title: Detection of drugs of abuse in exhaled breath from users following recovery from intoxication.
abstract: It has recently been demonstrated that amphetamine, methadone and tetrahydrocannabinol are detectable in exhaled breath following intake. Exhaled breath, therefore, constitutes a new possible matrix for drugs-of-abuse testing. The present work aims to further explore this possibility by a study on patients treated for acute intoxication with abused drugs. Fifty-nine patients (44 males, age range 24-74) were included in the study, and breath, plasma and urine samples were collected following recovery, together with interview data. Analyses of breath and plasma samples were conducted with liquid chromatography-mass spectrometry methods. Urine was screened using immunochemical reagents and positive findings confirmed with liquid chromatography-mass spectrometry methods. The following analytes were investigated: methadone, amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine, codeine, 6-acetylmorphine, diazepam, oxazepam, morphine, benzoylecgonine, cocaine, buprenorphine and tetrahydrocannabinol. In 53 of the studied cases, recent intake of an abused substance prior to admission was reported. In 35 of these (66%), the breath analysis gave a positive finding. Identifications were based on correct chromatographic retention time and product ion ratios obtained in selected reaction monitoring mode. Generally, data from breath, plasma, urine and self-report were in agreement. Detected substances in breath included amphetamine, methamphetamine, buprenorphine, 6-acetylmorphine, morphine, codeine, methadone, tetrahydrocannabinol, diazepam, oxazepam and cocaine. Problem analytes with low detection rates were benzodiazepines and tetrahydrocannabinol. This study gives further support to the possibility of developing exhaled breath into a new matrix for drugs-of-abuse testing by extending the number of analytes that are documented to be detectable in breath.
authors.affiliation: Department of Medicine, section of Clinical Pharmacology, Karolinska Institutet, Stockholm, Sweden. olof.beck@karolinska.se
authors.forename: Olof
authors.initials: O
authors.lastname: Beck
authors.forename: Niclas
authors.initials: N
authors.lastname: Stephanson
authors.forename: Sören
authors.initials: S
authors.lastname: Sandqvist
authors.forename: Johan
authors.initials: J
authors.lastname: Franck
mesh_terms: D000328:Adult; D000368:Aged; D000661:Amphetamine / Q000097:blood / Q000652:urine; D001944:Breath Tests / Q000379:methods; D002047:Buprenorphine / Q000097:blood / Q000652:urine; D002853:Chromatography, Liquid; D003042:Cocaine / Q000031:analogs & derivatives / Q000097:blood / Q000652:urine; D003061:Codeine / Q000097:blood / Q000652:urine; D062787:Drug Overdose / Q000175:diagnosis*; D045853:Exhalation; D005260:Female; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D008691:Methadone / Q000097:blood / Q000652:urine; D008694:Methamphetamine / Q000097:blood / Q000652:urine; D008875:Middle Aged; D009020:Morphine / Q000097:blood / Q000652:urine; D009022:Morphine Derivatives / Q000097:blood / Q000652:urine; D015203:Reproducibility of Results; D015813:Substance Abuse Detection / Q000379:methods*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D009022:Morphine Derivatives; D002047:Buprenorphine; D008694:Methamphetamine; C005618:benzoylecgonine; D009020:Morphine; D000661:Amphetamine; D003042:Cocaine; C026979:6-O-monoacetylmorphine; D008691:Methadone; D003061:Codeine