methods of urine drug tests that are commonly used and provide an overview of false-positive/false-negative data for commonly misused substances in the following categories: cannabinoids, central nervous system (CNS) depressants, CNS stimulants, hallucinogens, designer drugs, and herbal drugs of abuse. We also present brief discussions of alcohol and tricyclic antidepressants as related to urine drug tests, for completeness. The goal of this review was to provide a useful tool for clinicians when interpreting urine drug test results and making appropriate clinical decisions on the basis of the information presented.

Cocaine and cannabinoids in the atmosphere of Northern Europe cities, comparison with Southern Europe and wastewater analysis

This study reports the first investigation of atmospheric illicit drug concentrations in Northern Europe using measurements of cocaine and cannabinoids in Amsterdam, London and Stockholm. Further, these measurements were compared to those made in Rome to explore the geographical and inter-city variability. Co-located measurements of atmospheric particulate mass and PAHs were used to help describe and interpret the illicit drug measurements with respect to atmospheric dispersion. Cocaine concentrations ranged from 0.03 to 0.14ng/m³ in Amsterdam, from 0.02 to 0.33ng/m³ in London and were below quantification limit (3pg/m³) in Stockholm. Cannabinol was the only cannabinoid molecule detected in the three cities. During this campaign, London reported the highest concentrations of cocaine and meaningful differences were detected between the urban background and city centre London sites. Mean cocaine concentrations measured in Amsterdam during March 2011 were also compared with those measured simultaneously in eight Italian cities. The cocaine concentration in Amsterdam was comparable to that measured at an urban background in Milan and at a densely populated site in Florence. Although correlating atmospheric concentrations directly with drug prevalence is not possible using current data, links between concentrations of cocaine and estimates of abuse prevalence assessed by the more routinely used wastewater analysis were also examined. A statistically significant correlation was found between the two sets of data (R²=0.66; p=0.00131). Results confirmed that meteorology, population rate and habits of consumption influence the atmospheric concentrations of drugs. If these confounding factors were better controlled for, the techniques described here could became an easy and cost effective tool to index the impact of cocaine abuse in the area; especially where local hot spots need to be identified.

What Can a Urine Drug Screening Immunoassay Really Tell Us?

Urine drug screening has become standard of care in many medical practice settings to assess compliance, detect misuse, and/or to provide basis for medical or legal action. The antibody-based enzymatic immunoassays used for qualitative analysis of urine have significant drawbacks that clinicians are often not aware of. Recent literature suggests that there is a lack of understanding of the shortcomings of these assays by clinicians who are ordering and/or interpreting them. This article addresses the state of each of the individual immunoassays that are most commonly used today in order to help the reader become proficient in the interpretation and application of the results. Some literature already exists regarding sources of "false positives" and "false negatives," but none seem to present the material with the practicing clinician in mind. This review aims to avoid overwhelming the reader with structures and analytical chemistry. The reader will be presented relevant clinical knowledge that will facilitate appropriate interpretation of immunoassays regardless of practice settings. Using this review as a learning tool and a reference, clinicians will be able to interpret the results of commonly used immunoassays in an evidence-based, informed manner and minimize the negative impact that misinterpretation has on patient care.

New developments on emerging organic pollutants in the atmosphere

BACKGROUND

The continuous progress in analytical techniques has improved the capability of detecting chemicals and recognizing new substances and extended the list of detectable contaminants widespread in all environmental compartments by human activities. Most concern is focused on water contamination by emerging compounds. By contrast, scarce attention is paid to the atmospheric sector, which in most cases represents the pathway of diffusion at local or global scale. Information concerning a list of organic pollutants is provided in this paper.

METHODS

The volatile methyl tert-butyl ether and siloxanes are taken as examples of information insufficient with regard to the potential risk induced by diffusion in the atmosphere. Illicit drugs, whose presence in the air was ascertained although by far unexpected, are considered to stress the needs of investigating not solely the environmental compartments where toxic substances are suspected to display their major influence. Finally, the identification of two recognized emerging contaminants, i.e., tris(2-chloroisopropyl) phosphate and N,N-diethyl-m-toluamide, in aerosols originally run to characterize other target compounds is presented with the purpose of underlining the wide diffusion of the organic emerging contaminants in the environment.

Quantitative analysis of methamphetamine in hair of children removed from clandestine laboratories--evidence of passive exposure?

In New Zealand many children have been removed from clandestine laboratories following Police intervention. In the last few years it has become standard procedure that these children have hair samples taken and these samples are submitted to the laboratory for analysis. There are various mechanisms for the incorporation of drugs into hair. The hair follicle has a rich blood supply, so any drug that may be circulating in the blood can be incorporated into the growing hair. Another mechanism is via external contamination, such as spilling a drug on the hair or through exposure to fumes or vapours. Hair samples were analysed for methamphetamine and amphetamine. From the 52 cases analysed 38 (73%) were positive for methamphetamine (>0.1 ng/mg) and amphetamine was detected in 34 of these cases. In no case was amphetamine detected without methamphetamine. The hair washes (prior to extraction) were also analysed (quantified in 30 of the positive cases) and only 3 had a wash to hair ratio of >0.1 (all were <0.5), which may be indicative of a low level of external contamination. This low level of evidence of external contamination suggests that the children are exposed to methamphetamine and are incorporating it into the hair through the blood stream.

Possible social relevance of illicit psychotropic substances present in the atmosphere

Although the worldwide presence of illicit psychotropic compounds in the environment is well known, the social impact of drug abuse on the community has yet to be determined. Besides, the possibility of deriving indicators of the prevalence of drug abuse from the content of illicit substances in the air remains unexplored. In this study, the atmospheric concentrations of psychotropic compounds recorded in Italy were plotted vs. a series of criminal statistics. Meaningful links were found between atmospheric cocaine and the amount of drugs seized, the number of drug related crimes and the demand for clinical treatment recorded in the Italian regions. Atmospheric cocaine and cannabinoids also seemed to be correlated with tumour insurgence and mental disease frequency, respectively. However, further investigations are necessary to elucidate/explain/clarify if the behaviours observed for cocaine vs. the parameters usually adopted to estimate drug abuse prevalence (correspond to an effective relationships)/are directly linked, and to understand why the same approach failed when applied to cannabinoids. Moreover, according to our study illicit drugs are suspected to promote long-term ill health effects even when present at low concentrations the air.

Urine drug screening: practical guide for clinicians

Drug testing, commonly used in health care, workplace, and criminal settings, has become widespread during the past decade. Urine drug screens have been the most common method for analysis because of ease of sampling. The simplicity of use and access to rapid results have increased demand for and use of immunoassays; however, these assays are not perfect. False-positive results of immunoassays can lead to serious medical or social consequences if results are not confirmed by secondary analysis, such as gas chromatography-mass spectrometry. The Department of Health and Human Services' guidelines for the workplace require testing for the following 5 substances: amphetamines, cannabinoids, cocaine, opiates, and phencyclidine. This article discusses potential false-positive results and false-negative results that occur with immunoassays of these substances and with alcohol, benzodiazepines, and tricyclic antidepressants. Other pitfalls, such as adulteration, substitution, and dilution of urine samples, are discussed. Pragmatic concepts summarized in this article should minimize the potential risks of misinterpreting urine drug screens.