Nails (fingernails and toenails) are made of keratin. As the nail grows, substances incorporate into the keratin fibers where they can be detected 3-6 months after use. Samples are collected by clipping of 2-3 mm of nail from all fingers (100 mg). We present drug testing results from 10,349 nail samples collected from high-risk cases during a 3-year period of time. Samples were analyzed by validated analytical methods. The initial testing was performed mostly using enzyme-linked immunosorbent assay, but by liquid chromatography-tandem mass spectrometry (LC-MS-MS) as well. Presumptive positive samples were subjected to confirmatory testing with sample preparation procedures including washing, pulverizing, digestion and extraction optimized for each drug class.
The total of 7,799 samples was analyzed for amphetamines. The concentrations ranged from 40 to 572,865 pg/mg (median, 100-3,687) for all amphetamine analytes.
- Amphetamine and methamphetamine were present in 14% of the samples,
- 22 samples were positive for 3,4-methylenedioxymethamphetamine (0.3%),
- 7 for methylenedioxyamphetamine (0.09%)
- and 4 for 3,4-methylenedioxy-N-ethylamphetamine (0.05%).
- Cocaine and related analytes were found in 5% samples (7,787 total), and the concentration range was 20-265,063 pg/mg (median 84-1,768).
- Opioids overall ranged from 40 to 118,229 pg/mg (median 123-830).
- The most prevalent opioid was oxycodone (15.1%) and hydrocodone (11.4%)
- compared with 1.0-3.6% for the others, including morphine, codeine, hydromorphone, methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine and oxymorphone.
- Carboxy-Δ-9-tetrahydrocannabinol positivity rate was 18.1% (0.04-262 pg/mg, median 6.41).
- Out of 3,039 samples, 756 were positive (24.9%) for ethyl glucuronide (20-3,754 pg/mg, median 88).
- Other drugs found in nails included barbiturates, benzodiazepines, ketamine, meperidine, tramadol, zolpidem, propoxyphene, naltrexone and buprenorphine.
Nail analyses have become a reliable way of determining the long-term use and abuse of drugs. Extraction techniques are simple and produce accurate and precise results. Sensitive analytical instrumentation, mainly LC-MS-MS, allows for detection of femtogram (10(-15) g) quantities of substances in nails. Samples were from a high-risk population, therefore the extraordinary positivity rate was observed.
Via: http://ht.ly/SsNUz
By: Shu I1, Jones J1, Jones M1, Lewis D1, Negrusz A2.
- 1United States Drug Testing Laboratories, Inc., 1700 South Mount Prospect Road, Des Plaines, IL 60017, USA.
- 2United States Drug Testing Laboratories, Inc., 1700 South Mount Prospect Road, Des Plaines, IL 60017, USA
Below: Conceptual Framework for Categorizing Twitter Messages Containing Personal Experiences and General Perceptions
Below: Author of Twitter Messages (individuals, organizations, news outlets, other (user name contained search terms, foreign languages, references to non-opioids)
We reviewed 540 messages, of which 375 (69%) messages were related to opioid behaviors. Of these, 316 (84%) originated from individual user accounts; 125 messages expressed personal experience with opioids. The majority of personal messages referenced using opioids to obtain a “high”, use for sleep, or other non-intended use (87,70%). General attitudes regarding opioid use included positive sentiment (52, 27%), comments on others peoples opioid use (57, 30%), and messages containing public health information or links (48, 25%).
In a sample of social media messages mentioning opioid medications, the most common theme amongst English users related to various forms of opioid misuse. Social media can provide insights into the types of misuse of opioids that might aid public health efforts to reduce non-medical opioid use.
Read more at: http://goo.gl/ngfokf HT @UCSF
