Monitoring pregnant women's illicit opiate and cocaine use with sweat testing.

Abstract

Dependence on illicit drugs during pregnancy is a major public health concern as there may be associated adverse maternal, fetal, and neonatal consequences. Sweat patches (n = 389) were collected from 39 pregnant volunteers who provided written informed consent for this Institutional Review Board-approved protocol and wore patches, replaced approximately weekly, from study entry until delivery. Patches were analyzed for opiates (heroin, 6-acetylmorphine, 6-acetylcodeine, morphine and codeine) and cocaine (cocaine, benzoylecgonine, ecgonine methyl ester, anhydroecgonine methyl ester) by solid phase extraction and gas chromatography mass spectrometry. Seventy-one percent (276) of collected sweat patches were > or =5 ng per patch (limit of quantification) for one or more analytes. Cocaine was present in 254 (65.3%) patches in concentrations ranging from 5.2 to 11,835 ng per patch with 154 of these high enough to satisfy the proposed Substance Abuse and Mental Health Services Administration guidelines for a confirmatory drug test (25 ng per patch). Interestingly, 6-acetylmorphine was the most prominent opiate analyte documented in 134 patches (34.4%) with 11.3% exceeding the proposed opiate Substance Abuse and Mental Health Services Administration cut-off (25 ng per patch). Heroin was identified in fewer patches (77), but in a similar concentration range (5.3-345.4 ng per patch). Polydrug use was evident by the presence of both cocaine and opiate metabolites in 136 (35.0%) patches. Sweat testing is an effective method for monitoring abstinence or illicit drug use relapse in this high-risk population of pregnant opiate- and/or cocaine-dependent women.

• Authors: Bertrand R Brunet, Allan J Barnes, Robin E Choo, Patrick Mura, Hendre E E Jones, Marilyn A Huestis
• Journal: Therapeutic drug monitoring (Ther Drug Monit) Vol. 32 Issue 1 Pg. 40-9 (Feb 2010) ISSN: 1536-3694 [Electronic] United States
• PMID: 19927046 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, N.I.H., Intramural)

Chemical References

• Illicit Drugs

Topics

• Adult
• Cocaine-Related Disorders (complications, diagnosis)
• Female
• Gas Chromatography-Mass Spectrometry (methods)
• Heroin Dependence (complications, diagnosis)
• Humans
• Illicit Drugs (adverse effects, pharmacokinetics)
• Opioid-Related Disorders (complications, diagnosis)
• Pregnancy
• Pregnancy Complications (diagnosis)
• Solid Phase Extraction (methods)
• Substance Abuse Detection (methods)
• Sweat (chemistry)
• Young Adult