title: Methadone and illegal drugs in hair from children with parents in maintenance treatment or suspected for drug abuse in a German community.
abstract: BACKGROUND
  Children living in homes with drug-addicted parents are in a steady danger of poisoning and may suffer from neglect, maltreatment, and lagging behind in development. Hair analysis could be a suitable way to examine this endangering exposure to drugs.
  
  
  METHODS
  Hair samples from 149 children (aged 1-14 years) living with parents substituted by methadone and/or suspected for abuse of illegal drugs, and from 124 of the parents in a German community were investigated by liquid chromatography-hybrid quadrupole time-of flight mass spectrometry and by headspace solid phase microextraction gas chromatography-mass spectrometry for methadone, heroin, cocaine, amphetamines, ecstasy, cannabinoids and benzodiazepines and their metabolites or degradation products (32 compounds).
  
  
  RESULTS
  From the children's hair, only in 35 samples, no drugs were detected. Cannabinoids were found in 56 samples, in 20 of them as the only drug. In the remaining 95 samples, methadone was identified 35 times with additional use of illegal drugs in 28 cases. Drug use in the children's environment was obvious for heroin in 44 cases, cocaine in 73 cases, amphetamine or ecstasy in 6 cases, and diazepam in 8 cases. The concentrations varied from limit of quantification to 2.16 ng/mg of methadone, 11.1 ng/mg of 6-acetylmorphine, 17.8 ng/mg of cocaine, 3.29 ng/mg of amphetamine, and 0.72 ng/mg of Δ-tetrahydrocannabinol. In general, hair from younger children contained higher concentrations than from their elder siblings. Systemic incorporation of methadone, cocaine, or cannabinoids appeared likely from detection of the nonhydrolytic metabolites 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine in 11 cases, norcocaine in 16 cases, and 11-nor-9-carboxy-Δ-tetrahydrocannabinol in 9 cases. Within the families, hair samples of children and parents provided often the same drug pattern. External deposition from smoke and by contact with contaminated surfaces or parent's hands and systemic deposition after passive smoking, administration, or oral intake by hand-to-mouth transfer were discussed as alternative incorporation mechanisms into hair.
  
  
  CONCLUSIONS
  Altogether, investigation of children's hair proved to be a useful way to detect endangering drug use in their environment and lead to a more thorough inspection and measures to improve their situation in many of the cases.
authors.affiliation: *Institute of Legal Medicine, University Medicine Charité, Berlin; †Institute of Legal Medicine, University Hospital Hamburg-Eppendorf, Hamburg; and ‡Forensic Toxicological Center, Munich, Germany.
authors.forename: Fritz
authors.initials: F
authors.lastname: Pragst
authors.forename: Sebastian
authors.initials: S
authors.lastname: Broecker
authors.forename: Martin
authors.initials: M
authors.lastname: Hastedt
authors.forename: Sieglinde
authors.initials: S
authors.lastname: Herre
authors.forename: Hilke
authors.initials: H
authors.lastname: Andresen-Streichert
authors.forename: Hans
authors.initials: H
authors.lastname: Sachs
authors.forename: Michael
authors.initials: M
authors.lastname: Tsokos
mesh_terms: D000293:Adolescent; D002648:Child; D016241:Child of Impaired Parents; D002675:Child, Preschool; D002853:Chromatography, Liquid / Q000379:methods; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods; D005858:Germany; D006197:Hair / Q000737:chemistry*; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis*; D007223:Infant; D013058:Mass Spectrometry / Q000379:methods; D008691:Methadone / Q000032:analysis*; D010290:Parents; D052617:Solid Phase Microextraction / Q000379:methods; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000534:rehabilitation
chemical_list: D013287:Illicit Drugs; D008691:Methadone