1,720,999 research outputs found
Workplace drug testing in Italy: one year of experience of the Forensic Toxicology laboratory, University of Pavia
No full textSystematic toxicological analysis of drugs in whole human blood by mixed-mode solid-phase extraction, trimethylsilyation, gas chromatography-mass spectrometry, and automated detection and identification of analytes.
No full textHair testing and self report of cocaine use
No full textIntroduction. Hair analysis is a useful tool in clinical, administrative and forensic fields; it allows to obtain long term information concerning drugs of abuse consumption, but the lack of data often does not allow to find a correlation between consumption and drug concentration in hair.
Aim. The purpose of this study was to compare the concentration of cocaine in hair with self-reported drug intake.
Methods. 113 subjects (61 Africans, 52 Caucasians) just admitted to the jail were asked to report their use of illicit drugs during the last three months and they were submitted to hair analysis. They had to answer about the class of drug used and the frequency of consumption (triple choice among: daily, 2-4 times per week, 1-2 times per month). Hair segments (3 cm) were analyzed by GC-MS for amphetamines, cannabinoids, cocaine and opiates.
Results. Useful data were obtained from 82 subjects declaring cocaine consumption: in 43 cases cocaine use was reported as daily, in 28 weekly and in 9 occasional. Cocaine (COC) and benzoylecgonine (BE) were always found in hair, and results were the following on average: daily use COC 53,93 ng/mg, BE 5,91 ng/mg; weekly use COC 28,91 ng/mg, BE 3,76 ng/mg; monthly use COC 7,65 ng/mg, BE 0,98 ng/mg. The study revealed good agreement between qualitative results and declared consumption. As regard the correlation between frequency of consumption and concentrations in hair, we often observed high concentrations against low consumption declared. There was quite good separation only between occasional and daily use (especially in Caucasian people), while concentrations found when weekly employment was reported are more scattered. Concentrations of cocaine found in Africans were very higher than in Caucasians.
Conclusions. Even if this study is based only on self-report, it provides some interesting information in order to distinguish the frequency of consumption, and particularly it underlines the great importance of racial bias on hair analysis
Systematic Toxicological Analysis by Gas Chromatography-Continuos Scan Mass Spectrometry
No full textDetermination of ethyl glucuronide in hair samples by liquid chromatography/electrospray tandem mass spectrometry
No full textA method for the determination of ethyl glucuronide (EtG) in hair samples, using liquid chromatography/electrospray tandem mass spectrometry (LC/ESI-MS/MS), was developed and validated. The treatment of hair samples was as follows: to 100 mg of washed (dichloromethane followed by methanol, 1 ml each) and cut (1-2 mm) material, 700 microl of water, 20 microl of internal standard solution (pentadeuterated EtG, D(5)-EtG, 500 microg/l) and 20 microl of methanol were added. Samples were incubated at 25 degrees C overnight and then ultrasonicated for 2 h. Finally, 8 microl of the centrifuged solution (13,000 rpm) were analyzed by LC/ESI-MS/MS in negative ion mode. The surviving ions of EtG and D(5)-EtG were monitored together with the following MRM transitions: m/z 221 --> 75, m/z 221 --> 85 (EtG) and m/z 226 --> 75, m/z 226 --> 85 (D(5)-EtG). The method exhibited a mean correlation coefficient better than 0.9998 over the dynamic range (3-2000 pg/mg). The lower limit of quantification (LLOQ) and the limit of detection (LOD) were 3 and 2 pg/mg respectively. The intra- and interday precision and accuracy were studied at four different concentration levels (3, 5, 56 and 160 pg/mg) and were always better than 7% (n = 5). Matrix effects did not exceed 20%. The method was applied to several hair samples taken from autopsies of known alcoholics, from patients in withdrawal treatment, from social drinkers, from adult teetotalers and from children not exposed to ethanol, with EtG concentrations globally ranging from < or =2 to 4180 pg/mg
Direct determination of ethyl glucuronide in hair samples by liquid chromatography/electrospray tandem mass spectrometry
No full textHair analysis in workplace drug testing and driving licence regranting as a tool to disclose patterns of drug use
No full textBackground: In Italy, hair analysis is used in the second level-tests of workplace drug testing (WDT) protocol and for driving licence regranting/renewal (DLR). The WDT National Protocol includes two-level tests. The second level of the protocol is required when in the first level-tests urine sample results positive. In this case, the worker is obliged to go to the Public Drug Treatment Unit to undergo an eventual diagnosis of drug dependence. The second level-tests consist of analysing both urine and hair for opiates, cocaine, amphetamines, cannabinoids, methadone and buprenorphine.
As far as driving licence regranting/renewal is concerned, subjects are instead always obliged to undergo toxicological analyses if they have either a documented past or a suspect present history of drug abuse, ( art. 187 “Driving under influence of drugs”), or if they are forced by the prefecture or by the traffic control authority. In some Regions such as Lombardy, hair analysis is used to rule out illicit drug use.
This study presents the data obtained from hair analysis performed in the Laboratory of Forensic Toxicology of the University of Pavia in the last two years.
Method: A total of 1017 hair samples were analysed for WDT (322) and DLR (695). Analyses were carried out by GC-MS using the method routinely applied on hair samples.
Results and Discussion: The positive rate for the WDT second leve-test was 45% versus the 10% for the DLR. The different percentage of positive results demonstrate how hair analysis is useful both for the diagnosis of drug dependence and as deterrent of drug consumption. As regard to positive results distribution, a cocaine abuse emerged in 74.6% of workers, while drivers resulted positive mainly for cannabinoids (41%), and cocaine (39%). On the contrary, the second main consumption in WDT analysis resulted the polydrug abuse (16,5%). Opiates percentage was 1.4% in both cases while positive samples for methadone were 9 in the DLR analysis versus 3 in the WDT one. MDMA was present only in two workers and in association with cocaine
A broad spectrum derivatization method for systematic toxicological analysis by GC-MS. Characterization of trimethylsilyl of polar drugs
No full text
Methadone-related deaths: a worrying increase
No full textObjectives. Methadone has been used in Italy in maintenance programs for heroin addicts since the early 1980s. Its use requires a careful evaluation of the dosage, in relation with the opioid tolerance developed by the patient under treatment. The number of methadone-related deaths observed by our Laboratory has been increasing during the last five years: the aim of this work is to discuss the causes of such an increment, whether there has been an increase in methadone use without medical prescription, an incorrect use of the drug when take-home doses were prescribed, simultaneous consumption of alcohol or drugs, or even doctor’s carelessness at the Addiction Units when judging the appropriate methadone dosage.
Materials and Methods. Between 2006 and 2010 we observed twenty cases of lethal poisoning related to methadone administration, seven of those in the year 2010 alone. Fifteen were males and five females, the average age being 32 (min 2 - max 54). The following toxicological analyses were carried out on postmortem samples: HS-GC quantitative analysis of ethanol in blood; GC-MS systematic toxicological analysis (STA) in blood followed by quantitative determination of identified drugs; GC-NPD determination of methadone in blood and in urine when available. Whenever possible (12 cases) GC-MS quantitative determination of methadone and morphine in hair (2 cm closest to the scalp) was performed.
Results. It has been established that half of the deaths had been caused by methadone only, while in the other ten there had been contribution, besides methadone, of other substances (especially ethanol). The evaluation of the anamnestic data has allowed to observe that six of the deceased subjects were not following any methadone therapy, five had take-home methadone doses, while three other subjects had started methadone therapy just a few days earlier. In three of the remaining six cases, all involving subjects with supervised methadone consumption, blood alcohol concentration was over 200 mg/100 ml, and in one case there were high concentrations of Promethazine and Levomepromazine, the only medications found besides methadone. Highest blood methadone average concentrations (891 ng/ml) were surprisingly those related to subjects who had just started methadone treatment, followed by those of subjects with take-home doses (720 ng/ml). Lowest concentrations (455 ng/ml) were, conversely, those of subjects who had taken methadone without a doctor’s prescription and those of patients with supervised consumption by a drug treatment service (695 ng/ml).
Conclusion. By evaluating the results we came to the following conclusions: 1) the death of three patients during induction into methadone treatment have been caused by administration of excessive starting doses; 2) when take-home doses are prescribed, sometimes patients display a tendency to irregular assumption of the drug, this being documented through the occasional findings of unconsumed syrup bottles at the patient’s domicile and through hair analysis, subsequently increasing the risk of overdosing; 3) in one single case, take-home methadone has indirectly lead to the death of a two years old girl who has drunk the syrup left unattended by her father; 4) among subjects with supervised consumption, high blood concentrations have generally not been observed, but there has been simultaneous alcohol or psychotropic drugs intake; 5) the abuse of methadone illegally obtained, often through patients allowed to carry it home, is rather common. Special caution has to be exercised in prescribing take-home doses, together with a more careful evaluation during induction into methadone treatment when tolerance is unclear.
Key Words: Methadone, intoxication, blood level
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