High prevalence of 6-acetylmorphine in morphine-positive oral fluid specimens.
Publication/Presentation Date
4-23-2003
Abstract
Identification of 6-acetylmorphine, a specific metabolite of heroin, is considered to be definitive evidence of heroin use. Although 6-acetylmorphine has been identified in oral fluid following controlled heroin administration, no prevalence data is available for oral fluid specimens collected in the workplace. We evaluated the prevalence of positive test results for 6-acetylmorphine in 77,218 oral fluid specimens collected over a 10-month period (January-October 2001) from private workplace testing programs. Specimens were analyzed by Intercept immunoassay (cutoff concentration=30 ng/ml) and confirmed by GC-MS-MS (cutoff concentrations=30 ng/ml for morphine and codeine, and 3 ng/ml for 6-acetylmorphine). Only morphine-positive oral fluid specimens were tested by GC-MS-MS for 6-acetylmorphine. A total of 48 confirmed positive morphine results were identified. An additional 107 specimens were confirmed for codeine only. Of the 48 morphine-positive specimens, 32 (66.7%) specimens were positive for 6-acetylmorphine. Mean concentrations (+/-S.E.M.) of morphine, 6-acetylmorphine and codeine in the 32 specimens were 755+/-201, 416+/-168 and 196+/-36 ng/ml, respectively. Concentrations of 6-acetylmorphine in oral fluid ranged from 3 to 4095 ng/ml. The mean ratio (+/-S.E.M.) of 6-acetylmorphine/morphine was 0.33+/-0.06. It is suggested that, based on controlled dose studies of heroin administration, ratios >1 of 6-acetylmorphine/morphine in oral fluid are consistent with heroin use within the last hour before specimen collection. The confirmation of 6-acetylmorphine in 66.7% of morphine-positive oral fluid specimens indicates that oral fluid testing for opioids may offer advantages over urine in workplace drug testing programs and in testing drugged drivers for recent heroin use.
Volume
133
Issue
1-2
First Page
22
Last Page
25
ISSN
0379-0738
Published In/Presented At
Presley, L., Lehrer, M., Seiter, W., Hahn, D., Rowland, B., Smith, M., Kardos, K. W., Fritch, D., Salamone, S., Niedbala, R. S., & Cone, E. J. (2003). High prevalence of 6-acetylmorphine in morphine-positive oral fluid specimens. Forensic science international, 133(1-2), 22–25. https://doi.org/10.1016/s0379-0738(03)00045-8
Disciplines
Medicine and Health Sciences
PubMedID
12742685
Department(s)
Department of Pathology and Laboratory Medicine
Document Type
Article