Morphine In Urine Research Articles

Detection of morphine and data processing using surface plasmon resonance imaging sensor

Abstract Based on the surface plasmon resonance imaging (SPRi) instrument, we established a new method of analyzing morphine in urine by processing a calibration curve. According to an inhibition immunoassay, gradient concentration of morphine and morphine-BSA fixed on the chip competitively combine with morphine antibody on the chip. Given the three mathematical models, the data of SPRi signals generated from SPRi with morphine was processed to obtain the calibration curve. Ultrafiltration was used to pretreat blank urine samples with adding morphine, and then investigated the advantages and disadvantages of each model. With a limit detection of 6.57 ng·mL−1, the method and mathematical models can provide robust support for SPRi sensors used in further environmental detection, such as the epidemiological study of sewage.

Association Between Variables and Transitions Among No Opioid Use, Opioid Use, and Subsequent Dropout Among Participants on Methadone Treatment: A Retrospective Study Utilizing a Multistate Model.

Although previous studies have reported the variables that influence opioid use or dropout among participants receiving methadone treatment, limited attention has been given to the variables related to transitions among no opioid use, opioid use, and dropout. This retrospective study utilized data collected from June 2010 to June 2022 at 11 methadone treatment clinics in Guangdong Province, China. Two transient states (no opioid use and opioid use) and 1 absorbing state (dropout) were defined based on monthly urine morphine test results and daily methadone intake records. We used a multistate model to explore the variables associated with transitions among no opioid use, opioid use, and dropout among participants. Among 3136 participants, with an average treatment duration of 497 days, 1646 (52.49%) underwent at least 1 period of opioid use, resulting in 3283 transitions from no opioid use to opioid use. The transitions between no opioid use and opioid use were significantly associated with variables such as age, gender, employment status, marital status, living situation, travel time to the clinic, human immunodeficiency virus and hepatitis C virus infection statuses, average methadone dosage, and attendance rates. The variables influencing participants' dropout varied depending on their opioid use behaviors. Additionally, the probability of a specified opioid use state remaining unchanged or transitioning to a different state at a defined time point would change over time. The opioid use behaviors of participants are dynamic. Methadone providers should offer targeted interventions based on participants' opioid use behaviors to effectively decrease rates of opioid use and improve retention.

Green electromembrane extraction of morphine by sodium alginate-g-polyacrylamide/agarose interpenetrating polymer network as a membrane

The isolation and pre-concentration of drugs from complex biological matrices prior to analysis remains a significant challenge. This study introduces a novel method for the extraction and determination of morphine from biological fluids utilizing a sodium alginate-g-polyacrylamide/agarose hydrogel electromembrane (EME) coupled with square wave voltammetry (SWV) at a glassy carbon electrode. This innovative approach eliminates the need for organic solvents, promoting a greener analytical methodology. The EME process involves the application of a direct current potential across the hydrogel membrane, facilitating the transport of charged morphine molecules from a donor solution (pH 7.0) to an acceptor solution (pH 3.0) under optimized conditions. Following extraction (70 V, 25 min), the acceptor solution is subjected to SWV analysis in a phosphate buffer solution (pH 6.0). This approach successfully extracts morphine, a highly polar compound (log P = 0.43), without requiring ion-pairing or carrier reagents. The method exhibits impressive limits of detection (LOD) and quantification (LOQ) of 0.036 μg/mL and 0.109 μg/mL, respectively. This work demonstrates the potential of the sodium alginate-g-polyacrylamide/agarose hydrogel EME coupled with SWV for the sensitive determination of morphine in urine and wastewater samples.

Unveiling Morphine: A Rapid and Selective Fluorescence Sensor for Forensic and Medical Analysis.

Opioid use, particularly morphine, is linked to CNS-related disorders, comorbidities, and premature death. Morphine, a widely abused opioid, poses a significant global health threat and serves as a key metabolite in various opioids. Here, we present a turn-off fluorescent sensor capable of detecting morphine with exceptional sensitivity and speed in various samples. The fluorescent sensor was developed through the dimerization process of 7-methoxy-1-tetralone and subsequent demethylation to produce the final product. Despite morphine possessing inherent fluorophoric properties and emitting light in an approximately similar wavelength as the sensor's fluorescent blue light, the introduction of the target molecule (morphine) in the presence of the sensor caused a reduction in the sensor's fluorescence intensity, which is attributable to the formation of the sensor-morphine complex. By utilizing this fluorescence quenching sensor, the chemo-selective detection of morphine becomes highly feasible, encompassing a linear range from 0.008 to 40 ppm with an impressive limit of detection of 8 ppb. Consequently, this molecular probe demonstrates a successful application in determining trace amounts of morphine within urine, yielding satisfactory analytical results. The study also explores the effect of several variables on the sensor's response and optimizes the detection of morphine in urine using a response surface methodology with a central composite design.

Heroin-induced osteoporosis presented with bilateral femoral neck insufficiency fractures in a male adult: a case report

BackgroundOsteoporosis has been associated with several disorders; however, there have been only a limited number of reports on heroin-induced osteoporosis. We report a rare case presented with bilateral femoral neck insufficiency fractures without trauma history, caused by heroin-induced osteoporosis. We collect sufficient clinical data and further shed light on the potential mechanism of how heroin affects bone formation and decreases bone density.Case presentationA 55-year-old male patient with normal body mass index (BMI) suffered from bilateral hips pain gradually without trauma history. He had intravenous heroin addiction for more than 30 years. Radiography revealed bilateral femoral neck insufficiency fractures. Laboratory tests showed elevated alkaline phosphatase levels (365 U/L) and decreased inorganic phosphate (1.7 mg/dL), calcium (8.3 mg/dL), 25-(OH)D3 (20.3 ng/ml) and testosterone levels (2.12 ng/ml). Magnetic resonance imaging (MRI) revealed increased signals on STIR images over the sacral ala and bilateral proximal femur, and multiple band-like lesions at the vertebrae of the thoracic and lumbar spine. Bone densitometry revealed osteoporosis with a T score of minus 4.0. The screen for urine morphine was positive (> 1000 ng/ml). Through assessment of the patient, the diagnosis was insufficiency fractures of bilateral femoral neck caused by opioid-induced osteoporosis. After hemiarthroplasty, regular medication with vitamin D3 and calcium, and detoxification treatment, and the patient recovered well after 6 months of follow-up.ConclusionThe aim of this report is to highlight the laboratory and radiology findings in a case of osteoporosis caused by opioid addiction and discuss the potential pathway by which osteoporosis is induced by opioids. When an unusual osteoporosis presents with insufficiency fractures, heroin-induced osteoporosis should be considered.

Recurrent event analysis for time to dropout of newly-enrolled MMT participants in Guangdong, China: a retrospective study using the Prentice-Williams-Peterson model

Background Recurrent dropout often occurs among participants receiving methadone maintenance treatment (MMT), which negatively affects treatment effectiveness. However, few researchers focused on this phenomenon including those in China. This study examined systematically factors associated with dropout based on recurrent events analysis among Chinese MMT participants. Methods This retrospective study involved participants who firstly enrolled in MMT program between 2006 and 2017 of nine clinics in the Guangdong Province. The factors influencing recurrent dropout were identified using Prentice-Williams-Peterson model with total time (PWP-TT), then a comparison with Cox proportional hazards model was conducted. Results Among a total of 1,319 participants, 1,922 treatment episodes were identified. There were 366 (27.7%) participants remained in MMT at one year follow-up. There was a progressive shortening of the treatment episode duration among participants with multiple treatment episodes. Protective factors included higher average age (≥50 years) before attending MMT, the higher last methadone dosage before each dropout (≥50ml) and higher average dosage (≥60ml) in each episode, while being divorced, arrested in the past 3 months, having contact with drug-using friends more than once per day, and being positive for the first morphine urine test were risk factors. Additionally, higher average dosage (≥60ml) had constant protective effects on subsequential treatment episodes. Conclusions The risk of dropout increased as participants experienced multiple treatment episodes in MMT. The influencing factors for recurrent dropout were variable across all treatment episodes. Greater efforts are needed to provide sufficient methadone dosage for the participants to decrease dropout rate.

Effect of light needle in the treatment of opioid use disorder: A protocol for a randomized controlled trial

Opioid use disorder occurs worldwide and creates an increasing economic burden and public health crisis. Some problems are associated with using opioid agonists; therefore, there is a need to develop non-opioid treatments to improve acute and long-term opioid withdrawal syndromes. We will enroll 100 participants with opioid use disorders receiving methadone maintenance treatment at an addiction treatment center and randomly allocate them to an experimental or control group. The experimental group will receive 12 sessions of light needle therapy within 4 weeks, while the control group will receive sham light needle treatment without any laser output. Urinary morphine levels were assessed before and after treatment. Participants will be asked to self-report their number of episodes or days of heroin use and heroin craving/refusal to use heroin in the previous week before and after treatment on a visual analogue scale score of 0 to 10. Quality of life will be reported using the Short Form-12v2 before and after 4 weeks of treatment. Pulse diagnosis and heart rate variability will be evaluated before and after treatment. Baseline patient characteristics will be compared between the groups using the independent t test and the χ2 test. Data between the 2 groups will be compared using generalized estimation equations, and paired t tests. This study aims to investigate the effect of adjuvant light needle therapy in patients with opioid use disorder on methadone maintenance treatment.

Exploring factors jointly associated with recurrent relapse and dropout of methadone maintenance treatment clients in Guangdong, China: A retrospective cohort study

BackgroundClients receiving methadone maintenance treatment (MMT) may experience multiple relapses, which may lead to dropout. However, previous studies mostly only explored the influencing factors of relapse or dropout separately. In this study, we investigated the influencing factors jointly associated with both recurrent relapse and dropout. MethodsThis study was conducted in 16 MMT clinics in Guangdong, China. Data on the clients’ demographic characteristics; drug-related behavior; HIV, HCV, and urine morphine test results; and daily methadone doses were collected. The outcomes were time to recurrent relapse and time to dropout. A joint frailty model was used to explore factors jointly associated with recurrent relapse and dropout. The hazard ratios (HRs) of the covariates in the multivariable model were adjusted, with HR > 1 indicating a faster time to recurrent relapse and dropout. ResultsAmong 1539 clients, 39.5% had ≥ 2 relapse events, and 90.8% of the clients dropped out. A high attendance rate was protective for recurrent relapse (HR50–80%=0.63, 95% CI: 0.51, 0.79; HR>80%=0.35, 95% CI: 0.28, 0.44) and dropout (HR50–80%=0.56, 95% CI: 0.47, 0.68; HR>80%=0.27, 95% CI: 0.23, 0.33). Being married (HR=0.80, 95% CI: 0.67, 0.96), having a fair relationship with family (HR=0.79, 95% CI: 0.67, 0.93) and drug injection (HR=0.80, 95% CI: 0.67, 0.96) were also protective for recurrent relapse. Female (HR=0.64, 95% CI: 0.50, 0.82) and a high methadone dose (≥60 ml/day; HR=0.79, 95% CI: 0.65, 0.96) were protective for dropout, and a longer traveling time to the clinic (>60 min; HR=1.59, 95% CI: 1.20, 2.10) was associated with an increased risk of dropout. ConclusionsIt is common for clients to experience recurrent relapse and dropout. The findings suggest that MMT clinics should provide holistic interventions and appropriate methadone doses for clients to improve treatment compliance.

Comparing the Effectiveness of Cognitive-Behavioral Therapy and Brief Intervention on Relapse Prevention among Drug Users.

This study aimed to compare the effectiveness and stability of group cognitive-behavioral therapy (CBT) and brief intervention (BI) for relapse prevention (RP) among drug users of drop-in-centers (DICs) in Ahvaz, Iran. The present study was a quasi-experimental one with a pretest-posttest design, a follow-up phase, and a control group. The statistical population included all drug users of drop- in-centers of Ahvaz in 2021. The sample of the study included 78 drug users selected randomly and assigned to two experimental groups and one control group (each 26 members). A morphine test (special kits) that detects the presence of morphine in urine was used to check the relapse. Data were analyzed using repeated measures ANOVA with SPSS (version 24). The results showed BI and CBT had a significant effect on reducing RP in drug users (P<0.001). The BI was more effective than CBT for RP. It can be concluded that both BI and CBT can be effective in reducing the likelihood of relapse among drug users but BI is more effective than CBT for RP.

An Unusual Case of High 6-Monoacetylmorphine and Low Morphine in Urine: Heroin Abuse or Analytical Error?

A 59-year-old male with a past medical history of chronic low back pain, opioid use disorder, and type 2 diabetes mellitus presented to an outpatient clinic for pain contract–related urine drug screen testing. Current medications included metformin, oxycodone, and Suboxone® (buprenorphine and naloxone combination). The patient stated that 5 days prior to the visit, he stopped taking Suboxone due to complaints of nausea and vomiting. Urine toxicology test results are summarized in Table 1. ... ... Suboxone is an opioid abuse management medication that is formulated with buprenorphine and naloxone. Naloxone has limited bioavailability when administered sublingually and should be barely detectable in urine. However, when Suboxone is taken parenterally, naloxone enters the blood stream and is largely excreted in urine. In this case, the presence of a high concentration of naloxone in urine with a high ratio to buprenorphine suggested parenteral administration (1). Heroin is readily metabolized into 6-MAM and then to morphine. Typically, the 6-MAM-to-morphine ratio is <0.26, so it is uncommon to see a high positive 6-MAM with very low morphine concentrations (2). The calculated 6-MAM-to-morphine ratio in this sample was 7.27. Conversion from morphine to 6-MAM due to contaminants in enzyme hydrolysis or acid hydrolysis used during sample preparation in urine samples with extremely high morphine (>100 000 μg/L) has been reported (3). In our case, morphine was very low, so this was unlikely, but to rule out any analytical cause, the positive urine sample was sent to a reference laboratory, which confirmed our findings. The fact that 2 laboratories using different mass spectrometry–based methods showed detectable 6-MAM supported heroin use, instead of a false positive due to an interference. The unusually low morphine result in some heroin users has been reported elsewhere and may be mostly attributed to inhibitors of carboxylesterases from the heroin synthesis process (2) or explained by polymorphism in the esterase enzymes metabolizing 6-MAM to morphine (4). The physician also requested serum fentanyl testing by mass spectrometry 5 days after the original urine sample collection (fentanyl was not part of our general urine drug screen), which came back positive for fentanyl and norfentanyl. In addition to the unexpected positive amphetamine result, all of this confirmed that this patient suffered from polysubstance abuse.

Association Between Inflammatory Cytokines, Executive Function, and Substance Use in Patients With Opioid Use Disorder and Amphetamine-Type Stimulants Use Disorder.

Long-term opioid and amphetamine-type stimulants (ATS) abuse may affect immunological function and impair executive function. We aimed to determine whether biomarkers of inflammation and executive function were associated with substance use in individuals with opioid use disorder (OUD) and ATS use disorder (ATSUD). The interactions between these biomarkers were also explored. We assessed plasma cytokines [tumor necrosis factor (TNF)-α, C-reactive protein (CRP), interleukin (IL)-8, IL-6, transforming growth factor (TGF)-β1, brain-derived neurotrophic factor (BDNF), and executive function in terms of the Wisconsin Card Sorting Test (WCST) and Continuous Performance Test (CPT) in OUD and ATSUD patients and healthy controls (HC). OUD and ATSUD patients were followed for 12 weeks, and their urine morphine and amphetamine tests, cytokine levels, and executive function were repeatedly measured. We enrolled 483 patients and 145 HC. Plasma TNF-α, CRP, IL-8, IL-6, and BDNF levels and most subscale scores on the WCST and CPT significantly differed between OUD and ATSUD patients and HC. Increased TNF-α levels and more perseveration error on the WCST were significantly associated with more urine drug-positive results and less abstinence. Plasma IL-6 and CRP levels were significantly negatively correlated with WCST and CPT performance. OUD and ATSUD patients had more inflammation and worse executive function than HC. Inflammatory markers and WCST performance were associated with their urinary drug results, and higher inflammation was associated with poor executive function. Studies on regulating the inflammatory process and enhancing executive function in OUD and ATSUD are warranted.

Urine thebaine determination by liquid chromatography tandem mass spectrometry after poppy seed consumption.

Laboratories are challenged to distinguish whether a positive urine morphine result is due to heroin use or possible poppy seed consumption. Thebaine is an opium alkaloid that has been shown to be present in the urine of individuals who have consumed poppy seeds, as well as those who have used opium. It is not present in heroin. We present a sensitive, specific liquid chromatography tandem mass spectrometry (LC-MS/MS) assay for thebaine. We show that thebaine is detectable after consumption of two different poppy seed-containing products for up to 72 h in urine. We discuss limitations of the assay and suggest how the test might best be used.

W257 Enzymatic hydrolysis of >10000 ng/ml of codeine, morphine, ethylmorphine and oxymorphone glucuronides in urine at RT for LC-MS-analysis

W257 Enzymatic hydrolysis of >10000 ng/ml of codeine, morphine, ethylmorphine and oxymorphone glucuronides in urine at RT for LC-MS-analysis

On-site quantitation of morphine in urine by fast derivatization and miniature mass spectrometry analysis

Analysis of drugs in urine is particularly useful for screening of public safety issues, monitoring of medicine appliance and detection of drugs of abuse. Tandem mass spectrometry (MS/MS) of morphine usually produces clusters of fragments, hindering accurate quantitation of morphine in biological samples by fast sampling and direct MS/MS method. In this work, we developed a method that enabled determination and quantitation of morphine in urine in 3 min. It consisted of a simple extraction process, a fast dansyl-derivatization process, and direct analysis by a miniature mass spectrometer. MS/MS of derivatized morphine produced a highly abundant product at m/z 285 in positive ion mode, significantly enhancing the sensitivity by more than 10 times. Quantitation of morphine in urine was achieved by in-trap collision-induced dissociation on the miniature mass spectrometer, with the limit of detection of 50 ng/mL and the limit of quantitation of 100 ng/mL. The performance of the method was also evaluated with a standard liquid chromatography-MS method, showing comparable quantitative accuracy. Finally, the method has applied into quantitation of morphine in real urine samples from individuals suspected to have used opioids.

Laser meridian massage decreased craving in men with opioid use disorder on methadone maintenance treatment

BackgroundThe incidence of opioid use disorder (OUD) is increasing worldwide, and the opioid-related overdose crisis is currently a major global challenge. This study investigated the effects of adjuvant laser meridian massage (LMM) in men with OUD undergoing methadone maintenance treatment (MMT). MethodsA case-controlled study was conducted from February 2019 to April 2020. Fourteen men with OUD on MMT were enrolled from an addiction treatment center as an experimental group. An age-matched control group comprising 13 men was also enrolled. The experimental group received LMM on the back, including over the Bladder meridian and Governor Vessel, three times weekly for 4 weeks. The control group received only MMT. Urinary morphine levels, patients’ self-reports of the number of episodes or days of heroin use, and visual analog scale scores for heroin craving/refusal to use heroin during the previous week were evaluated. Quality of life was reported using the Short Form (SF)-12v2. ResultsThe experimental group showed a significant decrease in heroin use (p < 0.05), whereas the control group showed a significant increase in heroin craving (p < 0.05). The SF-12v2 Health Survey revealed a significant improvement in physical health in the experimental group (P < 0.05). ConclusionThe results of this study suggest that laser meridian massage can be considered a safe, well-tolerated, and potentially useful adjuvant intervention for opioid use disorder.

Qualitative and quantitative analysis of opiate and related metabolites in human urine samples by UPLC-MS/MS

Although opioids such as morphine are regarded as essential drugs for clinical pain treatment, they are forbidden in athletic events. To maintain the fairness of the competition, rapid detection and quantitative analysis methods are employed. The present study developed a sensitive and robust LC-MS/MS method for the simultaneous quantification of morphine, codeine, and active metabolites, including morphine 3β-glucuronide, morphine 6β-glucuronide, codeine 6β-glucuronide. With a methanol/0.1% formic acid gradient, morphine, codeine, and metabolites were separated on an F5 column. We detected all compounds by multiple reaction mode (MRM) in the positive mode. In addition, the method had a range of reliable concentration-responses of 1.25–100 ng/mL (r2 > 0.995) for morphine, codeine, and metabolites in urine. The selectivity of the method was established in six different human subjects. For accuracy and precision, they were within 15% of the nominal values. There was no carryover, and the matrix effect was within the allowable range. The average storage stability at Low, Mid, and High QC levels met the requirements, respectively. The assay fulfilled all predefined acceptance criteria. A specific, stable, and precise LC-MS/MS method has been validated for morphine, codeine, and active metabolite quantification in human urine. Moreover, this straightforward method is reproducible and robust to support future morphine, codeine, active metabolite-related pharmacokinetics, bioequivalence, and clinical studies.

Add-on repetitive transcranial magnetic stimulation in patients with opioid use disorder undergoing methadone maintenance therapy

ABSTRACT Background: Repetitive transcranial magnetic stimulation (rTMS) shows potential therapeutic effects for individuals with addiction, but few studies have examined individuals with opioid use disorder (OUD). Objectives: We conducted an add-on double-blinded, sham-controlled rTMS feasibility pilot trial to examine OUD participants undergoing methadone maintenance therapy (MMT). The current report focused on the effects of rTMS on (1) craving and heroin use behavior and (2) depression, impulsivity, and attention. Methods: Active or sham rTMS treatment was applied to the left dorsolateral prefrontal cortex (DLPFC) over a total of 11 sessions in 4 weeks (15-Hz frequency, 4 seconds per train, intertrain interval of 26 seconds, 40 trains per session) in OUD participants (ClinicalTrials.gov registration number: NCT03229642). Craving, heroin use severity, urine morphine tests, the Hamilton Depression Rating Scale (HDRS), the Barratt Impulsiveness Scale-11 (BIS-11), and the Continuous Performance Tests (CPTs) were measured. Results: Twenty-two OUD participants were enrolled, of which eleven (8 males) were undergoing active rTMS and nine (8 males) were in the sham rTMS group. After 12 weeks of follow-up, the active rTMS group did not show significantly greater improvements than the sham group with respect to craving, heroin use, or urine morphine test results. However, HDRS scores, BIS-11 attentional subscales, and CPTs commission T-scores (C-TS) were significantly lower in the active rTMS group (P = .003, 0.04, and 0.02, respectively) than in the sham group. Conclusion: Add-on rTMS did not appear to improve heroin use behavior but may have benefitted depressive symptoms, impulse control and attention in OUD participants undergoing MMT.

HIV and HCV infection status and related risk factors in drug users at the Sino-Vietnamese border in Guangxi, 2012 — 2019

Objective To understand the prevalence rates and the related risk factors of HIV, HCV and HIV/HCV coinfection in drug users in the Sino-Vietnamese border areas of Guangxi, and we provide reference for high-risk intervention in this population. Methods From April to June every year from 2012 to 2019, a questionnaire developed by the state was used to carry out continuous cross-sectional surveys on the post surveillance sites in Guangxi border areas, community drug addicts and morphine urine test positive persons in methadone clinics in the past month, and blood samples were taken from them for the detections of HIV and hepatitis C virus (HCV) antibodies. Results A total of 12 842 drug users were monitored from 2012 to 2019. The overall positive rates of HIV, HCV and HIV/HCV co-infection were 3.84%, 43.34% and 3.14%, respectively. HIV, HCV and HIV/HCV co-infection rates showed an decrease trend year by year. The prevalence differed in drug users with different demographic characteristics. Logistic regression analysis showed that HIV infection related risk factors included being female, primary education and injecting drug use. HCV infection related risk factors included 20 years old or more, divorced or widowed, minorities other than Han and Zhuang, being traditional drug user or mixed drug user, and injecting drug use. HIV/HCV co-infection related risk factors included being female, primary education and injecting drug use. Conclusion The HIV infection rate and HCV antibody positive rate in drug users in border areas of Guangxi were relatively high, and the infection rate of HIV/HCV combined infection were low. The use of novel type drugs was in increase. Targeted effective interventions should be conducted in female and older drug users as well as drug users having a history of injection drug use. 摘要:目的 了解广西中越边境地区吸毒人群中HIV、丙肝病毒(HCV)及HIV/HCV合并感染情况及其影响因素, 为在该人群中开展髙危行为干预提供参考依据。 方法 2012—2019年间每年4一6月, 采用国家统一制定的问卷对广 西中越边境哨点监管场所、社区和美沙酮门诊最近1个月吗啡尿检阳性者开展连续横断面调査, 并采集调査对象血液 标本进行HIV和HCV抗体检测。 结果 2012—2019年共监测12 842名毒品使用者。HIV感染率为3.84%, HCV抗体 阳性率为43.34%, HIV/HCV合并感染率为3.14%。HIV、HCV及HIV/HCV合并感染率整体上呈逐年下降的趋势。不同 行为特征的吸毒人群感染情况不同。Logistic回归分析显示, 女性、小学学历、有注射吸毒史是感染HIV的危险因素。年龄>20岁、离异或丧偶、除汉族和壮族外的其他少数民族、传统毒品和混合毒品使用者、有注射毒品史是感染HCV的 危险因素。而女性、小学文化、有注射毒品史是HIV/HCV合并感染的危险因素。 结论 广西边境吸毒人群整体HIV感 染率和HCV抗体阳性率较髙, HIV/HCV合并感染率较低, 新型毒品使用者比例呈上升趋势。提示需针对女性、髙年龄 组及有注射吸毒史的吸毒人群开展有效干预措施。

Simultaneous determination of four opioids in urine by solid-phase extraction and derivatization coupled with gas chromatography-mass spectrometry

Police officers currently use the colloidal gold rapid testing method to detect heroin in the urine of drug abusers, but the results are often rendered erroneous due to the presence of antitussive drugs, which contain opioids. The traditional manual liquid-liquid extraction method for urine testing has low efficiency and poor sensitivity, and hence, it fails to meet the requirements of the public security department to crack down on drug abusers. Therefore, to avoid punishment, most rapid-test-positive people make false claims about intaking cough suppressants. It is imperative to establish a highly efficient automatic method for the simultaneous determination of multiple opioids in urine, to rule out the use of heroin. A method based on solid-phase extraction and derivatization coupled with gas chromatography-mass spectrometry (GC-MS) has been developed for the simultaneous detection of morphine, O6-acetylmorphine, codeine, and acetyl codeine in urine. Since these four opioids exists as cations in acidic aqueous solution, the urine samples collected from dead bodies or drug addicts were adjusted to pH 6 by using phosphate buffer, enriched, and purified by MCX-SPE columns. Then, morphine, O6-acetylmorphine, and codeine were derivatized by N-methyl-N-(trimethylsilyl) trifluoroacetamide (MSTFA) for GC-MS testing. The effects of sample loading and elution flow rate, percentage of formic acid in the wash solvent (methanol), percentage of ammonia in the eluent (methanol), volume of the wash solvent, and drying time of the cartridge on the extraction efficiency were investigated in detail. The best results were obtained under the following conditions:sample loading and elution flow rate, 1.0 mL/min; volume fraction of formic acid in the wash solvent, 3%; volume fraction of ammonia in the eluent solvent, 5%; volume of 3% (v/v) formic acid in methanol (eluent), 1 mL; and drying time of the cartridge, 1 min. The GC-MS results showed good linearity in the range of 0.02-0.8 μg/mL with correlation coefficients (r2) ≥ 0.998. The limits of detection (LODs) and limits of quantification (LOQs) were 0.0016-0.0039 μg/mL and 0.0054-0.0128 μg/mL, respectively. The recoveries of the target analytes were between 93.0% and 110.3% at spiked levels of 0.02, 0.1, and 0.2 μg/mL. As opposed to similar reported methods, our method showed high sensitivity and recovery; furthermore, the matrix interference was eliminated, and the chromatographic peaks of the analytes were completely separated from the impurity peaks at the level of 0.2 μg/mL. The automatic solid-phase extraction equipment is convenient to operate and allows one to process samples in batches. The conditions for solid-phase extraction can be precisely controlled, and the detection accuracy is greatly improved. In addition, a large number of sample tests can be performed by a few experimenters. Hence, this method facilitates simple and rapid forensic toxicology testing and drug abuse monitoring on a large scale.

Determination of codeine, morphine and 6-acetylmorphine in urine

A simple yet effective GC/MS protocol was developed and evaluated for the determination of free codeine, free morphine, 6-acetylmorphine, total codeine and total morphine in urine. Optimal recovery was achieved with extraction conducted at pH 9.0. Trimethylsilyl-derivatives of these analytes and the internal standard (nalorphine) were found adequately stable for a 72-hour period. Quantitative determination of the analytes was performed by selective ion monitoring. Excellent linearity was observed over the 50-1000 ng/mL concentration range studied. The intraday and interday precisions range from 0.47 to 7.72% for codeine, 0.31 to 8.09% for morphine and 0.49 to 6.15% for 6-acetylmorphine. The overall recoveries for codeine, morphine and 6-acetylmorphine were found to be 98.3%, 76.7% and 85.6% respectively.