title: Evaluation of acetylcodeine as a specific marker of illicit heroin in human hair.
abstract: In addition to acetylmorphine (6-AM), acetylcodeine (AC) has been suggested as a marker for the use of illicit heroin. Because no procedure was available for AC testing in hair, a new method was developed for the simultaneous identification and quantitation of morphine (MOR), codeine (COD), 6-AM, and AC. After decontamination, each hair specimen was cut into 1-mm pieces. A 50-mg aliquot was incubated overnight at 50 degrees C in 1 mL Soerensen buffer (pH 7.6) in presence of 200 ng of MOR-d3, COD-d3, 6-AM-d3, and AC-d3. After pH adjustment to 8.4, the analytes were extracted in 5 mL of chloroform/isopropanol/n-heptane (25:10:65, v/v/v). The organic phase was removed and evaporated to dryness, and the residue was derivatized by silylation (BSTFA + 1% TMCS). Drugs were analyzed by gas chromatography-mass spectrometry in electron impact mode. Limits of quantitation were set to 0.1 ng/mg. Fifty hair specimens obtained from subjects who died from fatal opiate overdose were analyzed. AC was detected in 22 samples in concentrations ranging from 0.17 to 5.60 ng/mg with a mean value of 1.04 ng/mg. 6-AM was also present in these samples at concentrations ranging from 1.35 to 41.10 ng/mg with a mean value of 7.79 ng/mg. Of the 28 specimens negative for AC, 21 were positive for 6-AM at concentrations ranging from 0.18 to 7.13 ng/mg. When detected, the AC concentrations were an average of 15.5% (2.8 to 32.6%) of the 6-AM concentrations. There was a positive relationship between AC concentrations and 6-AM concentrations (r = 0.915, p = 0.001). Neither AC nor COD was identified in hair specimens collected from 20 subjects taking part in a heroin-maintenance program in Switzerland and receiving pure pharmaceutical heroin hydrochloride daily. Although it is indicative of illicit heroin use, AC would not make a suitable biomarker in place of 6-AM because of its low concentration in hair compared with that of 6-AM and its absence in about 50% of the specimens that tested positive for 6-AM.
authors.affiliation: Institut de Médecine Légale, Strasbourg, France.
authors.forename: P
authors.initials: P
authors.lastname: Kintz
authors.forename: C
authors.initials: C
authors.lastname: Jamey
authors.forename: V
authors.initials: V
authors.lastname: Cirimele
authors.forename: R
authors.initials: R
authors.lastname: Brenneisen
authors.forename: B
authors.initials: B
authors.lastname: Ludes
mesh_terms: D015415:Biomarkers; D003061:Codeine / Q000031:analogs & derivatives* / Q000032:analysis; D008401:Gas Chromatography-Mass Spectrometry; D006197:Hair / Q000737:chemistry*; D003932:Heroin / Q000032:analysis* / Q000627:therapeutic use; D006556:Heroin Dependence / Q000534:rehabilitation; D006801:Humans; D009020:Morphine / Q000032:analysis; D009022:Morphine Derivatives / Q000032:analysis; D009294:Narcotics / Q000032:analysis* / Q000627:therapeutic use; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D015415:Biomarkers; D009022:Morphine Derivatives; D009294:Narcotics; C053740:acetylcodeine; D003932:Heroin; D009020:Morphine; C026979:6-O-monoacetylmorphine; D003061:Codeine