title: Acetylcodeine as a urinary marker to differentiate the use of street heroin and pharmaceutical heroin.
abstract: Acetylcodeine (ACOD) is a synthesis byproduct present in street heroin but not in pharmaceutical diacetylmorphine (DAM) as used in the Swiss program Heroin-Assisted Treatment for Opiate Dependent Drug Users (HAT). ACOD was evaluated and validated as an urine marker to detect the consumption of street heroin by HAT participants. A gas chromatography-mass spectrometry method allowing the quantitation of ACOD concentrations as low as 0.2 ng/mL urine has been developed. In opiate-naïve subjects, intravenous (i.v.) ACOD showed a plasma elimination half-life of 237 +/- 18 min, urine peak concentrations 2 h after administration, and a detection window of 8 h. Only 0.4 +/- 0.1% was excreted unchanged, with codeine (COD) as the main metabolite. ACOD may be formed by transacetylation when i.v. DAM and oral codeine are co-administered. To avoid false-positive results, the calculation of COD/ACOD ratios is recommended. In a study with 105 HAT participants, 14% of the tested urines were ACOD positive. Only a low correlation was found between the anonymously self-declared consumption of street heroin and the ACOD positive rate.
authors.affiliation: Department of Clinical Research, Laboratory of Phytopharmacology, Bioanalytics and Pharmacokinetics, University of Bern, CH-3010 Bern, Switzerland. brenneisen@dkf5.unibe.ch
authors.forename: Rudolf
authors.initials: R
authors.lastname: Brenneisen
authors.forename: Felix
authors.initials: F
authors.lastname: Hasler
authors.forename: Daniel
authors.initials: D
authors.lastname: Würsch
mesh_terms: D000107:Acetylation; D000328:Adult; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003061:Codeine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood / Q000652:urine*; D005260:Female; D003932:Heroin / Q000032:analysis* / Q000627:therapeutic use; D006556:Heroin Dependence / Q000517:prevention & control; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis*; D008297:Male; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D015415:Biomarkers; D013287:Illicit Drugs; C053740:acetylcodeine; D003932:Heroin; D003061:Codeine