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International Journal of Legal Medicine

, Volume 123, Issue 5, pp 363–369 | Cite as

Cocaine and opiate concentrations in hair from subjects in a heroin maintenance program in comparison to a methadone substituted group

  • Frank MusshoffEmail author
  • Katrin Lachenmeier
  • Dirk Lichtermann
  • Burkhard Madea
Original Article

Abstract

One month before (T-1) and 12 months after (T12) controlled i.v. administration of pharmaceutical heroin–HCl (10–100 mg/day) in the context of a heroin maintenance program (HMP), concentrations of opiates and cocaine as well as its metabolites were determined in head hair (n = 46) using a validated gas chromatographic–mass spectrometric method. In addition, a patient collective of a methadone maintenance program (MMP, daily doses 15–260 mg) was examined (n = 35). The incidence of additional cocaine consumption decreased in both groups during the study period (T-1 to T12): in HMP from 64.6% to 45.8% and in MMP from 71.4% to 60.0%. A significant reduction of cocaine consumption was defined as an at least 30% reduction of analyte concentrations in hair (Δc > 30%). Accordingly, in HMP, a decrease in 45.8% of initially (T-1) cocaine-positive patients was determined; in MMP, the reduction was 48.6%. In 22.9% of HMP and 37.1% of MMP, an increase of cocaine concentrations was detected. Codeine and acetylcodeine were found in 50.0% and 43.5% (T-1) and 13.0% and 10.9% (T12) of the samples of the HMP, as well as in 45.7% and 25.7% (T-1) and 17.1% and 5.7% (T12) in MMP, respectively. The missing of acetylcodeine, in particular at T-1, questions its applicability as a characteristic marker of a preceding consumption of illicit heroin in hair analysis.

Keywords

Heroin maintenance program Hair analysis Opiates Acetylcodeine GC/MS 

Supplementary material

414_2008_272_MOESM1_ESM.doc (50 kb)
Table S1 GC–MS procedure: mean measurement values, residual standard deviation (RSD), intraday and interday precision (P) and accuracy at concentrations of 0.5, 5 and 25 ng/mg (49.5 KB)
414_2008_272_MOESM2_ESM.doc (247 kb)
Table S2 Concentrations of heroin, 6-monoacetylmorphine, morphine, codeine, acetylcodeine, cocaine, cocaethylene and benzoylecgonine (in ng/mg) analysed with GC–MS in hair of participants of the heroin maintenance program at T-1 and T12 (247 KB)
414_2008_272_MOESM3_ESM.doc (166 kb)
Table S3 Concentrations of heroin, 6-monoacetylmorphine, morphine, codeine, acetylcodeine, cocaine, cocaethylene and benzoylecgonine (in ng/mg) analysed with GC-MS in hair of participants of the methadone maintenance program at T-1 and T12 (165 KB)

References

  1. 1.
    Madea B, Musshoff F (2004) Haaranalytik, Technik und Interpretation in Medizin und Recht. Deutscher Ärzteverlag, CologneGoogle Scholar
  2. 2.
    Pragst F, Balikova MA (2006) State of the art in hair analysis for detection of drug and alcohol abuse. Clin Chim Acta 370:17–49PubMedCrossRefGoogle Scholar
  3. 3.
    Musshoff F, Madea B (2007) New trends in hair analysis and scientific demands on validation and technical notes. Forensic Sci Int 165:204–215PubMedCrossRefGoogle Scholar
  4. 4.
    Musshoff F, Madea B (2007) Analytical pitfalls in hair testing. Anal Bioanal Chem 388:1475–1494PubMedCrossRefGoogle Scholar
  5. 5.
    Thieme D, Rolf B, Sachs H, Schmid D (2008) Correlation of inter-individual variations of amitriptyline metabolism examined in hairs with CYP2C19 and CYP2D6 polymorphisms. Int J Legal Med 122:149–155PubMedCrossRefGoogle Scholar
  6. 6.
    Sachs H, Arnold W (1989) Results of comparative determination of morphine in human hair using RIA and GC/MS. J Clin Chem Clin Biochem 27:873–877PubMedGoogle Scholar
  7. 7.
    Cassani M, Spiehler V (1993) Analytical requirements, perspectives and limits of immunological methods for drugs in hair. Forensic Sci Int 63:175–184PubMedCrossRefGoogle Scholar
  8. 8.
    Strano-Rossi S, Bermejo-Barrera A, Chiarotti M (1995) Segmental hair analysis for cocaine and heroin abuse determination. Forensic Sci Int 70:211–216PubMedCrossRefGoogle Scholar
  9. 9.
    Tagliaro F, Valentini R, Manetto G, Crivellente F, Carli G, Marigo M (2000) Hair analysis by using radioimmunoassay, high-performance liquid chromatography and capillary electrophoresis to investigate chronic exposure to heroin, cocaine and/or ecstasy in applicants for driving licences. Forensic Sci Int 107:121–128PubMedCrossRefGoogle Scholar
  10. 10.
    Lachenmeier K, Musshoff F, Madea B (2005) Determination of opiates and cocaine in hair using automated enzyme immunoassay screening methodologies followed by gas chromatographic–mass spectrometric (GC–MS) confirmation. Forensic Sci Int 159:189–199PubMedCrossRefGoogle Scholar
  11. 11.
    Moeller MR, Fey P, Wennig R (1993) Simultaneous determination of drugs of abuse (opiates, cocaine and amphetamine) in human hair by GC/MS and its application to a methadone treatment program. Forensic Sci Int 63:185–206PubMedCrossRefGoogle Scholar
  12. 12.
    Cone EJ, Darwin WD, Wang WL (1993) The occurrence of cocaine, heroin and metabolites in hair of drug abusers. Forensic Sci Int 63:55–68PubMedCrossRefGoogle Scholar
  13. 13.
    Wang WL, Darwin WD, Cone EJ (1994) Simultaneous assay of cocaine, heroin and metabolites in hair, plasma, saliva and urine by gas chromatography–mass spectrometry. J Chromatogr B Biomed Appl 660:279–290PubMedCrossRefGoogle Scholar
  14. 14.
    Kintz P, Mangin P (1995) Simultaneous determination of opiates, cocaine and major metabolites of cocaine in human hair by gas chromatography/mass spectrometry (GC/MS). Forensic Sci Int 73:93–100PubMedCrossRefGoogle Scholar
  15. 15.
    Gaillard Y, Pepin G (1997) Simultaneous solid-phase extraction on C18 cartridges of opiates and cocainics for an improved quantitation in human hair by GC–MS: one year of forensic applications. Forensic Sci Int 86:49–59PubMedCrossRefGoogle Scholar
  16. 16.
    Hoeld KM, Wilkins DG, Rollins DE (1998) Simultaneous quantitation of cocaine, opiates, and their metabolites in human hair by positive ion chemical ionization gas chromatography–mass spectrometry. J Chromatogr Sci 36:125–130Google Scholar
  17. 17.
    Pichini S, Pacifici R, Altieri I, Pellegrini M, Zuccaro P (1999) Determination of opiates and cocaine in hair as trimethylsilyl derivatives using gas chromatography–tandem mass spectrometry. J Anal Toxicol 23:343–348PubMedGoogle Scholar
  18. 18.
    Goldberger BA, Caplan YH, Maguire T, Cone EJ (1991) Testing human hair for drugs of abuse. III. Identification of heroin and 6-acetylmorphine as indicators of heroin use. J Anal Toxicol 15:226–231PubMedGoogle Scholar
  19. 19.
    Nakahara Y, Takahashi K, Shimamine M, Saitoh A (1992) Hair analysis for drugs of abuse. IV. Determination of total morphine and confirmation of 6-acetylmorphine in monkey and human hair by GC/MS. Arch Toxicol 66:669–674PubMedCrossRefGoogle Scholar
  20. 20.
    Polettini A, Groppi A, Montagna M (1993) Rapid and highly selective GC/MS/MS detection of heroin and its metabolites in hair. Forensic Sci Int 63:217–225PubMedCrossRefGoogle Scholar
  21. 21.
    Kauert G, Rohrich J (1996) Concentrations of delta 9-tetrahydrocannabinol, cocaine and 6-monoacetylmorphine in hair of drug abusers. Int J Legal Med 108:294–299PubMedCrossRefGoogle Scholar
  22. 22.
    Uhl M (1997) Determination of drugs in hair using GC/MS/MS. Forensic Sci Int 84:281–294PubMedCrossRefGoogle Scholar
  23. 23.
    Charles BK, Day JE, Rollins DE, Andrenyak D, Ling W, Wilkins DG (2003) Opiate recidivism in a drug-treatment program: comparison of hair and urine data. J Anal Toxicol 27:412–428PubMedGoogle Scholar
  24. 24.
    Sabzevari O, Abdi K, Amini M, Shafiee A (2004) Application of a simple and sensitive GC–MS method for determination of morphine in the hair of opium abusers. Anal Bioanal Chem 379:120–124PubMedCrossRefGoogle Scholar
  25. 25.
    Jurado C, Gimenez MP, Menendez M, Repetto M (1995) Simultaneous quantification of opiates, cocaine and cannabinoids in hair. Forensic Sci Int 70:165–174PubMedCrossRefGoogle Scholar
  26. 26.
    Montagna M, Stramesi C, Vignali C, Groppi A, Polettini A (2000) Simultaneous hair testing for opiates, cocaine, and metabolites by GC–MS: a survey of applicants for driving licenses with a history of drug use. Forensic Sci Int 107:157–167PubMedCrossRefGoogle Scholar
  27. 27.
    Girod C, Staub C (2000) Analysis of drugs of abuse in hair by automated solid-phase extraction, GC/EI/MS and GC ion trap/CI/MS. Forensic Sci Int 107:261–271PubMedCrossRefGoogle Scholar
  28. 28.
    Wilkins D, Rollins DE, Seaman J, Haughey H, Krueger G, Foltz R (1995) Quantitative determination of codeine and its major metabolites in human hair by gas chromatography-positive ion chemical ionization mass spectrometry: a clinical application. J Anal Toxicol 19:269–274PubMedGoogle Scholar
  29. 29.
    Polettini A, Stramesi C, Vignali C, Montagna M (1997) Determination of opiates in hair. Effects of extraction methods on recovery and on stability of analytes. Forensic Sci Int 84:259–269PubMedCrossRefGoogle Scholar
  30. 30.
    Nakahara Y (1999) Hair analysis for abused and therapeutic drugs. J Chromatogr B Biomed Sci Appl 733:161–180PubMedCrossRefGoogle Scholar
  31. 31.
    Kintz P, Bundeli P, Brenneisen R, Ludes B (1998) Dose–concentration relationships in hair from subjects in a controlled heroin-maintenance program. J Anal Toxicol 22:231–236PubMedGoogle Scholar
  32. 32.
    Kintz P, Jamey C, Cirimele V, Brenneisen R, Ludes B (1998) Evaluation of acetylcodeine as a specific marker of illicit heroin in human hair. J Anal Toxicol 22:425–429PubMedGoogle Scholar
  33. 33.
    Girod C, Staub C (2001) Acetylcodeine as a marker of illicit heroin in human hair: method validation and results of a pilot study. J Anal Toxicol 25:106–111PubMedGoogle Scholar
  34. 34.
    Backmund M (2001) Substitution und Heroin-Substitutionsbehandlung–eine kurze Übersicht. Suchtmed 3:225–228Google Scholar
  35. 35.
    Haasen C, Verthein U, Degwitz P, Berger J, Krausz M, Naber D (2007) Heroin-assisted treatment for opioid dependence: a randomised, controlled trial. Br J Psychiatry 191:55–62PubMedCrossRefGoogle Scholar
  36. 36.
    Peters FT, Maurer HH (2002) Bioanalytical method validation and its implications for forensic and clinical toxicology—a review. Accredit Qual Assur 7:441–449CrossRefGoogle Scholar
  37. 37.
    Peters FT, Drummer OH, Musshoff F (2007) Validation of new methods. Forensic Sci Int 165:216–224PubMedCrossRefGoogle Scholar
  38. 38.
    Schmitt G, Herbold M, Peters F (2003) Methodenvalidierung im forensisch-toxikologischen Labor. Arvecon GmbH, GermanyGoogle Scholar
  39. 39.
    Dobler-Mikola A, Pfeifer S, Müller V, Uchtenhagen A (2000) Vergleich Methadon- und Heroinverschreibungen in der Schweiz. Suchttherapie 1:63–66CrossRefGoogle Scholar
  40. 40.
    O'Neal CL, Poklis A (1998) The detection of acetylcodeine and 6-acetylmorphine in opiate positive urines. Forensic Sci Int 95:1–10PubMedCrossRefGoogle Scholar
  41. 41.
    Musshoff F, Lachenmeier K, Wollersen H, Lichtermann D, Madea B (2005) Opiate concentrations in hair from subjects in a controlled heroin-maintenance program and from opiate-associated fatalities. J Anal Toxicol 29:345–352PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Frank Musshoff
    • 1
    Email author
  • Katrin Lachenmeier
    • 1
  • Dirk Lichtermann
    • 2
  • Burkhard Madea
    • 1
  1. 1.Institute of Forensic MedicineUniversity of BonnBonnGermany
  2. 2.Department of PsychiatryUniversity of BonnBonnGermany

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