SOFT/TIAFT 98 - A Practical Approach for Identifying Opiate Users in Workplace Drug Testing ...

SOFT - TIAFT 1998

Scientific Session 2

Wednesday October 7, 1998

A PRACTICAL APPROACH FOR IDENTIFYING OPIATE USERS IN WORKPLACE DRUG TESTING PROGRAMS WITH SIMULTANEOUS DETECTION OF CODEINE, MORPHINE, AND 6-ACETYLMORPHINE IN URINE
	Buddha D. Paul, Eric T. Shimomura, and Michael L. Smith Division of Forensic Toxicology, Office of the Armed Forces Medical Examiner, Armed Forces Institute of Pathology, Rockville, MD 20850, USA

Proposed Department of Health and Human Services guidelines require opiates to be tested for total-codeine and total-morphine at cutoff concentrations of 2000 ng/mL, followed by 6-acetylmorphine (6-AM) at a cutoff concentration of 10 ng/mL. We recommend tests for free-codeine, free-morphine, and 6-AM at cutoff concentrations of 100, 100, and 10 ng/mL, respectively. For identifying heroin users, 6-AM at a cutoff concentration of 10 ng/mL correlates better with free morphine at a cutoff concentration of 100 ng/mL than with total-morphine at cutoff concentrations 300, 2000, or 4000 ng/mL (Table).

Drug	Cutoff ng/mL	Drug > cutoff 6-AM > 10 ng/mL	Drug < cutoff 6-AM > 10 ng/mL	Drug > cutoff 6-AM, ng/mL 0.1-9.9
Total-morphine	4000	7	9	1	0
Total-morphine	2000	10	6	3	3
Total-morphine	300	16	0	8	30
Free-morphine	100	16	0	6	3

Number of positive urine specimens from heroin users (n = 54).

Additional results indicated that the recommended cutoff concentrations for free-codeine, free-morphine, and 6-AM produce fewer false positive and false negative results than the other cutoff concentrations. The compounds can all be measured in one confirmation method using solid-phase extraction and pentafluoropropionic anhydride derivatization followed by GC-MS SIM analysis. Quantitations were linear from 6-1000 ng/mL for codeine, 5-5000 ng/mL for morphine, and 0.5-800 ng/mL for 6-AM. Recoveries were >90%.

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