title: Detection of acetylcodeine in urine as an indicator of illicit heroin use: method validation and results of a pilot study.
abstract: BACKGROUND
  Acetylcodeine (AC), an impurity of illicit heroin synthesis, has been suggested as an interesting biomarker of illicit heroin use.
  
  
  METHODS
  Procedures were developed for quantification of (a) morphine, 6-monoacetylmorphine (6-AM), and codeine in urine and (b) diacetylmorphine and AC in urine. Solid-phase extraction of the analytes was performed, and the extracted analytes were analyzed by selected-ion monitoring with gas chromatography-mass spectrometry. This procedure required prior derivatization with propionic anhydride.
  
  
  RESULTS
  Different validation parameters were determined, such as linearity, reproducibility, extraction recoveries, and cutoffs. Seventy-one urine specimens of illicit heroin abusers and 44 urine specimens of subjects in a heroin maintenance program were analyzed. AC was detected in 85.9% of the samples of the first group but not in any of the samples from subjects taking medical heroin. In the two groups, there were 94.4% and 84.1% 6-AM positive urine specimens, respectively. Detection times were determined for AC and codeine by parallel administration of heroin containing various percentages of AC to four voluntary patients in a heroin maintenance program. The measured detection times were 8 and 23 h for AC and codeine, respectively.
  
  
  CONCLUSIONS
  These results indicate that, together with detection of 6-AM in urine, AC is a suitable marker of illicit heroin use.
authors.affiliation: Institut Universitaire de Médecine Légale, 9 Avenue de Champel, 1211 Geneva 4, Switzerland. christian.staub@medecine.unige.ch
authors.forename: C
authors.initials: C
authors.lastname: Staub
authors.forename: M
authors.initials: M
authors.lastname: Marset
authors.forename: A
authors.initials: A
authors.lastname: Mino
authors.forename: P
authors.initials: P
authors.lastname: Mangin
mesh_terms: D015415:Biomarkers / Q000652:urine; D003061:Codeine / Q000031:analogs & derivatives* / Q000652:urine*; D008401:Gas Chromatography-Mass Spectrometry; D006556:Heroin Dependence / Q000652:urine*; D006801:Humans; D007118:Immunoassay; D015203:Reproducibility of Results; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D015415:Biomarkers; C053740:acetylcodeine; D003061:Codeine