Prevalence and disposition of drugs of abuse and opioid treatment drugs in oral fluid
Prevalence and disposition of drugs of abuse and opioid treatment drugs in oral fluid
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DOI：
10.1093/jat/31.8.424
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发表时间：
2007-10-01
影响因子：
2.5
通讯作者：
Tsanaclis, Lolita
中科院分区：
文献类型：
--
作者：
Cone, Edward J.;Clarke, Joe;Tsanaclis, Lolita
已在许多条件下研究了口腔液中药物滥用的检测，但很少在大型人群数据库中进行评价。我们在英国一家商业实验室的数据库中评估了口腔液体检测，该数据库由8679个确认的阳性结果组成。结果来自2004年5月至2006年9月期间收集的635，000份标本。使用Intercept®口腔液采集装置采集口腔液样本，通过酶免疫测定法进行筛选，并通过GC-MS或GC-MS-MS进行确认。数据库按采集设置（法律的/治疗，N= 8198份样本;工作场所，N= 481份样本）和药物组（不考虑采集设置）进行组织。药物组如下（确认阳性数量）：苯丙胺（468）;苯二氮卓类（892）;丁丙诺啡（276）;大麻素（725）;可卡因（1443）;美沙酮（998）;和阿片类（5739）。本研究的目的是提供药物/代谢物流行率数据、浓度和口腔液体中遇到的药物/代谢物模式。按收集环境比较结果表明，相对频率存在差异，主要是阿片类药物和大麻素。在法律的/治疗环境中采集的标本中最常观察到阿片类药物阳性，而大麻素最常报告在工作场所。通过按药物组对数据进行评价，获得了一系列关于药物和代谢物发生率和浓度的信息。安非他明是安非他明组报告的主要药物;约10%的患者对MDA和/或MDMA也呈阳性;甲基安非他明很少报告。苯二氮卓类组报告了地西泮、去甲地西泮、奥沙西泮、替马西泮、利血平和碘拉西泮的多种复方制剂。丁丙诺啡（一种阿片类治疗药物）是报告的主要分析物，但经常报告低浓度的去甲丁丙诺啡。四氢大麻酚是大麻素组报告的主要分析物，经常与大麻二酚和大麻酚一起报告。仅在10.8%的样本中报告了THCCOOH，并且在不存在THC的情况下从未报告过。在5.7%的标本中报告了HO-THC。在可卡因组中，可卡因存在，通常与BZE组合，但也作为17.3%的标本中的唯一分析物。AEME和可卡因分别占10.4%和5.5%。美沙酮是另一种阿片类治疗药物，在美沙酮组的所有标本中报告; EDDP在30.1%的标本中报告。在阿片类药物组中，最常报告吗啡、可待因和6-乙酰吗啡，通常合并使用。当吗啡存在时，6-乙酰吗啡的检测频率（N= 4575份样本）为77.5%。令人惊讶的是，经常报告海洛因（19.0%;N= 1091份标本）和6-乙酰可待因（24.9%;N= 1431份标本）。对这一大型口腔液数据库的分析结果提供了关于检测频率、药物和代谢物模式以及滥用药物浓度数据的丰富的新信息。
Testing oral fluid for drugs of abuse has been studied under many conditions but rarely has been evaluated in large population databases. We evaluated oral fluid tests in a database from a commercial laboratory in the United Kingdom composed of 8679 confirmed positive results. The results originated from 635,000 specimens collected over the period of May 2004 through September 2006. Oral fluid specimens were collected with the Intercept®oral fluid collection device, screened by enzyme immunoassay, and confirmed by GC-MS or GC-MS-MS. The database was organized by collection settings (legal/treatment,N= 8198 specimens; and workplace,N= 481 specimens) and by drug groups (without consideration of collection setting). The drug groups were as follows (number of confirmed positives): amphetamines (468); benzodiazepines (892); buprenorphine (276); cannabinoids (725); cocaine (1443); methadone (998); and opiates (5739). The goal of the study was to provide drug/metabolite prevalence data, concentrations, and drugs/metabolite patterns encountered in oral fluid. Comparison of results by collection setting indicated differences in relative frequency, primarily for opiates and cannabinoids. Opiate positives were most frequently observed for specimens collected in legal/treatment settings, whereas cannabinoids were most frequently reported in the workplace. An array of information on drug and metabolite occurrences and concentration arose from evaluation of the data by drug groups. Amphetamine was the predominant drug reported for the Amphetamines Group; approximately 10% were also positive for MDA and/or MDMA; and methamphetamine was rarely reported. Multiple combinations of diazepam, nordiazepam, oxazepam, temazepam, chlordiazepoxide, and Iorazepam were reported for the Benzodiazepine Group. Buprenorphine, an opioid treatment drug, was the predominant analyte reported, but low concentrations of norbuprenorphine were frequently reported. THC was the predominant analyte reported in the Cannabinoids Group and was frequently reported in combination with cannabidiol and cannabinol. THCCOOH was reported in only 10.8% of these specimens and was never reported in the absence of THC. HO-THC was reported in 5.7% of the specimens. In the Cocaine Group, cocaine was present, often in combination with BZE, but also as the sole analyte in 17.3% of the specimens. AEME and cocaethylene were reported in 10.4% and 5.5% of the specimens. Methadone, another opioid treatment drug, was reported in all specimens for the Methadone Group; EDDP was reported in 30.1% of the specimens. In the Opiates Group, morphine, codeine and 6-acetylmorhine were most frequently reported, often in combination. The frequency of detection of 6-acetylmorphine when morphine was present (N= 4575 specimens) was 77.5%. Surprisingly, heroin (19.0%;N= 1091 specimens) and 6-acetylcodeine (24.9%;N= 1431 specimens) were frequently reported. The results from analysis of this large oral fluid database offer a rich mixture of new information on detection frequency, drug and metabolite patterns, and concentration data on drugs of abuse.