title: Hair analysis for opiates: hydromorphone and hydrocodone as indicators of heroin use.
abstract: BACKGROUND
  Identification of external contamination is a challenge in hair analysis. This study investigates metabolite ratios of hydromorphone to morphine and hydrocodone to codeine as indicators to distinguish contamination from heroin use provided that hydromorphone/hydrocodone intake is excluded.
  
  
  RESULTS
  Hair samples after external contamination with street heroin proved to be negative for hydromorphone/hydrocodone. Hair samples from individuals with suspected street heroin use/contamination or opiate medication were analyzed for 6-monoacetylmorphine, morphine, acetylcodeine, codeine, hydromorphone and hydrocodone, and metabolite ratios of hydromorphone to morphine and hydrocodone to codeine were assessed. Hair samples from individuals with medicinal heroin/morphine/codeine use displayed significantly higher metabolite ratios than those with suspected street heroin use/contamination.
  
  
  CONCLUSIONS
  Hydromorphone/hydrocodone are solely formed during body passage. Thus, metabolite ratios can be used to distinguish morphine/heroin use from external contamination.
authors.affiliation: Center for Forensic Hairanalytics, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Milena M
authors.initials: MM
authors.lastname: Madry
authors.affiliation: Center for Forensic Hairanalytics, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Mona M
authors.initials: MM
authors.lastname: Bosshard
authors.affiliation: Forensic Pharmacology & Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kraemer
authors.affiliation: Center for Forensic Hairanalytics, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Markus R
authors.initials: MR
authors.lastname: Baumgartner
mesh_terms: D000701:Analgesics, Opioid / Q000032:analysis*; D002853:Chromatography, Liquid / Q000379:methods; D005260:Female; D006197:Hair / Q000737:chemistry*; D003932:Heroin / Q000032:analysis*; D006556:Heroin Dependence / Q000175:diagnosis; D006801:Humans; D006853:Hydrocodone / Q000032:analysis*; D004091:Hydromorphone / Q000032:analysis*; D008297:Male; D009020:Morphine / Q000032:analysis; D009022:Morphine Derivatives / Q000032:analysis; D053610:Opiate Alkaloids / Q000032:analysis*; D015813:Substance Abuse Detection / Q000379:methods*; D053719:Tandem Mass Spectrometry / Q000379:methods
chemical_list: D000701:Analgesics, Opioid; D009022:Morphine Derivatives; D053610:Opiate Alkaloids; D006853:Hydrocodone; D003932:Heroin; D009020:Morphine; C026979:6-O-monoacetylmorphine; D004091:Hydromorphone
keywords: LC–MS/MS; Society of Hair Testing; drug analysis; external contamination; hair testing; hydrocodone; hydromorphone; metabolite ratios; opiates; seized heroin