Abstract
Studying the origin of opiate and/or opiate metabolites in individual urine specimens after consumption of cold syrups is vital for patients, doctors, and law enforcement. A rapid liquid chromatography–tandem mass spectrometry method using “dilute-and-shoot” analysis without the need for extraction, hydrolysis and/or derivatization has been developed and validated. The approach provides linear ranges of 2.5–1000 ng mL−1 for 6-acetylmorphine, codeine, chlorpheniramine, and carbinoxamine, 2.5–800 ng mL−1 for morphine and morphine-3-β-d-glucuronide, and 2.5–600 ng mL−1 for morphine-6-β-d-glucuronide and codeine-6-β-d-glucuronide, with excellent correlation coefficients (R2 > 0.995) and matrix effects (< 5%). Urine samples collected from the ten participants orally administered cold syrups were analyzed. The results concluded that participants consuming codeine-containing cold syrups did not routinely pass urine tests for opiates, and their morphine–codeine concentration ratios (M/C) were not always < 1. In addition, the distribution map of the clinical total concentration of the sum of morphine and codeine against the antihistamines (chlorpheniramine or carbinoxamine) were plotted for discrimination of people who used cold syrups. The 15 real cases have been studied by using M/C rule, cutoff value, and distribution map, further revealing a potential approach to determine opiate metabolite in urine originating from cold syrups.
Highlights
Opiate metabolites usually refer to the metabolites of morphine, codeine, and heroin
The results showed that distributions of samples 9–11 were overlapped with those determined in the clinical trials, confirming the suspects in the three cases consumed cold syrups containing codeine and chlorpheniramine
The results of a clinical trial revealed that people consuming cold syrups do not consistently pass opiate urine tests and the samples do not have morphine–codeine concentration ratios < 1 routinely
Summary
Opiate metabolites usually refer to the metabolites of morphine, codeine, and heroin. Morphine and codeine are natural substances present in poppies, whereas heroin is a semisynthetic product derived from morphine. Heroin, considered one of the most serious drugs abused worldwide, has led to numerous deaths—approximately 15,482 in 2017 [1]. In forensic science, several analytical methods, including gas chromatography–mass spectrometry (GC–MS) [2,3], GC–tandem MS (GC-MS/MS) [4,5], and liquid chromatography-mass spectrometry (LC-MS/MS) [6,7], have been adapted for the identification of heroin, other opiates, and their metabolites. Some natural foods and medicines, such as cold syrups that contain certain amounts of codeine, can produce opiate metabolites in urine. A person suspected of abusing heroin might defend himself by claiming to have taken medicines or foods containing codeine or morphine, which is referred to as the “poppy seed
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