Journal Article

Simultaneous Liquid Chromatography-Mass Spectrometry Quantification of Urinary Opiates, Cocaine, and Metabolites in Opiate-Dependent Pregnant Women in Methadone-Maintenance Treatment

Diaa M. Shakleya, Riet Dams, Robin E. Choo, Hendree Jones and Marilyn A. Huestis

in Journal of Analytical Toxicology

Volume 34, issue 1, pages 17-25
Published in print January 2010 | ISSN: 0146-4760
Published online January 2010 | e-ISSN: 1945-2403 | DOI: http://dx.doi.org/10.1093/jat/34.1.17
Simultaneous Liquid Chromatography-Mass Spectrometry Quantification of Urinary Opiates, Cocaine, and Metabolites in Opiate-Dependent Pregnant Women in Methadone-Maintenance Treatment

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Opiates, cocaine, and metabolites were quantified by liquid chromatography-mass spectrometry (LC-MS) in 284 urine specimens, collected thrice weekly, to monitor possible drug relapse in 15 pregnant heroin-dependent women. Opiates were detected in 149 urine specimens (52%) with limits of quantification (LOQ) of 10–50 µg/L. Morphine, morphine-3-glucuronide, and/or morphine-6-glucuronide were positive in 121 specimens; 6-acetylmorphine, a biomarker of heroin ingestion, was quantifiable in only 7. No heroin, 6-acetylcodeine, papaverine, or noscapine were detected. One hundred and sixty-five urine specimens (58%) from all 15 participants were positive for one or more cocaine analytes (LOQ 10–100 µg/L). Ecgonine methylester (EME) and/or benzoylecgonine were the major cocaine biomarkers in 142. Anhydroecgonine methylester, a biomarker of smoked cocaine, was positive in six; cocaethylene and/or ecgonine ethylester, biomarkers of cocaine and ethanol co-ingestion, were found in 25. At the current Substance Abuse Mental Health Services Administration cutoffs for total morphine (2000 µg/L), codeine (2000 µg/L), 6-acetylmorphine (10 µg/L), and benzoylecgonine (100 µg/L), 16 opiate- and 29 cocaine-positive specimens were identified. Considering 100 µg/L EME as an additional urinary cocaine biomarker would identify 51 more positive cocaine specimens. Of interest is the differential pattern of opiate and cocaine biomarkers observed after LC-MS as compared to gas chromatography-mass spectrometry analysis.

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Subjects: Medical Toxicology ; Toxicology (Non-medical)

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