title: Methamphetamine and amphetamine isomer concentrations in human urine following controlled Vicks VapoInhaler administration.
abstract: Legitimate use of legal intranasal decongestants containing l-methamphetamine may complicate interpretation of urine drug tests positive for amphetamines. Our study hypotheses were that commonly used immunoassays would produce no false-positive results and a recently developed enantiomer-specific gas chromatography-mass spectrometry (GC-MS) procedure would find no d-amphetamine or d-methamphetamine in urine following controlled Vicks VapoInhaler administration at manufacturer's recommended doses. To evaluate these hypotheses, 22 healthy adults were each administered one dose (two inhalations in each nostril) of a Vicks VapoInhaler every 2 h for 10 h on Day 1 (six doses), followed by a single dose on Day 2. Every urine specimen was collected as an individual void for 32 h after the first dose and assayed for d- and l-amphetamines specific isomers with a GC-MS method with >99% purity of R-(-)-α-methoxy-α-(trifluoromethyl)phenylacetyl derivatives and 10 µg/L lower limits of quantification. No d-methamphetamine or d-amphetamine was detected in any urine specimen by GC-MS. The median l-methamphetamine maximum concentration was 62.8 µg/L (range: 11.0-1,440). Only two subjects had detectable l-amphetamine, with maximum concentrations coinciding with l-methamphetamine peak levels, and always ≤ 4% of the parent's maximum. Three commercial immunoassays for amphetamines EMIT(®) II Plus, KIMS(®) II and DRI(®) had sensitivities, specificities and efficiencies of 100, 97.8, 97.8; 100, 99.6, 99.6 and 100, 100, 100%, respectively. The immunoassays had high efficiencies, but our first hypothesis was not affirmed. The EMIT(®) II Plus assay produced 2.2% false-positive results, requiring an enantiomer-specific confirmation.
authors.affiliation: U.S. Army Forensic Toxicology Drug Testing Laboratory, Fort Meade, MD, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Smith
authors.affiliation: U.S. Army Forensic Toxicology Drug Testing Laboratory, Fort Meade, MD, USA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Nichols
authors.affiliation: U.S. Army Forensic Toxicology Drug Testing Laboratory, Fort Meade, MD, USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Underwood
authors.affiliation: U.S. Army Forensic Toxicology Drug Testing Laboratory, Fort Meade, MD, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Fuller
authors.affiliation: U.S. Army Forensic Toxicology Drug Testing Laboratory, Fort Meade, MD, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Moser
authors.affiliation: Division of Workplace Programs, Department of Health and Human Services, Substance Abuse Mental Health Services Administration, Rockville, MD, USA.
authors.forename: Ron
authors.initials: R
authors.lastname: Flegel
authors.affiliation: Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd., Suite 200 Room 05A-721, Baltimore, MD 21224, USA Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Gorelick
authors.affiliation: Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd., Suite 200 Room 05A-721, Baltimore, MD 21224, USA Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, USA.
authors.forename: Matthew N
authors.initials: MN
authors.lastname: Newmeyer
authors.affiliation: Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd., Suite 200 Room 05A-721, Baltimore, MD 21224, USA.
authors.forename: Marta
authors.initials: M
authors.lastname: Concheiro
authors.affiliation: Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd., Suite 200 Room 05A-721, Baltimore, MD 21224, USA mhuestis@intra.nida.nih.gov.
authors.forename: Marilyn A
authors.initials: MA
authors.lastname: Huestis
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000661:Amphetamine / Q000652:urine*; D003404:Creatinine / Q000652:urine; D004305:Dose-Response Relationship, Drug; D005189:False Positive Reactions; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D064368:Healthy Volunteers; D006801:Humans; D007118:Immunoassay / Q000379:methods; D008297:Male; D008694:Methamphetamine / Q000652:urine*; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D013237:Stereoisomerism; D015813:Substance Abuse Detection / Q000379:methods; D055815:Young Adult
chemical_list: D008694:Methamphetamine; D003404:Creatinine; D000661:Amphetamine