Detection of Acetylcodeine in Urine as an Indicator of Illicit Heroin Use: Method Validation and Results of a Pilot Study

• Published in: Clinical chemistry (Baltimore, Md.) Vol. 47; no. 2; pp. 301 - 307
• Main Authors: Staub, Christian, Marset, Miguel, Mino, Annie, Mangin, Patrice
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Washington, DC Am Assoc Clin Chem 01.02.2001; American Association for Clinical Chemistry
• Subjects: Analysis; Biological and medical sciences; Biomarkers - urine; Codeine - analogs & derivatives; Codeine - urine; Drug addictions; Gas Chromatography-Mass Spectrometry; General pharmacology; Heroin Dependence - urine; Humans; Immunoassay; Medical sciences; Pharmacology. Drug treatments; Reproducibility of Results; Substance Abuse Detection - methods; Toxicology; Consumption; Human; Urine; Validation; Biochemical analysis; Morphine derivatives; Illicit drug; Coupled method; Codeine(acetyl); Biological indicator; Differential diagnostic; Gas chromatography; Chemotherapy; Treatment; Morphine(6-monoacetyl); Clinical biology; Analytical method; Drug of abuse; Diagnosis; Mass spectrometry; Heroin
• ISSN: 0009-9147; 1530-8561
• DOI: 10.1093/clinchem/47.2.301

Background: Acetylcodeine (AC), an impurity of illicit heroin synthesis, has been suggested as an interesting biomarker of illicit heroin use. Methods: Procedures were developed for quantification of (a) morphine, 6-monoacetylmorphine (6-AM), and codeine in urine and (b) diacetylmorphine and AC in urine. Solid-phase extraction of the analytes was performed, and the extracted analytes were analyzed by selected-ion monitoring with gas chromatography–mass spectrometry. This procedure required prior derivatization with propionic anhydride. Results: Different validation parameters were determined, such as linearity, reproducibility, extraction recoveries, and cutoffs. Seventy-one urine specimens of illicit heroin abusers and 44 urine specimens of subjects in a heroin maintenance program were analyzed. AC was detected in 85.9% of the samples of the first group but not in any of the samples from subjects taking medical heroin. In the two groups, there were 94.4% and 84.1% 6-AM positive urine specimens, respectively. Detection times were determined for AC and codeine by parallel administration of heroin containing various percentages of AC to four voluntary patients in a heroin maintenance program. The measured detection times were 8 and 23 h for AC and codeine, respectively. Conclusions: These results indicate that, together with detection of 6-AM in urine, AC is a suitable marker of illicit heroin use.