Drugs in hair: a new extraction procedure

Screening for drugs of abuse in hair with ion spray LC-MS-MS

Analyzing hair for many substances can be tedious and expensive, and a rapid screening method should prove helpful. Generally, screening has been performed using immunological tests, mainly in workplace drug testing, where the number of samples has been high. The aim of this study was to develop an LC-MS-MS method for the simultaneous analysis of several drugs of abuse in human hair as an alternative to immunological screening tests. In 75 randomly selected autopsy cases, hair was analyzed in addition to the usual specimens of blood and urine. The method included nicotine, cotinine, morphine, codeine, 6-acetylmorphine, ethylmorphine, amphetamine, methamphetamine, MDA, MDMA, benzoylecgonine, cocaine, 7-aminoflunitrazepam and diazepam. The LC-MS-MS analysis was performed on a SCIEX API 2000 MS-MS instrument equipped with an electrospray interface. To 20-50 mg of hair, 0.5 ml of mobile phase A (acetonitril:methanol:20 mM formate buffer, pH 3.0 (10:10:80)) and 25 microl of internal standard were added and the sample was incubated in a water bath at 37 degrees C during 18 h. Using a threshold of 20 ng/sample, equivalent to 1 ng/mg if 20mg hair is used, 26 positive results were found in 16 cases. Three of the 26 positive detections could not be confirmed by GC-MS. Two of the cases were not previously known as drug users. Of the 59 negative cases, only one case had a positive blood sample showing 0.01 and 0.07 microg/g femoral blood of 6-acetylmorphine and morphine, respectively. This might indicate drug abstinence resulting in decreased tolerance or even a "first time" use of heroin resulting in death. We conclude that the use of hair analysis in postmortem cases can reveal both unknown drug use, as well as confirm a period of drug abstinence prior to an acute fatal overdose. The proposed LC-MS-MS method showed high sensitivity, was very easy to perform and seemed appropriate for screening purposes.

Screening for drugs of abuse in hair with ion spray LC–MS–MS

Analyzing hair for many substances can be tedious and expensive, and a rapid screening method should prove helpful. Generally, screening has been performed using immunological tests, mainly in workplace drug testing, where the number of samples has been high. The aim of this study was to develop an LC-MS-MS method for the simultaneous analysis of several drugs of abuse in human hair as an alternative to immunological screening tests. In 75 randomly selected autopsy cases, hair was analyzed in addition to the usual specimens of blood and urine. The method included nicotine, cotinine, morphine, codeine, 6-acetylmorphine, ethylmorphine, amphetamine, methamphetamine, MDA, MDMA, benzoylecgonine, cocaine, 7-aminoflunitrazepam and diazepam. The LC-MS-MS analysis was performed on a SCIEX API 2000 MS-MS instrument equipped with an electrospray interface. To 20-50 mg of hair, 0.5 ml of mobile phase A (acetonitril:methanol:20 mM formate buffer, pH 3.0 (10:10:80)) and 25 microl of internal standard were added and the sample was incubated in a water bath at 37 degrees C during 18 h. Using a threshold of 20 ng/sample, equivalent to 1 ng/mg if 20mg hair is used, 26 positive results were found in 16 cases. Three of the 26 positive detections could not be confirmed by GC-MS. Two of the cases were not previously known as drug users. Of the 59 negative cases, only one case had a positive blood sample showing 0.01 and 0.07 microg/g femoral blood of 6-acetylmorphine and morphine, respectively. This might indicate drug abstinence resulting in decreased tolerance or even a "first time" use of heroin resulting in death. We conclude that the use of hair analysis in postmortem cases can reveal both unknown drug use, as well as confirm a period of drug abstinence prior to an acute fatal overdose. The proposed LC-MS-MS method showed high sensitivity, was very easy to perform and seemed appropriate for screening purposes.

Morphine extraction in necrophagous insects remains for determining ante-mortem opiate intoxication

To study the potential use of insects remains as toxicological indicators, we measured morphine in desiccated entomological materials using a radioimmunoassay method (Coat-A-Count Serum Morphine, Dade Behring, France) following enzymatic hydrolysis.First, enzymatic cuticle extraction of morphine (pronase digestion preceded by a 2h incubation with a dithiothreitol solution) was performed on various substrates (Calliphoridae puparial cases and desiccated adults, and desiccated pupae of Dermestidae) which were then tested to identify possible interferences with the radioimmunoassay procedure. This same procedure was performed on puparial cases and desiccated adults of Lucilia sericata (Diptera, Calliphoridae) previously reared on minced meat containing various morphine concentrations. Morphine was detected only in cuticle powder from insects reared on meats containing 100 and 1000mg/kg. Higher concentrations were measured in puparial cases. Rearings on psoas from eight heroin overdose victims confirmed previous experimental results. Remains of necrophagous insects, particularly puparial cases, are often preserved for a long time, and consequently can serve as late alternative specimens for toxicological analysis when suitable tissues are not available.

Incidence of opiates, amphetamines, and cocaine in hair and blood in fatal cases of heroin overdose

The purpose of the present study was to investigate the occurrence in hair, of some drugs of abuse in deaths caused by heroin overdose, in comparison to findings in blood. Blood, urine and hair samples were obtained during routine post mortem examinations. Samples were analysed for amphetamines, opiates, and cocaine. Immunometric drug screening was performed in urine and positive results confirmed with gas chromatography-mass spectrometry (GC-MS) of blood samples. All hair samples were analyzed with GC-MS. Hair samples were either incubated with methanol for determination of opiates and cocaine, or dissolved in sodium hydroxide for determination of amphetamines. All 19 blood samples were positive for morphine (0.04-0.4 microgram g-1) and ten were also positive for 6-acetylmorphine (0.003-0.02 microgram g-1). Thirteen of the hair samples were positive for 6-acetylmorphine and seven of which were positive also for morphine. Concentrations ranged from 0.3-7.4 and 0.3-1.3 (ng mg-), respectively. Amphetamine was found in three blood samples (0.04-1.2 micrograms g-1) and in eleven hair samples (0.4-18.3 ng mg-). Cocaine was determined in one blood sample (0.03 microgram g-1) and two hair samples (0.7-6.5 ng mg-). Out of the nineteen cases studied, eight showed chronic multi drug use on the basis of the results of hair analysis. In six subjects no opiates could be detected in hair, suggesting; "first" or occasional intake of heroin, which could be a contributing factor to the overdose death, because of lack of tolerance. We conclude that analysis of hair can be a useful complement to analysis of more conventional autopsy material, especially when investigating overdose deaths and previous histories of drug use and abuse.

The measurement of morphine in the hair of heroin abusers

Several techniques have been described for the determination of morphine in hair as a method of monitoring past heroin use. However, although some of the techniques [notably radioimmunoassay (RIA)] may appear relatively simple to perform, any results obtained must be interpreted with caution. In this study, hair specimens from four known heroin abusers were sectionally analysed by a specific RIA for morphine. Prior to analysis, all hair sections were cleaned to remove any possible surface contamination. Five different hair digestion procedures were evaluated to determine the most effective method that could be used to liberate morphine from hair. The greatest analytical recovery was obtained by incubation with 1.0 M sodium hydroxide for 18 h at 55 degrees C, neutralization with 1.0 M hydrochloric acid, and pH adjustment with 0.1 M phosphate buffer (pH 7.0). The morphine concentrations detected in the hair specimens ranged from 0.5 to 13.2 ng/mg of hair. It was also found that the use of shorter length segments (e.g. 1 cm length) gave a clearer, more detailed picture of the historic pattern of heroin use in the four subjects studied.

Analytical procedures for determination of opiates in hair: a review

This article reviews the analysis of opiates in hair. Hair matrix pretreatment, hydrolysis, extraction and detection procedures are presented amongst a study of over 70 bibliographic data. In addition, a new method for the extraction of opiates from hair, in which a powdered sample of hair is extracted directly by subcritical fluid, is presented.

The determination of cocaine in hair: a review

The explosion of literature related to the analysis of hair for cocaine and its products is reviewed. In the commonly accepted applications of hair testing for cocaine, those related to criminal or civil investigations and pharmacotoxicologic studies occupy most of the relevant published work. This review uses detailed, 'binary' (yes/no) tables to demonstrate trends in the literature, and allows researchers and caseworkers quick access to the literature most important for answering a variety of questions.

Simultaneous assay of cocaine, heroin and metabolites in hair, plasma, saliva and urine by gas chromatography-mass spectrometry

As part of an ongoing research program on the development of drug detection methodology, we developed an assay for the simultaneous measurement of cocaine, heroin and metabolites in plasma, saliva, urine and hair by solid-phase extraction (SPE) and gas chromatography-mass spectrometry (GC-MS). The analytes that could be measured by this assay were the following: anhydroecgonine methyl ester; ecgonine methyl ester;. ecgonine ethyl ester; cocaine; cocaethylene; benzoylecgonine; cocaethylene; norcocaethylene; benzoylnorecgonine; codeine; morphine; norcodeine; 6-acetylmorphine; normorphine; and heroin. Liquid specimens were diluted, filtered and then extracted by SPE. Additional handling steps were necessary for the analysis of hair samples. An initial wash procedure was utilized to remove surface contaminants. Washed hair samples were extracted with methanol overnight at 40 degrees C. Both wash and extract fractions were collected, evaporated and purified by SPE. All extracts were evaporated, derivatized with N,O-bis(trimethylsilyl)trifluoroacetamide (BSTFA) with 1% trimethylchlorosilane (TMCS) and analyzed by GC-MS. The limit of detection (LOD) for cocaine, heroin and metabolites in biological specimens was approximately 1 ng/ml with the exception of norcodeine, normorphine and benzoylnorecgonine (LOD = 5 ng/ml). The LOD for cocaine, heroin and metabolites in hair was approximately 0.1 ng/mg of hair with the exception of norcodeine (LOD = 0.3 ng/mg) and normorphine and benzoylnorecgonine (LOD = 0.5 ng/mg). Coefficients of variation ranged from 3 to 26.5% in the hair assay. This assay has been successfully utilized in research on the disposition of cocaine, heroin and metabolites in hair, plasma, saliva and urine and in treatment studies.

Analytical requirements, perspectives and limits of immunological methods for drugs in hair

The analytical requirements for analysis of drugs in hair are sensitivity in the range of picograms per milligram of hair, specificity for lipophilic drugs and absence of matrix effects with hair digests. These requirements are met by immunoassays which are also inexpensive, rapid and easy to use. However, in applying immunoassays to hair testing, certain limitations of the assay and of interpretation of assay results should be kept in perspective. These limitations are illustrated in this review with examples of the analysis of opiates in hair from patients and opiate addicts. The first requirement for immunological analysis of hair digests is that the digest must not denature the antibody proteins of the immunoassay reagents. For this reason enzymatic digests are better for immunological assay than chemical digests. Strongly acidic or alkaline digests must be brought to a neutral pH before immunoassay. Immunoassays used for analysis of hair should be calibrated with spiked hair digest standards to correct for possible matrix effects. The second requirement is that the immunoassay have the sensitivity and specificity to detect the drug in hair. Drugs of abuse are found in hair in the range of 10 pg-10 ng/mg hair. Radioimmunoassays are capable of detection and quantitation in this concentration range. Although the mechanism of drug incorporation into hair is not known, it is now apparent that primarily the parent drug and lipophilic metabolites are found in hair. For example, the ratio of cocaine/benzoylecgonine averages 10 (range 2-50) in published reports of analysis of hair from cocaine users. Therefore, immunoassays which are highly sensitive for the parent drug are required and results of immunoassays should be expressed as equivalents. When spiking standards for calibration of hair digest immunoassays, parent drug known to be present in hair should be used, e.g. cocaine not benzoylecgonine. With immunoassays which are specific for the lipophilic metabolite found in hair such as 6-MAM, differential radioimmunoassay can be used to discriminate between medical and illicit sources for the opiate drugs found in hair. Because of the low concentrations of drugs encountered in hair, immunoassays for hair have been used at cutoff concentrations at their limits of detection. The limit of detection (LOD) has been determined by calculating the mean and standard deviation (S.D.) for the assay response for a number of negative hair samples. The cutoff was then set at a distance of 2, 3, or 5 S.D.s from the mean response.(ABSTRACT TRUNCATED AT 400 WORDS)

Improved enzymatic hydrolysis of hair

An enzymatic hair extraction method is proposed for drug analysis. Pronase digestion of various aliquots of hair from a cocaine abuser was preceded by a 2-h incubation with a dithiothreitol solution. The extraction solution was tested to identify possible interferences in the radioimmunoassay and was compared with other hydrolysis methods to assess the results of extraction.

Comparison of quantitative results of drugs in human hair by GC/MS

Until the first determination of opiates in human hair by GC/MS in 1985, radioimmunological results of hair examinations met with opposition. Since then, further GC/MS methods have been developed that have led not only to considerably increased sensitivity, but can also be used in hair analysis for screening purposes and can detect substances for which RIA kits are not available. In the present study different extraction methods were used along with two GC/MS processes which back-up each other. These methods include the enzymatic dissolution of the hair, incubation with a buffer solution followed by a solid-phase extraction and incubation with methanol without a further extraction. The GC/MS examination for heroin, cocaine, hashish and selected pharmaceuticals was carried out after derivatization with pentafluoropropionic acid anhydride or pentafluoro-1-propanol. Because of the higher sensitivity and versatility of GC/MS, two GC/MS processes were used to confirm each other instead of backing-up radioimmunological measurements with GC/MS.

Variability of opiates concentrations in human hair according to their anatomical origin: head, axillary and pubic regions

The concentrations of morphine and codeine were investigated in hair from the head, axillary and pubic regions obtained from 20 fatal heroin cases. Hair preparation involves decontamination procedure in dichloromethane at 37 degrees C for 15 min, solubilization in sodium hydroxide at 100 degrees C for 5 min, neutralization with hydrochloric acid and centrifugation. After extraction in chloroform/isopropanol/n-heptane (50:17:33; v/v) at pH 9.2, drugs were derivatized with BSTFA + 1% TMCS and separated on a 12-m BP-5 capillary column. Quantification was done by GC/MS using selected ion monitoring. The highest morphine concentrations were found in public hair (0.80-41.34 ng/mg), followed by hair of the head (0.62-27.10 ng/mg), and axillary hair (0.40-24.20 ng/mg). Codeine was also detected in all samples, and the codeine/morphine ratios ranged from 0.54 to 0.273. The differences observed in drug concentration in the three kinds of hair are discussed in the light of the existing literature.

Overview on extraction procedures

The literature reviewed shows that many of the analytical problems related to the toxicological analysis of hair have been resolved, but in some cases, as for the application of the extraction methods, it is worth highlighting that the parameters must be carefully valued owing to the different operative options that are documented in the literature. Besides, the choice of a suitable extractive procedure may be influenced by various factors, including the following: (i) the type of drug which the analysis is targeted at and its characteristics of stability in different hydrolytic systems; (ii) ratio of distribution of the abused substances and their metabolites in the hair; and (iii) method used for the subsequent qualitative and quantitative analysis. Hence the selection of the extraction method requires some considerations, particularly when this kind of analysis is used in the forensic field. In this regard, emphasis is actually placed on pharmacokinetic incorporation and retention of drugs into hair. Furthermore, lacking any source of certified reference material, more studies concerning the recovery, accuracy and, if possible, quality control programs, could be implemented in order to test each procedure and improve the reliability of the extraction steps in the toxicological analysis of hair.

Challenging declarations of abstinence by the determination of morphine in hair by radioimmunoassay

Morphine extracted from dated hair segments and analysed by adaptation of a specific solid-phase 125I radioimmunoassay for the measurement of morphine in urine has provided long term histories of the heroin usage of individual patients. Results expressed as ng morphine/mg hair are compared with a pre-determined cut-off level of 0.3 ng morphine/mg hair, from a known drug-free population (n = 21). Morphine concentrations in hair samples from known heroin abusers are found to be above the cut-off limit (range 0.6-9.4 ng morphine/mg hair), and suggest a possible correlation between heroin intake and concentration of morphine in hair. Intra-assay relative standard deviation (RSD), at morphine levels of 9.27 and 1.12 ng morphine/mg hair are 2.4 and 5.5%, respectively, and acceptable recoveries from drug-free hair spiked with morphine are also achieved. The developed segmental hair analysis regime has been used successfully to challenge a self-declaration of heroin abstinence. Routine cumulative urine screening was unable to provide such evidence. The potential for hair drug analysis is discussed.

Automated kinetic-spectrofluorimetric method for the determination of morphine in urine

The continuous addition of reagent technique was used with spectrofluorimetric detection for the kinetic determination of morphine in urine samples. The method thus developed is based on the oxidative dimerization of morphine to fluorescent pseudomorphine by potassium hexacyanoferrate(III) in a basic medium. The optimum pH, oxidant concentration and instrumental variables were determined. The method permits the sensitive determination of morphine over a wide concentration range (15-925 ng ml-1) with high precision (relative standard deviation approximately 2%), selectivity and sample throughput (48 samples h-1). A novel sorption--desorption procedure was used to isolate morphine from whole urine, which provided recoveries of between 85 and 100%. The results showed the usefulness of the proposed method for controlling a wide variety of medicinal problems (e.g., therapeutic, overdose and doping analysis).