title: Analysis of diacetylmorphine, caffeine, and degradation products after volatilization of pharmaceutical heroin for inhalation.
abstract: Pharmaceutical smokable heroin was developed for a clinical trial on medical co-prescription of heroin and methadone. This product, consisting of 75% w/w diacetylmorphine base and 25% w/w caffeine anhydrate, was intended for use via "chasing the dragon", that is, inhalation after volatilization. This procedure involves heating the powder mixture, which may lead to formation of degradation products that could subsequently be inhaled. We developed a method that used a high-performance liquid chromatography system that was compatible with photodiode-array detection and mass spectrometric detection to separate diacetylmorphine- and caffeine-related compounds in a wide polarity range for analysis of the vapor. This method was used to analyze the contents of the plastic drinking straws that were used by patients to inhale the vapors from pharmaceutical heroin used via chasing the dragon, which were considered to be representative of the vapors the patients inhaled. They contained primarily unchanged diacetylmorphine, its main metabolite 6-acetylmorphine, caffeine, and some morphine. Several unidentified peaks were observed in the straw chromatograms. Chemical structures were proposed for nine degradation products: morphine derivatives with different substitution patterns of the C(3), C(6), and/or N(17) positions, which comprised 0.4-9.7% of the straw sample residue weight. Activity and toxicity of most of these compounds are unknown and require further investigation.
authors.affiliation: Department of Pharmacy and Pharmacology, Slotervaart Hospital, Louwesweg 6, PO Box 90440, 1006 BK Amsterdam, The Netherlands. apmlk@slz.nl
authors.forename: Marjolein G
authors.initials: MG
authors.lastname: Klous
authors.forename: WeiChing
authors.initials: W
authors.lastname: Lee
authors.forename: Michel J X
authors.initials: MJ
authors.lastname: Hillebrand
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
authors.forename: Jan M
authors.initials: JM
authors.lastname: van Ree
authors.forename: Jos H
authors.initials: JH
authors.lastname: Beijnen
mesh_terms: D002110:Caffeine / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics*; D002851:Chromatography, High Pressure Liquid; D003932:Heroin / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics*; D006801:Humans; D019570:Inhalation Exposure; D008297:Male; D009294:Narcotics / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics*; D012907:Smoking; D021241:Spectrometry, Mass, Electrospray Ionization; D015813:Substance Abuse Detection / Q000379:methods*; D014835:Volatilization
chemical_list: D000697:Central Nervous System Stimulants; D009294:Narcotics; D002110:Caffeine; D003932:Heroin