Monitoring pregnant women's illicit opiate and cocaine use with sweat testing.
Dependence on illicit drugs during pregnancy is a major public health concern as there may be associated adverse maternal, fetal, and neonatal consequences. Sweat patches (n = 389) were collected from 39 pregnant volunteers who provided written informed consent for this Institutional Review Board-approved protocol and wore patches, replaced approximately weekly, from study entry until delivery. Patches were analyzed for opiates (heroin, 6-acetylmorphine, 6-acetylcodeine, morphine and codeine) and cocaine (cocaine, benzoylecgonine, ecgonine methyl ester, anhydroecgonine methyl ester) by solid phase extraction and gas chromatography mass spectrometry. Seventy-one percent (276) of collected sweat patches were > or =5 ng per patch (limit of quantification) for one or more analytes. Cocaine was present in 254 (65.3%) patches in concentrations ranging from 5.2 to 11,835 ng per patch with 154 of these high enough to satisfy the proposed Substance Abuse and Mental Health Services Administration guidelines for a confirmatory drug test (25 ng per patch). Interestingly, 6-acetylmorphine was the most prominent opiate analyte documented in 134 patches (34.4%) with 11.3% exceeding the proposed opiate Substance Abuse and Mental Health Services Administration cut-off (25 ng per patch). Heroin was identified in fewer patches (77), but in a similar concentration range (5.3-345.4 ng per patch). Polydrug use was evident by the presence of both cocaine and opiate metabolites in 136 (35.0%) patches. Sweat testing is an effective method for monitoring abstinence or illicit drug use relapse in this high-risk population of pregnant opiate- and/or cocaine-dependent women.
Brunet
Bertrand R
BR
INSERM UMR 927, Université de Poitiers, Faculté de Médecine et Pharmacie, Poitiers, France.
Barnes
Allan J
AJ
Choo
Robin E
RE
Mura
Patrick
P
Jones
Hendre E E
HE
Huestis
Marilyn A
MA
D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications / Q000175:diagnosis*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods; D006556:Heroin Dependence / Q000150:complications / Q000175:diagnosis; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects / Q000493:pharmacokinetics; D009293:Opioid-Related Disorders / Q000150:complications / Q000175:diagnosis*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis; D052616:Solid Phase Extraction / Q000379:methods; D015813:Substance Abuse Detection / Q000379:methods*; D013542:Sweat / Q000737:chemistry*; D055815:Young Adult
D013287:Illicit Drugs