Urine labeling with orally applied marker substances in drug substitution therapy

Matrix Effects of Urine Marker Substances in LC-MS/MS Analysis of Drug of Abuse

BACKGROUND

Analysis of drug abuse is frequently performed using high-performance liquid chromatography with an MS/MS detector and electrospray ionization. In this context, matrix effects, like signal reduction by ion suppression of individual analytes, play an important role. In this study, the authors evaluated the matrix effect caused by polyethylene glycol (PEG) with chain lengths ranging from 6 to 12 repeating units in drug analysis by LC-MS/MS. Selected chain lengths were used in the Ruma urine marker system.

METHODS AND RESULTS

Amphetamines, opiates, opioids, antidepressants, psychotics, benzodiazepines, z-substances, and individual drugs, including THCCOOH, cocaine, LSD, and some of their metabolites were investigated. The matrix effect was investigated at PEG concentrations of 500 mcg/mL and 20 mcg/mL. The effect of each PEG molecule was determined. Furthermore, the effects of different common sample preparations on the PEG matrix effects were evaluated. There was a strong correlation between the retention time of PEG and the drug that was ion-suppressed by PEG. The matrix effect decreased to the point where it was within an acceptable range at the lower PEG concentrations investigated in this study.

CONCLUSIONS

Matrix effects were observed for drugs with approximately the same retention times as the individual PEGs. The influence of the different workup methods was not as clear, which may be because of the similar solubilities of the PEGs and some analytes. At low PEG concentrations, the matrix effect was always below 60%, except for nortilidine. All the drugs were detectable. The effect on quantification was less than 15% for substances with deuterated analytes as internal standards and less than 32% for analytes without their own internal standards.

[Urine Screening for Narcotics under Court-Imposed Abstinence Requirements: Comparative Validity of Forensic-Toxicological Analyses with Involvement of Public Health Services]

AIM OF THE STUDY

Assessment of the comparative validity between qualitative and quantitative analyses of urine screenings for defined narcotics residues under court-imposed abstinence restrictions.

METHODS

Following the introduction of a valid marker system which, based on the application of a defined sugar substance and its detection in the urine of person under probation in 2006, urine samples were assayed in administrative cooperation by a Bavarian public health office for probationary services for evidence of narcotics. The urine samples were sent to an external laboratory in order to carry out forensic toxicological analyses for defined narcotics. The qualitative and quantitative laboratory results were reported back to the public health department so that a digital-based data set of a total of 380 persons with more than 27,000 individual analyses from a total of 14 consecutive calendar years could be established and retrospectively evaluated in an anonymised form.

RESULTS

The overall prevalences of findings positive for narcotics were 2.7% (n=366 of 13,531) for the qualitative and 2.6% (n=348 of 13,525) for the subsequent quantitative result categorisations, with cannabis and opiates being detected most frequently in both test methods. Using the kappa coefficient as a quantitative measure for the comparative validity of both test methods, the test results showed the highest agreement (1.000) for buprenorphine and lowest agreement for PCP (0.880). No age- and gender-specific stratifications could be recorded for a total of ten different narcotic substances; substance-specific case numbers differed among the analyses.

CONCLUSION

Based on the strong to very strong correspondences between qualitative and quantitative narcotics analysis results, it could be assumed that both analysis methods accurately recorded violations of abstinence requirements and were to be classified as sufficiently substantiating for judicial decisions under the Narcotics Act (Betäubungsmittelgesetz, BtMG). According to these results, the content of urine screenings for narcotics controlling abstinence should be discussed.

The Urine Marker Test: An Alternative Approach to Supervised Urine Collection for Doping Control

BACKGROUND

Urine sample collection for doping control tests is a key component of the World Anti-Doping Agency's fight against doping in sport. However, a substantial number of athletes experience difficulty when having to urinate under supervision. Furthermore, it cannot always be ensured that athletes are actually delivering their own urine. A method that can be used to alleviate the negative impact of a supervised urination procedure and which can also identify urine as coming from a specific athlete is the urine marker test. Monodisperse low molecular weight polyethylene glycols (PEGs) are given orally prior to urination. Urine samples can be traced to the donor by analysis of the PEGs previously given.

OBJECTIVE

The objective of this study was to investigate the use of the urine marker during urine doping control testing.

METHODS

Two studies investigated athletes' acceptance of this new method via two questionnaires (n = 253). Furthermore, a third study (n = 91) investigated whether ingestion of the marker can identify the urine as coming from a specific person and whether the marker interferes with the detection of prohibited substances.

RESULTS AND CONCLUSIONS

The results indicate that this new method finds wide acceptance both from athletes who have only heard about the procedure and those who have actually tested the new method. Furthermore, the marker, which can identify urine as coming from a specific person, does not interfere with the detection of prohibited substances.

Need and utility of a polyethylene glycol marker to ensure against urine falsification among heroin users

BACKGROUND

Deceptive methods of falsifying urine samples are of concern for anyone who relies on accurate urine toxicology results. A novel method to combat these efforts utilizes polyethylene glycol (PEG) markers administered orally prior to providing a urine sample. By using various PEG combinations to create a tracer capsule of unique composition, each urine sample can be matched to that individual. The goal of this study was to determine the effectiveness of using the PEG marker system among active heroin users screening for research studies.

METHODS

Upon each screening visit, participants (N=55) were randomized to provide an unobserved urine sample, or the PEG tracer procedure was used. LCMS analysis was used to distinguish the PEG combinations, and allowed us to provide a unique qualitative analysis of patterns of drug use (N=168, total urine specimens).

RESULTS

The unique composition of the tracer capsules was accurately detected in 83.5% of the urine specimens. Analyses of inconsistencies implicated a number of possible attempts at fraudulence (11.4%) and investigator/lab error (5.1%). Among this sample, the concurrent use of multiple classes of psychoactive drugs was more common than not, though concomitant drug use was often underreported.

CONCLUSION

Urine drug testing should be the minimum standard for obtaining information about drug use as self-report was unreliable even in a situation where there were no perceived adverse consequences for full disclosure. In cases where there are significant pressures for individuals to falsify these data, more protective collection methods such as the PEG marker system should be considered.

Efficacy of a polyethylene glycol marker system in urine drug screening in an opiate substitution program

AIMS

Screening for concomitant drug consumption is necessary in opiate substitution therapy of opiate-dependent patients. Adulteration of samples is a common problem in this setting. A recently developed polyethylene glycol marker system allows reliable identification of urine samples. In this study, we aimed to compare the rates of drug detection in conventional and marker urine samples.

DESIGN

This cross-sectional evaluation was performed in an ambulatory opiate substitution program. We studied 55 opiate-dependent patients (32 men, 23 women). In all patients we compared the rates of drugs detected in the marker urine with the most recent conventional urine control. Additionally we assessed the rate of marker urine manipulation.

FINDINGS

In the conventional urine controls, opiates and benzodiazepines were found in 3.6 and 27%, respectively, whereas in the marker urine controls, these rates were 33 and 40%, respectively. Signs of urine manipulation were present in 35%. The rates of concomitant consumption and urine manipulation were higher among the patients without than among those with take-home substitution.

CONCLUSIONS

With the marker urine, an unexpectedly high prevalence of concomitant consumption can be found. Marker urine testing has a significantly higher sensitivity for the detection of concomitant drug use.