Abstract
Buprenorphine is becoming the medication of choice to help patients withdraw from opioid addiction. However, treatment is compromised by the inability of physicians to assess patient usage during scheduled examinations. Here we describe the development of a point-of-care (POC) analyzer that can rapidly measure both illicit and treatment drugs in patient saliva, ideally in the physician’s office, and with a degree of accuracy similar to chromatography. The analyzer employs a relatively simple supported liquid extraction to isolate the drugs from the saliva and surface-enhanced Raman spectroscopy (SERS) to detect the drugs. The SERS-based POC analyzer was used to identify buprenorphine and opioids in saliva samples by matching library spectra to samples collected from 7 veterans. The total analysis time, including sample preparation, was ~25 minutes. Buprenorphine concentration was estimated between 0 and 3 μg/mL. While no other prescription opioids were detected in any samples, heroin was identified in one sample; Δ-9 tetrahydrocannabinol (THC) was detected in 3 samples; and acetaminophen, caffeine, and nicotine were detected in several samples, none of which interfered with the measurements. The analysis was in very good agreement with urinalysis, correctly identifying the presence or absence of buprenorphine and THC in 13 of 14 measurements.
Highlights
Since Operation Iraqi Freedom and Operation Enduring Freedom, there has been a significant increase in the use of opioids, such as OxyContin and Vicodin, by United States military personnel
Veterans Affairs (VA) patients being treated for substance-use disorders (SUDs) that already were providing urine samples were recruited to provide saliva samples according to IRB Protocol 00008942 (Chesapeake IRB, Inc.), the Human Subjects Subcommittee of the VA Connecticut Healthcare System (West Haven, CT) and by the Yale IRB
This study demonstrated the potential of a SERS-based POC analyzer to detect drugs in patient saliva
Summary
Since Operation Iraqi Freedom and Operation Enduring Freedom, there has been a significant increase in the use of opioids, such as OxyContin and Vicodin, by United States military personnel. In an effort to reduce current and future SUD patients, Veterans Affairs (VA) hospitals expanded the use of drugs to reduce opioid dependence and side effects [3,4]. Opioid treatments are not effective if patients discontinue medications or give in to withdrawal symptoms and re-initiate drug use. This is not uncommon, since most patients are not hospitalized and often treated as outpatients. In effect, it is the patient’s responsibility to take treatment drugs according to the prescribed schedule. The 2014 DVAOIG report indicates that a very low percent of veterans take the follow-up urine tests [1]. This low percentage may be attributed to the clinical setting and methods used to analyze urine [1]
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