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

• Published in: Journal of analytical toxicology 2010-01, Vol.34 (1), p.17-25
• Main Authors: Shakleya, Diaa M., Dams, Riet, Choo, Robin E., Jones, Hendree, Huestis, Marilyn A.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Chromatography, High Pressure Liquid; Cocaine - urine; Cocaine-Related Disorders - diagnosis; Cocaine-Related Disorders - urine; Drug addictions; Female; Humans; Medical sciences; Methadone - therapeutic use; Methadone - urine; Morphine Derivatives - urine; Narcotics - therapeutic use; Narcotics - urine; Opioid-Related Disorders - diagnosis; Opioid-Related Disorders - rehabilitation; Opioid-Related Disorders - urine; Pregnancy; Spectrometry, Mass, Electrospray Ionization - methods; Substance Abuse Detection - methods; Toxicology; Urinalysis - methods; Young Adult
• ISSN: 0146-4760; 1945-2403; 1945-2403
• DOI: 10.1093/jat/34.1.17

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.