title: Application of drug testing using exhaled breath for compliance monitoring of drug addicts in treatment.
abstract: OBJECTIVE
  Exhaled breath has recently been identified as a possible matrix for drug testing. This study explored the potential of this new method for compliance monitoring of patients being treated for dependence disorders.
  
  
  METHODS
  Outpatients in treatment programs were recruited for this study. Urine was collected as part of clinical routine and a breath sample was collected in parallel together with a questionnaire about their views of the testing procedure. Urine was analyzed for amphetamines, benzodiazepines, cannabis, cocaine, buprenorphine, methadone and opiates using CEDIA immunochemical screening and mass spectrometry confirmation. The exhaled breath was collected using the SensAbues device and analyzed by mass spectrometry for amphetamine, methamphetamine, diazepam, oxazepam, tetrahydrocannabinol, cocaine, benzoylecgonine, buprenorphine, methadone, morphine, codeine and 6-acetylmorphine.
  
  
  RESULTS
  A total of 122 cases with parallel urine and breath samples were collected; 34 of these were negative both in urine and breath. Out of 88 cases with positive urine samples 51 (58%) were also positive in breath. Among the patients on methadone treatment, all were positive for methadone in urine and 83% were positive in breath. Among patients in treatment with buprenorphine, 92% were positive in urine and among those 80% were also positive in breath. The questionnaire response documented that in general, patients accepted drug testing well and that the breath sampling procedure was preferred.
  
  
  CONCLUSIONS
  Compliance testing for the intake of prescribed and unprescribed drugs among patients in treatment for dependence disorders using the exhaled breath sampling technique is a viable method and deserves future attention.
authors.affiliation: Dependence Clinic Västmanland, Västerås.
authors.forename: Sten
authors.initials: S
authors.lastname: Carlsson
authors.forename: Robert
authors.initials: R
authors.lastname: Olsson
authors.forename: Irene
authors.initials: I
authors.lastname: Lindkvist
authors.forename: Olof
authors.initials: O
authors.lastname: Beck
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000662:Amphetamines / Q000032:analysis / Q000652:urine; D001944:Breath Tests / Q000379:methods*; D002047:Buprenorphine / Q000032:analysis / Q000652:urine; D003042:Cocaine / Q000031:analogs & derivatives / Q000032:analysis / Q000652:urine; D055030:Drug Users; D045853:Exhalation; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000032:analysis / Q000652:urine; D008694:Methamphetamine / Q000032:analysis / Q000652:urine; D008875:Middle Aged; D009020:Morphine / Q000032:analysis / Q000652:urine; D009022:Morphine Derivatives / Q000032:analysis / Q000652:urine; D010349:Patient Compliance; D015813:Substance Abuse Detection / Q000379:methods*; D055815:Young Adult
chemical_list: D000662:Amphetamines; D009022:Morphine Derivatives; D002047:Buprenorphine; D008694:Methamphetamine; C005618:benzoylecgonine; D009020:Morphine; D003042:Cocaine; C026979:6-O-monoacetylmorphine; D008691:Methadone
keywords: Breath tests; buprenorphine; drug abuse testing; methadone; patient compliance; urine