title: Identifying methamphetamine exposure in children.
abstract: OBJECTIVE
  Methamphetamine (MAMP) use, distribution, and manufacture remain a serious public health and safety problem in the United States, and children environmentally exposed to MAMP face a myriad of developmental, social, and health risks, including severe abuse and neglect necessitating child protection involvement. It is recommended that drug-endangered children receive medical evaluation and care with documentation of overall physical and mental conditions and have urine drug testing. The primary aim of this study was to determine the best biological matrix to detect MAMP, amphetamine (AMP), methylenedioxymethamphetamine (MDMA), methylenedioxyamphetamine (MDA), and 3,4-methylenedioxyethylamphetamine (MDEA) in environmentally exposed children.
  
  
  METHODS
  Ninety-one children, environmentally exposed to household MAMP intake, were medically evaluated at the Child and Adolescent Abuse Resource and Evaluation Diagnostic and Treatment Center at the University of California, Davis Children's Hospital. MAMP, AMP, MDMA, MDA, and MDEA were quantified in urine and oral fluid (OF) by gas chromatography mass spectrometry and in hair by liquid chromatography tandem mass spectrometry.
  
  
  RESULTS
  Overall drug detection rates in OF, urine, and hair were 6.9%, 22.1%, and 77.8%, respectively. Seventy children (79%) tested positive for 1 or more drugs in 1 or more matrices. MAMP was the primary analyte detected in all 3 biological matrices. All positive OF (n = 5), and 18 of 19 positive urine specimens also had a positive hair test.
  
  
  CONCLUSIONS
  Hair analysis offered a more sensitive tool for identifying MAMP, AMP, and MDMA environmental exposure in children than urine or OF testing. A negative urine or hair test does not exclude the possibility of drug exposure, but hair testing provided the greatest sensitivity for identifying drug-exposed children.
authors.affiliation: *Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD; †Psychemedics Corporation, Culver City, CA; ‡Data, Benchmark and Evaluation Section, Maternal, Child and Adolescent Health Division, California Department of Public Health, Sacramento, CA; and §Student Health Service, California State University, Chico, CA.
authors.forename: Marisol S
authors.initials: MS
authors.lastname: Castaneto
authors.forename: Allan J
authors.initials: AJ
authors.lastname: Barnes
authors.forename: Karl B
authors.initials: KB
authors.lastname: Scheidweiler
authors.forename: Michael
authors.initials: M
authors.lastname: Schaffer
authors.forename: Kristen K
authors.initials: KK
authors.lastname: Rogers
authors.forename: Deborah
authors.initials: D
authors.lastname: Stewart
authors.forename: Marilyn A
authors.initials: MA
authors.lastname: Huestis
mesh_terms: D000293:Adolescent; D019969:Amphetamine-Related Disorders / Q000453:epidemiology*; D000662:Amphetamines / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D002853:Chromatography, Liquid / Q000379:methods; D004781:Environmental Exposure / Q000032:analysis; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods; D006197:Hair / Q000737:chemistry; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008694:Methamphetamine / Q000032:analysis*; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D000662:Amphetamines; D008694:Methamphetamine