Fentanyl as a marker of illicit drug use in morphine-positive urine specimens from workplace drug testing
Published by Oxford University Press 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US..
Total morphine is an important urinary marker of heroin use but can also be present from prescriptions or poppy seed ingestion. In specimens with morphine concentrations consistent with poppy seed ingestion (<4,000 ng/mL), 6-acetylmorphine has served as an important marker of illicit drug use. However, as illicit fentanyl has become increasingly prevalent as a contaminant in the drug supply, fentanyl might be an alternative marker of illicit opioid use instead of or in combination with 6-acetylmorphine. The aim of this study was to quantify opiates, 6-acetylmorphine, fentanyl and fentanyl analogs in 504 morphine-positive (immunoassay 2,000 ng/mL cutoff) urine specimens from workplace drug testing. Almost half (43%) of morphine-positive specimens had morphine concentrations below 4,000 ng/mL, illustrating the need for markers to differentiate illicit drug use. In these specimens, fentanyl (22% co-positivity) was more prevalent than 6-acetylmorphine (12%). Co-positivity of 6-acetylmorphine and semi-synthetic opioids increased with morphine concentration, while fentanyl prevalence did not. In 110 fentanyl-positive specimens, the median norfentanyl concentration (1,520 ng/mL) was 9.6× higher than the median fentanyl concentration (159 ng/mL), illustrating the possibility of using norfentanyl as a urinary marker of fentanyl use. The only fentanyl analog identified was para-fluorofentanyl (n = 50), with results from most specimens consistent with para-fluorofentanyl contamination in illicit fentanyl. The results confirm the use of fentanyl by employees subject to workplace drug testing and highlight the potential of fentanyl and/or norfentanyl as important markers of illicit drug use.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
|---|---|
| Enthalten in: |
Journal of analytical toxicology - 48(2024), 3 vom: 28. März, Seite 185-190 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Vikingsson, Svante [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
76I7G6D29C |
|---|
| Anmerkungen: |
Date Completed 29.03.2024 Date Revised 29.03.2024 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1093/jat/bkae003 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM367898144 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM367898144 | ||
| 003 | DE-627 | ||
| 005 | 20240330000852.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240201s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/jat/bkae003 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1355.xml |
| 035 | |a (DE-627)NLM367898144 | ||
| 035 | |a (NLM)38300512 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Vikingsson, Svante |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Fentanyl as a marker of illicit drug use in morphine-positive urine specimens from workplace drug testing |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.03.2024 | ||
| 500 | |a Date Revised 29.03.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published by Oxford University Press 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US. | ||
| 520 | |a Total morphine is an important urinary marker of heroin use but can also be present from prescriptions or poppy seed ingestion. In specimens with morphine concentrations consistent with poppy seed ingestion (<4,000 ng/mL), 6-acetylmorphine has served as an important marker of illicit drug use. However, as illicit fentanyl has become increasingly prevalent as a contaminant in the drug supply, fentanyl might be an alternative marker of illicit opioid use instead of or in combination with 6-acetylmorphine. The aim of this study was to quantify opiates, 6-acetylmorphine, fentanyl and fentanyl analogs in 504 morphine-positive (immunoassay 2,000 ng/mL cutoff) urine specimens from workplace drug testing. Almost half (43%) of morphine-positive specimens had morphine concentrations below 4,000 ng/mL, illustrating the need for markers to differentiate illicit drug use. In these specimens, fentanyl (22% co-positivity) was more prevalent than 6-acetylmorphine (12%). Co-positivity of 6-acetylmorphine and semi-synthetic opioids increased with morphine concentration, while fentanyl prevalence did not. In 110 fentanyl-positive specimens, the median norfentanyl concentration (1,520 ng/mL) was 9.6× higher than the median fentanyl concentration (159 ng/mL), illustrating the possibility of using norfentanyl as a urinary marker of fentanyl use. The only fentanyl analog identified was para-fluorofentanyl (n = 50), with results from most specimens consistent with para-fluorofentanyl contamination in illicit fentanyl. The results confirm the use of fentanyl by employees subject to workplace drug testing and highlight the potential of fentanyl and/or norfentanyl as important markers of illicit drug use | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Narcotics |2 NLM | |
| 650 | 7 | |a Morphine |2 NLM | |
| 650 | 7 | |a 76I7G6D29C |2 NLM | |
| 650 | 7 | |a Morphine Derivatives |2 NLM | |
| 650 | 7 | |a Fentanyl |2 NLM | |
| 650 | 7 | |a UF599785JZ |2 NLM | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 650 | 7 | |a Illicit Drugs |2 NLM | |
| 700 | 1 | |a Winecker, Ruth E |e verfasserin |4 aut | |
| 700 | 1 | |a Kuntz, David J |e verfasserin |4 aut | |
| 700 | 1 | |a Clark, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Jacques, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Hart, E Dale |e verfasserin |4 aut | |
| 700 | 1 | |a Hayes, Eugene D |e verfasserin |4 aut | |
| 700 | 1 | |a Flegel, Ronald R |e verfasserin |4 aut | |
| 700 | 1 | |a Davis, Lisa S |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of analytical toxicology |d 1980 |g 48(2024), 3 vom: 28. März, Seite 185-190 |w (DE-627)NLM012646741 |x 1945-2403 |7 nnns |
| 773 | 1 | 8 | |g volume:48 |g year:2024 |g number:3 |g day:28 |g month:03 |g pages:185-190 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/jat/bkae003 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 48 |j 2024 |e 3 |b 28 |c 03 |h 185-190 | ||