Simultaneous liquid chromatography-mass spectrometry quantification of urinary opiates, cocaine, and metabolites in opiate-dependent pregnant women in methadone-maintenance treatment.
Opiates, cocaine, and metabolites were quantified by liquid chromatography-mass spectrometry (LC-MS) in 284 urine specimens, collected thrice weekly, to monitor possible drug relapse in 15 pregnant heroin-dependent women. Opiates were detected in 149 urine specimens (52%) with limits of quantification (LOQ) of 10-50 microg/L. Morphine, morphine-3-glucuronide, and/or morphine-6-glucuronide were positive in 121 specimens; 6-acetylmorphine, a biomarker of heroin ingestion, was quantifiable in only 7. No heroin, 6-acetylcodeine, papaverine, or noscapine were detected. One hundred and sixty-five urine specimens (58%) from all 15 participants were positive for one or more cocaine analytes (LOQ 10-100 microg/L). Ecgonine methylester (EME) and/or benzoylecgonine were the major cocaine biomarkers in 142. Anhydroecgonine methylester, a biomarker of smoked cocaine, was positive in six; cocaethylene and/or ecgonine ethylester, biomarkers of cocaine and ethanol co-ingestion, were found in 25. At the current Substance Abuse Mental Health Services Administration cutoffs for total morphine (2000 microg/L), codeine (2000 microg/L), 6-acetylmorphine (10 microg/L), and benzoylecgonine (100 microg/L), 16 opiate- and 29 cocaine-positive specimens were identified. Considering 100 microg/L EME as an additional urinary cocaine biomarker would identify 51 more positive cocaine specimens. Of interest is the differential pattern of opiate and cocaine biomarkers observed after LC-MS as compared to gas chromatography-mass spectrometry analysis.
Shakleya
Diaa M
DM
Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, Maryland 21224, USA.
Dams
Riet
R
Choo
Robin E
RE
Jones
Hendree
H
Huestis
Marilyn A
MA
D000328:Adult; D002851:Chromatography, High Pressure Liquid; D003042:Cocaine / Q000652:urine*; D019970:Cocaine-Related Disorders / Q000175:diagnosis / Q000652:urine*; D005260:Female; D006801:Humans; D008691:Methadone / Q000627:therapeutic use / Q000652:urine*; D009022:Morphine Derivatives / Q000652:urine*; D009294:Narcotics / Q000627:therapeutic use / Q000652:urine*; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000534:rehabilitation / Q000652:urine*; D011247:Pregnancy; D021241:Spectrometry, Mass, Electrospray Ionization / Q000379:methods; D015813:Substance Abuse Detection / Q000379:methods; D016482:Urinalysis / Q000379:methods; D055815:Young Adult
D009022:Morphine Derivatives; D009294:Narcotics; D003042:Cocaine; D008691:Methadone