title: The detection of hydrocodone in meconium: two case studies.
abstract: The detection of hydrocodone in meconium samples is reported for the first time. Hydrocodone, a semisynthetic antitussive and analgesic, is often prescribed as a painkiller following minor surgery or dental work. It also cross-reacts in enzyme and fluorescence polarization immunoassay opiate systems. In two cases recently received by our laboratory, hydrocodone was detected following a positive opiate immunoassay screening result. The meconium samples were not hydrolyzed because previous work in our laboratory showed that greater than 70% of morphine in meconium is not glucuronide bound. The confirmatory procedures showed that, in case No. 1, codeine was also detected but at a much lower concentration than the hydrocodone. In case No. 2, morphine was detected but, again, at a much lower concentration than the hydrocodone. Even though in both samples another opiate was also detected, the possibility still remains that a positive opiate test result may be reported by screen-only laboratories based solely on the presence of hydrocodone. We present a novel extraction method and a gas chromatographic-mass spectrometric confirmatory procedure for the determination of hydrocodone and hydromorphone in meconium.
authors.affiliation: U.S. Drug Testing Laboratories, Chicago, IL, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Moore
authors.forename: D
authors.initials: D
authors.lastname: Deitermann
authors.forename: D
authors.initials: D
authors.lastname: Lewis
authors.forename: J
authors.initials: J
authors.lastname: Leikin
mesh_terms: D003061:Codeine / Q000032:analysis / Q000378:metabolism; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D006853:Hydrocodone / Q000032:analysis*; D006868:Hydrolysis; D004091:Hydromorphone / Q000032:analysis / Q000378:metabolism; D007231:Infant, Newborn; D008470:Meconium / Q000737:chemistry*; D009020:Morphine / Q000032:analysis / Q000378:metabolism
chemical_list: D006853:Hydrocodone; D009020:Morphine; D004091:Hydromorphone; D003061:Codeine