Amphetamines detected in exhaled breath from drug addicts: A new possible method for drugs-of-abuse testing.

Department of Medicine, Karolinska Institutet, Stockholm, Sweden. <>
Journal of analytical toxicology (Impact Factor: 2.11). 06/2010; 34(5):233-7.
Source: PubMed

ABSTRACT Testing for drugs of abuse in sample matrices alternative to urine such as blood, sweat, and saliva have received increasing attention and is needed, for example, in traffic medicine. Human breath is known to contain a large number of substances including non-volatile molecules. We explore whether intake of amphetamines could be detected by analytical investigation of exhaled breath from drug addicts. Exhaled breath was collected from 12 drug addict patients after recovering from acute intoxication. Self-reported intake of "amphetamine" was confirmed by analysis of urine and plasma. The compounds were trapped by filtering the air through a modified silica surface and subsequently analyzed by a combined liquid chromatography-tandem mass spectrometry method. As a control, exhaled breath was collected in the same way from eight healthy volunteers. Here we report for the first time that amphetamine and methamphetamine are present in exhaled breath following ingestion of these compounds by drug addicts. Both amphetamine and methamphetamine were indisputably identified by means of the mass spectrometry technique in exhaled breath samples from all 12 patients. Identifications were based on monitoring two product ions in selected reaction monitoring mode and having correct relative ratios (+/- 20%). Excretion rates ranged from 0.2 to 139 pg/min. No amphetamine or methamphetamine was detected in the control subjects. This finding, using a yet non-validated sampling procedure, opens a new possibility for drugs-of-abuse testing. Collection of exhaled breath is likely to be more convenient and safe as compared to matrices presently in use.

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    ABSTRACT: Exhaled breath has recently been identified as a matrix for the detection of drugs of abuse. This work aims to further document this application using a new and simple collection device in patients following recovery from acute intoxication. Breath, plasma and urine samples were collected from 47 patients (38 males, age range 25-74) together with interview data. Analysis of breath and plasma samples was done by liquid chromatography-mass spectrometry methods. Urine was screened using immunochemical reagents and positive findings confirmed with liquid chromatography-mass spectrometry methods. The 12 analytes investigated were: methadone, amphetamine, methamphetamine, 6-acetylmorphine, morphine, benzoylecgonine, cocaine, diazepam, oxazepam, alprazolam, buprenorphine and tetrahydrocannabinol. In all 47 cases, recent intake of an abused substance prior to admission was reported, but in one case the substance (ketobemidone) was not investigated. In 40 of the remaining cases (87%) breath analysis gave a positive finding of any of the substances that were part of the analytical investigation. Identifications were based on correct chromatographic retention time and product ion ratios obtained in selected reaction monitoring mode. In general, data from breath, plasma, urine and self-reporting were in good agreement, but in 23% of the cases substances were detected that had not been self-reported. All substances covered were detected in a number of breath samples. Considering that breath sampling was often done about 24 h after intake, the detection rate was considered to be high for most substances. Analytes with low detection rates were benzodiazepines, and a further increase in analytical sensitivity is needed to overcome this. This study further supports use of exhaled breath as a new matrix in clinical toxicology.
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    ABSTRACT: Within the field of toxicology exhaled breath is used as specimen only for determination of alcohol. However, it was recently discovered that when using sensitive liquid chromatography-mass spectrometry (LC-MS) technique, amphetamine, methamphetamine, and methadone are detectable in exhaled breath following intake by drug addicts. We therefore undertook to develop a method for determination of methadone in exhaled breath condensate from patients undergoing methadonemaintenance treatment. Exhaled breath condensate was collected from 14 patients after intake of the daily methadone dose. The exhaled breath condensate was collected for 10 min using an Ecoscreen instrument. After extraction of any trapped methadone from the condensate by solid-phase extraction, the final extract was analyzed by a combined LC-MS-MS method. Recovery of methadone from breath condensate in the solid-phase extraction was 104%, no significant matrix effects were observed, and the quantification using methadone-d(3) as internal standard was accurate (10% bias) and precise (coefficient of variation 6.2%). Methadone was indisputably identified by means of the MS technique in exhaled breath condensate from all 14 patients. Identification was based on monitoring two product ions in selected reaction monitoring mode with correct relative ratio (± 20%) and correct retention time. Excretion rates ranged from 23.6 to 275 pg/min. No methadone was detected in five control subjects (< 2 pg/min). This finding confirms that methadone is present in exhaled breath from patients in methadone treatment. Collection of exhaled breath specimen is likely to be complementary to other matrices presently in use in testing for drugs-of-abuse.
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