Sweat testing in opioid users with a sweat patch
Sweat testing in opioid users with a sweat patch
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DOI：
10.1093/jat/20.6.393
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发表时间：
1996-10-01
影响因子：
2.5
通讯作者：
Edel, Y
中科院分区：
文献类型：
--
作者：
Kintz, P;Tracqui, A;Edel, Y
多年来，毒物学家一直在使用血液或尿液的生物材料中检测到滥用药物的存在。近年来，灵敏分析技术的显著进步使汗液等非常规样品中的药物分析成为可能。在一家戒毒中心进行的一项研究中，20名已知的海洛因滥用者使用了汗片。受试者戴了五天的贴片，几乎没有感到不适。在同一时期，还收集了两个尿样。用气相色谱-质谱法(GC-MS)或液质联用法(LC-MS)分析的目标药物包括鸦片类药物(海洛因、6-一乙酰吗啡、吗啡、可待因)、可卡因(可卡因、苯甲酰基吗啡、淫羊藿甲酯)、Δ9-四氢大麻酚、苯二氮卓类药物(去甲安定、奥西潘)、苯丙胺(苯丙胺、甲基苯丙胺、亚甲二氧基苯丙胺、亚甲基二氧基苯丙胺、甲基二氧乙基苯丙胺)和丁丙诺啡。12例斑块中阿片类药物阳性。检出海洛因(37~175 ng/片)和/或6-乙酰吗啡(60~2386 ng/片)8例，可待因暴露(67~4018 ng/片)4例。当检测到海洛因时，海洛因的浓度总是低于6-乙酰吗啡，6-乙酰吗啡是汗液中发现的主要分析物。只有一例发现可卡因(324 ng/贴片)和代谢物。9例患者中检出Δ-9-四氢大麻酚(4-38 ng/贴片)。苯二氮卓类药物的浓度很低，去甲安定和奥沙西潘的浓度分别为2~44和2~15 ng/片。1例检出MDEA(121 ng/贴片)及其代谢物丙二醛(22 ng/贴片)。丁丙诺啡是在严密的医疗监督下服用的，检测到的范围为1.30-153.2 ng/贴片，日剂量与汗液排泄量之间没有明显的关系。所有的尿液测试结果都与汗液检测结果一致，但要识别相同的药物，有必要同时检测两个尿液样本和一个汗液样本。结论是，汗液测试似乎提供了一种相对非侵入性的手段，可以获得一周内药物暴露的累积估计。这项新技术可能会在药物滥用者的治疗和监测中找到有用的应用，因为贴片提供了对药物暴露或违章行为的长期持续监测。
For many years, toxicologists have detected the presence of drugs of abuse in biological materials using blood or urine. In recent years, remarkable advances in sensitive analytical techniques have enabled the analysis of drugs in unconventional samples such as sweat. In a study conducted in a detoxification center, sweat patches were applied to 20 known heroin abusers. Subjects wore the patch with minimal discomfort for five days. During the same period, two urine specimens were also collected. Target drugs analyzed either by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-mass spectrometry (LC-MS) included opiates (heroin, 6-monoacetylmorphine, morphine, codeine), cocaine (cocaine, benzoylecgonine, ecgonine methyl ester), Δ9-tetrahydrocannabinol, benzodiazepines (nordiazepam, oxazepam), amphetamines (amphetamine, methamphetamine, methylenedioxyamphetamine [MDA], metbylenedioxymethamphetamine [MDMA], metbylenedioxyethylamphetamine [MDEA]), and buprenorphine. Patches were positive for opiates in 12 cases. Heroin (37–175 ng/patch) and/or 6-acetylmorphine (60–2386 ng/patch) were identified in eight cases, and codeine exposure (67–4018 ng/patch) was determined in four cases. When detected, heroin was always present in lower concentrations than 6-acetylmorphine, which was the major analyte found in sweat. Cocaine (324 ng/patch) and metabolites were found in only one case. Δ9-Tetrahydrocannabinol (4–38 ng/patch) was identified in nine cases. Benzodiazepine concentrations were very low, ranging from 2 to 44 and from 2 to 15 ng/patch for nordiazepam and oxazepam, respectively. MDEA (121 ng/patch) and its metabolite, MDA (22 ng/patch), were detected in one case. Buprenorphine, which was administered as therapy under close medical supervision, was detected in the range 1.3–153.2 ng/patch with no apparent relationship between the daily dose and amount excreted in sweat. All the urine tests were consistent with the sweat findings, but to identify the same drugs it was necessary to test two urine specimens along with only one sweat specimen. It was concluded that sweat testing appears to offer the advantage of being a relatively noninvasive means of obtaining a cumulative estimate of drug exposure over the period of a week. This new technology may find useful applications in the treatment and monitoring of substance abusers, as the patch provides a long-term continuous monitor of drug exposure or noncompliance.