Abstract
Simple SummaryHair testing for classic drugs of abuse offers the possibility of longer detection times (for drug substances) when compared to urine analysis. Hair analysis is routinely used to detect drug abuse in forensic cases and clinical toxicology, whereas it is rarely used at addiction clinics to monitor the clinical efficacy of therapeutic interventions. Here, we explore for the first time whether hair analysis might represent a valid tool to track the clinical improvements in a population of patients with cocaine use disorder (CocUD) who underwent a repetitive transcranial magnetic stimulation (rTMS) treatment.In recent years, hair has become an alternative biological specimen for drug testing in the fields of forensic and clinical toxicology. The advantages of hair testing include larger detection windows (months/years), depending on the length of the hair shaft, compared to those of urine/blood (hours to 2–4 days for most drugs). Segmental hair analysis can disclose a month-to-month (considering 1 cm segment cuts) information of drug exposure (single or repeated) and potentially identify patterns of drug use/administration. Repetitive transcranial magnetic stimulation (rTMS) was recently proposed as a valid tool for therapeutic purposes in addictions, including cocaine use disorder (CocUD). Here, we proposed hair testing analyses of classic drugs of abuse in a clinical setting to monitor the clinical changes in treatment-seeker CocUD patients undergoing protocol treatments with rTMS stimulating the left dorsolateral prefrontal cortex (l-DLPFC). We collected hair samples from nine CocUD patients at different stages from the beginning of treatments. Hair sample analyses revealed significant changes in the patterns of cocaine use, according to the negativity of urine screening tests and the clinical reductions of craving. These data, albeit preliminary, suggest that hair testing analysis of classic drugs of abuse could be extended to clinical settings to monitor the clinical efficacy of innovative therapeutic interventions, such as rTMS.
Highlights
In contrast to drug testing in conventional matrices, testing of hair may provide data on long-term exposure to drugs
We test whether hair testing for drugs of abuse is a useful methodology in a clinical setting to monitor the clinical changes observed in cocaine use disorder (CocUD) patients who underwent the repetitive transcranial magnetic stimulation (rTMS) protocol treatment stimulating the left-DLPFC [9]
Nine subjects were enrolled in this pilot study to assess the usefulness of drug hair testing for monitoring the clinical efficacy of an innovative therapeutic intervention, such us rTMS, for cocaine addiction
Summary
In contrast to drug testing in conventional matrices, testing of hair may provide data on long-term exposure to drugs. The typical hair sample (3.0 cm cut close to the scalp) identifies drug use as far as three months back, while body hair may go back even further, as opposed to urine analysis, which typically detects drug use from the past 48 to 72 h [1,2,3]. For this reason, hair testing is a well-recognized method for forensic, legal, and clinical purposes, to assess one’s individual history of drugs of abuse [4]. We used a validated analytical methodology, already applied in several clinical and epidemiological studies [10,11], to assess the pattern changes of drug use in patients who underwent innovative protocol treatments with rTMS
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