Development and validation of a liquid chromatography–tandem mass spectrometry (LC–MS/MS) method including 25 novel synthetic opioids in hair and subsequent analysis of a Swiss opioid consumer cohort

• Published in: Drug testing and analysis Vol. 16; no. 11; pp. 1384 - 1391
• Main Authors: Polke, Max, Concheiro, Marta, Cooper, Gail, Bogdal, Christian, Baumgartner, Markus R., Krämer, Thomas, Binz, Tina M.
• Format: Journal Article
• Language: English
• Published: England 01.11.2024
• Subjects: fentanyl; hair analysis; LC–MS/MS; NSOs; Switzerland; hair analysis; LC-MS/MS; NSOs; Switzerland; fentanyl
• ISSN: 1942-7603; 1942-7611
• DOI: 10.1002/dta.3663

Major public health concern is raised by the evidence that common drugs like heroin are now frequently laced or replaced with highly potent novel synthetic opioids (NSOs). The objective of this study was to explore the prevalence and patterns of NSOs in a cohort of Swiss opioid users by hair analysis. Hair analysis is considered an ideal tool for retrospective consumption monitoring. Hair samples from 439 opioid users in Zurich were analyzed. Study inclusion required a previous positive hair test result for heroin metabolites, oxycodone, fentanyl, methadone, or tramadol. The samples were extracted with a two‐step extraction procedure, followed by a targeted LC–MS/MS (QTRAP® 6500+) analysis in multiple reaction monitoring mode for a total of 25 NSOs. The method underwent full validation and demonstrated good selectivity and sensitivity with limits of detection (LOD) as low as 0.1 pg/mg. The analyzed sample cohort demonstrated a positivity rate for NSOs of 2.5%, including the following NSOs: butyrylfentanyl, acrylfentanyl, furanylfentanyl, methoxyacetylfentanyl, ocfentanil, U‐47700, isobutyrylfentanyl and benzylfentanyl. Furthermore, we were able to identify specific consumption patterns among drug users. The results indicate that hair analysis is a valuable tool for investigating the prevalence of NSOs in drug‐using populations, which seems to be low in the case of Swiss opioid users. Nevertheless, the results highlight the need for sensitive analytical detection methods in forensic toxicology to identify and monitor substance distribution in different populations. This study investigated the prevalence and abuse patterns of novel synthetic opioids (NSOs) among Swiss opioid users by means of a validated LC–MS/MS‐based hair analysis method. Among a cohort of 439 Swiss opioid users, a positivity rate for NSOs of 2.5% was found, including NSOs such as butyrylfentanyl or acrylfentanyl. These findings contribute to the development of appropriate public health and policy measures to mitigate the risks associated with NSO abuse.