SOFT 2004 Meeting Abstracts - Society of Forensic Toxicologists

F9
ESTIMA TE OF DETECTION PERIOD IN URINE FOR MARKERS OF STREET HEROIN
Sue Paterson*, Rosa Cordero, Simon Burlinson
Toxicology Unit, Imperial College London, St Dunstan's Road, London W6 8RP, UK
Nick Lintzeris
National Addiction Centre, 4 Windsor Walk, London SE5, UK
There is growing international interest in prescribed pharmaceutical heroin as treatment for individuals who
are unable to stop injecting opiate drugs. The rationale for this treatment is one of "harm minimisation". In
a previous paper (1) co-workers reported on the GC-MS analysis of over 1000 urine samples from patients
attending a substance misuse service during which metabolites of various contaminants of street heroin
were detected. They concluded that the detection of papaverine and noscapine metabolites was likely to
provide a reasonably sensitive and highly specific means of identifying the illicit use of heroin in patients
prescribed diamorphine. We believe that these markers offer the best means of determining the use of street
heroin in these patients. The aim of this study was to estimate the detection period for identifying markers
in the urine of street heroin users. Over 50 urine samples were collected from patients who admitted to the
use of street heroin within the previous 72 hours. The researcher interviewed each subject regarding all
episodes of drug use within the preceding 72 hours, including details of amount used, route of
administration and time of use. The time the urine was passed was also noted. These samples were analysed
by the method currently in use for the routine analysis of urine samples from patients attending drug
treatment centres, that is mixed-mode solid-phase extraction (SPE) followed by GC-MS (2). Urine samples
were subjected to enzymatic hydrolysis followed by SPE using Bakerbond narc-2 columns. The eluent was
selectively derivatised with N-methyl-bis-tritluoroacetamide and N-methyl-N-trimethylsilyltrifluoroacetamide
+ 1% trimethylchlorosilane. Analysis was performed using a GC-MS system operating in full
scan mode. The study samples were analysed for the commonly abused drugs plus a range of other drugs
including antidepressants and certain anti psychotics that are prescribed to these patients. In addition, the
metabolites of papaverine, hydroxy and dihydroxypapaverine, and the metabolites of noscapine, meconine
and hydroxymeconine, were looked for in each sample. Other contaminants of street heroin including
papaverine, noscapine, thebaine, and acetylcodeine were also monitored. Using this assay the limit of
detection for morphine was 0.05 ugimL. The limit of detection for hydroxy and dihydroxypapaverine could
not be determined as pure standards were not commercially available. A characteristic peak pattern in the
chromatogram was found to be indicative of the presence of the papaverine metabolites, which were then
matched by retention time and spectra obtained from the elucidation of these metabolite derivatives as
reported previously (1). Initial analysis of the data shows that hydroxy and dihydroxpapaverine were
detected in urine for approximately the same period as morphine. This data supports the findings of
McLachlan-Troup et al that hydroxy and dihydroxypapaverine can be used to determine if patients
prescribed injectable diamorphine are "topping-up" with street heroin. Papaverine, noscapine, thebaine and
acetyl codeine were not detected in any of the study samples.
l. N, McLachlan-Troup, G.W. Taylor, B.c. Trathen. Diamorphine treatment for opiate dependence:
putative markers of concomitant heroin misuse. Addiction Biology, 2001; 6: 223-231
2. S Paterson, R Cordero, S McCulloch, P Houldsworth. Analysis of urine for drugs of abuse using mixedmode
solid-phase extraction and gas chromatography/mass spectrometry. Ann. Ojefin. Biochem. 2000; 37:
690-700.
Keywords: Street heroin markers, papaverine metabolites, noscapine metabolites
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