Testing hair for fentanyl exposure: a method to inform harm reduction behavior among individuals who use heroin
Testing hair for fentanyl exposure: a method to inform harm reduction behavior among individuals who use heroin
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DOI：
10.1080/00952990.2018.1550652
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发表时间：
2019-01-02
影响因子：
2.7
通讯作者：
Tofighi, Babak
中科院分区：
文献类型：
--
作者：
Palamar, Joseph J.;Salomone, Alberto;Tofighi, Babak
背景：在美国，芬太尼暴露导致的死亡人数继续增加。芬太尼测试条现在可用于测试尿液中芬太尼的存在，但需要额外的测试方法来确定过去的暴露和确定特定类似物的暴露。目的：通过毛发测试调查此类类似物的暴露情况。研究方法：对40名报告上个月使用海洛因的住院戒毒人员（7.5%为女性）进行了调查，并提供了头发样本供日后检测。虽然结果无法提供给患者，但他们被问到，如果被告知他们的头发对芬太尼检测呈阳性，他们将如何回应。使用UHPLC-MS/MS检测芬太尼、其他六种新型合成阿片类药物和芬太尼生物标志物/代谢物的既往暴露。结果：27.5%的人报告在过去一年中已知使用芬太尼，67.5%的人报告可疑暴露。97.5%（40人中的39人）对芬太尼检测呈阳性，90.0%对4-ANPP（生物标志物）和去甲芬太尼（代谢物）检测呈阳性; 82.5%对乙酰芬太尼检测呈阳性，47.5%对呋喃基芬太尼检测呈阳性，7.5%对U-47700检测呈阳性。大多数参与者（82.5%）报告说，如果他们得知自己的头发检测呈阳性，他们会警告其他人芬太尼; 75.0%的人报告说，他们会尝试停止使用海洛因，65.0%的人报告说，他们会确保附近有人有纳洛酮，以扭转潜在的过量。结论：毛发检测在检测过去暴露于芬太尼，其类似物和其他新型合成阿片类药物中是有用的。需要进一步的研究来确定使用海洛因的个人是否会影响吸毒和寻求治疗的行为。
Background: Deaths from fentanyl exposure continue to increase in the US. Fentanyl test strips are now available to test urine for presence of fentanyl, but additional testing methods are needed to determine past exposure and to determine exposure to specific analogs. Objectives: To investigate exposure to such analogs through hair testing. Methods: Forty individuals in inpatient detoxification (7.5% female) reporting past-month heroin use were surveyed and provided a hair sample to be tested at a later date. While results could not be provided to patients, they were asked how they would respond if informed that their hair tested positive for fentanyl. UHPLC-MS/MS was used to test for past exposure to fentanyl, six other novel synthetic opioids, and fentanyl biomarkers/metabolites. Results: 27.5% reported known fentanyl use in the past year and 67.5% reported suspected exposure. 97.5% (39 of 40) tested positive for fentanyl, 90.0% tested positive for 4-ANPP (a biomarker) and norfentanyl (a metabolite); 82.5% tested positive for acetyl-fentanyl, 47.5% tested positive for furanyl-fentanyl, and 7.5% tested positive for U-47700. Most participants (82.5%) reported they would warn others about fentanyl if they learned their hair tested positive; 75.0% reported they would try to stop using heroin, and 65.0% reported they would ensure that someone nearby has naloxone to reverse a potential overdose. Conclusions: Hair testing is useful in detecting past exposure to fentanyl, its analogs, and other novel synthetic opioids. Further research is needed to determine whether individuals who use heroin learning about exposure affects drug-taking and treatment-seeking behavior.