Cocaine and opiate concentrations in hair from subjects in a heroin maintenance program in comparison to a methadone substituted group

• Published in: International journal of legal medicine Vol. 123; no. 5; pp. 363 - 369
• Main Authors: Musshoff, Frank, Lachenmeier, Katrin, Lichtermann, Dirk, Madea, Burkhard
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.09.2009; Springer Nature B.V
• Subjects: Cocaine - analogs & derivatives; Cocaine - analysis; Codeine - analogs & derivatives; Codeine - analysis; Dopamine Uptake Inhibitors - analysis; Forensic Medicine; Gas Chromatography-Mass Spectrometry; Hair - chemistry; Heroin - therapeutic use; Heroin Dependence - rehabilitation; Humans; Linear Models; Medical Law; Medicine; Medicine & Public Health; Methadone - therapeutic use; Narcotics - analysis; Narcotics - therapeutic use; Original Article; Substance Abuse Detection; Opiates; Hair analysis; Acetylcodeine; Heroin maintenance program; GC/MS
• ISSN: 0937-9827; 1437-1596; 1437-1596
• DOI: 10.1007/s00414-008-0272-0

One month before (T-1) and 12 months after (T12) controlled i.v. administration of pharmaceutical heroin–HCl (10–100 mg/day) in the context of a heroin maintenance program (HMP), concentrations of opiates and cocaine as well as its metabolites were determined in head hair ( n  = 46) using a validated gas chromatographic–mass spectrometric method. In addition, a patient collective of a methadone maintenance program (MMP, daily doses 15–260 mg) was examined ( n  = 35). The incidence of additional cocaine consumption decreased in both groups during the study period (T-1 to T12): in HMP from 64.6% to 45.8% and in MMP from 71.4% to 60.0%. A significant reduction of cocaine consumption was defined as an at least 30% reduction of analyte concentrations in hair (Δ c  > 30%). Accordingly, in HMP, a decrease in 45.8% of initially (T-1) cocaine-positive patients was determined; in MMP, the reduction was 48.6%. In 22.9% of HMP and 37.1% of MMP, an increase of cocaine concentrations was detected. Codeine and acetylcodeine were found in 50.0% and 43.5% (T-1) and 13.0% and 10.9% (T12) of the samples of the HMP, as well as in 45.7% and 25.7% (T-1) and 17.1% and 5.7% (T12) in MMP, respectively. The missing of acetylcodeine, in particular at T-1, questions its applicability as a characteristic marker of a preceding consumption of illicit heroin in hair analysis.