Prevalence of heroin markers in urine for pain management patients

Julie Knight, Brandi L. Puet, Anne DePriest, Rebecca Heltsley, Cheryl Hild, David L. Black, Timothy Robert, Yale H. Caplan, Edward J. Cone

Research output: Contribution to journalArticle

Abstract

Surveys of current trends indicate heroin abuse is associated with nonmedical use of pain relievers. Consequently, there is an interest in evaluating the presence of heroin-specific markers in chronic pain patients who are prescribed controlled substances. A total of 926,084 urine specimens from chronic pain patients were tested for heroin/diacetylmorphine (DAM), 6-acetylmorphine (6AM), 6-acetylcodeine (6AC), codeine (COD), and morphine (MOR). Heroin and markers were analyzed using liquid chromatography tandem mass spectrometry (LC-MS-MS). Opiates were analyzed following hydrolysis using LC-MS-MS. The prevalence of heroin use was 0.31%, as 2871 were positive for one or more heroin-specific markers including DAM, 6AM, or 6AC (a known contaminant of illicit heroin). Of these, 1884 were additionally tested for the following markers of illicit drug use: 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), methamphetamine (MAMP), 11-nor-9-carboxy-δ9-tetracannabinol (THCCOOH), and benzoylecgonine (BZE); 654 (34.7%) had positive findings for one or more of these analytes. The overall prevalence of heroin markers were as follows: DAM 1203 (41.9%), 6AM 2570 (89.5%), 6AC 1082 (37.7%). MOR was present in 2194 (76.4%) and absent (

Original languageEnglish (US)
Pages (from-to)79-83
Number of pages5
JournalForensic Science International
Volume243
DOIs
StatePublished - 2014

Fingerprint

Heroin
Pain Management
Urine
Chronic Pain
Morphine
Opiate Alkaloids
3,4-Methylenedioxyamphetamine
Controlled Substances
Heroin Dependence
N-Methyl-3,4-methylenedioxyamphetamine
Codeine
Methamphetamine
Street Drugs
Tandem Mass Spectrometry
Liquid Chromatography
Hydrolysis
Pain

Keywords

  • 6AM
  • Compliance monitoring
  • Heroin
  • Pain management
  • Urine drug testing

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medicine(all)

Cite this

Knight, J., Puet, B. L., DePriest, A., Heltsley, R., Hild, C., Black, D. L., ... Cone, E. J. (2014). Prevalence of heroin markers in urine for pain management patients. Forensic Science International, 243, 79-83. https://doi.org/10.1016/j.forsciint.2014.04.037

Prevalence of heroin markers in urine for pain management patients. / Knight, Julie; Puet, Brandi L.; DePriest, Anne; Heltsley, Rebecca; Hild, Cheryl; Black, David L.; Robert, Timothy; Caplan, Yale H.; Cone, Edward J.

In: Forensic Science International, Vol. 243, 2014, p. 79-83.

Research output: Contribution to journalArticle

Knight, J, Puet, BL, DePriest, A, Heltsley, R, Hild, C, Black, DL, Robert, T, Caplan, YH & Cone, EJ 2014, 'Prevalence of heroin markers in urine for pain management patients', Forensic Science International, vol. 243, pp. 79-83. https://doi.org/10.1016/j.forsciint.2014.04.037
Knight, Julie ; Puet, Brandi L. ; DePriest, Anne ; Heltsley, Rebecca ; Hild, Cheryl ; Black, David L. ; Robert, Timothy ; Caplan, Yale H. ; Cone, Edward J. / Prevalence of heroin markers in urine for pain management patients. In: Forensic Science International. 2014 ; Vol. 243. pp. 79-83.
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