Urine Drug Test Results Research Articles

Psychiatric Disorders, Drug Use, and Medical Status in Injection Drug Users With HIV Disease

The authors reviewed records of 84 HIV‐infected methadone‐ maintenance treatment (MMT) patients for psychiatric disorders, HIV disease status, and urine drug‐test results. Sixty‐six patients (79%) required psychiatric consultation (P+). Their diagnoses are presented. P+ patients and patients not requiring consultation (P−) were compared for drug abuse, HIV status, and zidovudine (AZT) treatment while in MMT. P+ patients had a higher rate of drug‐positive urine tests than P− patients, were more likely to have progressed to AIDS, and were less likely to have AZT prescribed. Among injection drug users in MMT, current psychiatric comorbidity is common and may be associated with worsened drug‐abuse treatment and HIV disease outcome. (American Journal on Addictions 1996; 5:249–258)

Enantiomeric composition of amphetamine and methamphetamine derived from the precursor compound famprofazone

Fourteen different metabolic precursors of amphetamine or methamphetamine have previously been identified. Many of these drugs are available only by prescription and several are only available in some parts of the world and not in others. One of these drugs, famprofazone, is available over-the-counter which complicates the interpretation of methamphetamine urine drug testing results. To assist in the interpretation of typical laboratory results, a study was conducted to determine the enantiomeric composition of the methamphetamine and amphetamine produced from the metabolism of famprofazone. Fifty mg of famprofazone was administered to a volunteer followed by collection of urine for the next 6 days. The resulting quantity, enantiomeric composition and percent conversion from famprofazone to the product amphetamine and methamphetamine was determined. The results showed the amphetamine and methamphetamine to include both the d- and l-enantiomers. Percent conversion and peak concentrations were similar to those reported in previous studies.

Hepatitis B in a Prenatal Population-Reply

In Reply. —We appreciate the interest by Dankner et al in our article. We agree that a full understanding of a community's baseline prevalence of any disease state is important before instituting general screening programs. A few points, however, bear further clarification. While it is true that based on our findings we proposed that empirical neonatal HBV prophylaxis be considered further, the recommendations were restricted to infants born to unregistered women with positive urine drug test results, not all women without prenatal care. Dankner et al do not mention finding any correlation between positive maternal HBsAg status and positive urine drug test results among the women they studied at their center. Dinsmoor and Gibbs1also showed a lower prevalence of asymptomatic HBV infection among pregnant Hispanic women in San Antonio, Tex, compared with non-Hispanic women, yet concluded that routine HBsAg screening in these women was still warranted because it

Hepatitis B in a Prenatal Population

<h3>To the Editor.</h3> —We read with interest the article by Silverman et al¹in the November 27, 1991, issue of<i>JAMA</i>. The authors found a high rate of hepatitis B surface antigen (HBsAg) positivity (6.7%) among their unregistered prenatal population. Positivity was highly correlated with positive urine drug test results. They recommended initiating hepatitis B virus (HBV) prophylaxis to neonates born of unregistered mothers, especially those with positive drug-test results. At the University of California San Diego Medical Center, with an average of about of 4000 deliveries per year, 25% to 30% of women present with no prenatal care. Included in the battery of tests for these women are HBsAg and urine drug screening. In order to compare our population with that of Silverman et al, we reviewed similar demographic, laboratory, and clinical data from our unregistered patients for one calendar year. In 1990 there were 3981 deliveries of

On the Dermal Absorption of Cocaine

A 5-mg dose of cocaine free base applied to the volar forearm skin surface of a volunteer resulted in a maximal urinary benzoylecgonine concentration of 55 ng/mL at 48 h, using discrete urine specimens. A total of 58 micrograms of benzoylecgonine, representing 1.2% of the dose, was excreted in the 96-h urine. An identical trial using 5 mg of cocaine hydrochloride resulted in a maximal urinary benzoylecgonine concentration of 15 ng/mL at 24 h. We conclude that dermal absorption of cocaine represents a minor, but significant route of exposure to this drug that needs to be considered when interpreting low-level urine drug testing results.