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: 2.86). 06/2010; 34(5):233-7. DOI: 10.1093/jat/34.5.233
Source: PubMed


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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Available from: Göran Palmskog, Nov 27, 2015
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    • "Interestingly, exhaled breath has become an emerging alternative matrix also for drug testing in recent time. It was first demonstrated that amphetamine could be detected in exhaled breath [7]. Subsequently, a number of other drugs of abuse substances have been found to be detectable in collected exhaled breath [8] [9] [10] [11] [12] [13] [14] [15] [16]. "
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    ABSTRACT: A mass spectrometric method for drugs of abuse testing in exhaled breath employing a sampling device collecting aerosol particles was developed and applied in routine use. Analytes covered were amphetamine, methamphetamine, 6-acetylmorphine, morphine, cocaine, benzoylecgonine, diazepam, oxazepam and tetrahydrocannabinol. The method involved eluting drugs from the collection filter with methanol, quantification using deuterated analogs as internal standards, reversed phase chromatography with gradient elution, positive electrospray ionization and monitoring of two product ions per analyte in selected reaction monitoring mode. The measuring range was 6.0-1000pg/filter. The intra- and inter-assay imprecision expressed as the coefficient of variation was less than 7%. Influence from matrix was noted for most compounds but was compensated for the use of co-eluting internal standards. The LLOQ was 6.0pg/filter with intra-assay CV <5% and accuracy within 99-102% for all analytes. No chromatographic interference was observed in 20 negative control samples. The LC-MS/MS method was successfully applied for measuring drugs in unknown samples collected for the purpose of drug testing. Among the 1096 analyzed samples analytical findings were made in breath in 39 cases (3.6%). Most frequently found substances were the following: amphetamine (25 cases) methamphetamine (10 cases), THC (8 cases), cocaine (4 cases), benzoylecgonine (2 cases) and diazepam (2 cases). In conclusion, a fully validated and robust screening method suitable for the routine measurement of drugs of abuse in exhaled breath with a simple procedure for specimen collection and sample preparation was successfully developed. Copyright © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Feb 2015 · Journal of Chromatography B
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    • "The discovery that amphetamine, methadone and tetrahydrocannabinol are readily detectable in exhaled 3 Author to whom any correspondence should be addressed. breath following intake has triggered further development of this matrix for drug testing [1] [2] [3]. For a long time, urine has been the principle specimen for drug testing, with important clinical and forensic applications [4] [5]. "
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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.
    Full-text · Article · Apr 2013 · Journal of Breath Research
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    ABSTRACT: Blood, oral fluid (saliva), urine and hair are the most commonly used biological matrices for drug testing in epidemiological drug research. Other biological matrices may also be used for selected purposes. Blood re-flects recent drug intake and may be used to assess impairment. Oral fluid reflects drug presence in blood and thereby also recent intake, but drug concentrations in this matrix cannot be used to accurately estimate con-centrations in blood. Urine reflects drug use during the last few days and in some cases for a longer period, but does not indicate the dose size or frequency of use. Hair reflects drug use during several months, but is a poor matrix for detecting use of cannabis. If using a single drug dose, this can be detected in blood and urine if the sample is taken within the detection timeframes, in most cases also in oral fluid. Single drug use is most often insufficient for producing a positive test result in a sample of hair. For cocaine and amphetamine, weekly use may be needed, while for cannabis a positive result is not guaranteed even after daily use. Refusal rates are lowest for oral fluid and highest for blood and hair samples. The analytical costs are lowest for urine and highest for hair. Combined use of questionnaires/interviews and drug testing detects more drug use than when using only one of those methods and is therefore expected to give more accurate data.
    Full-text · Article · Jan 2011 · Norsk Epidemiologi
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