Simultaneous determination of opiates, methadone, amphetamines, cocaine, and metabolites in human placenta and umbilical cord by LC-MS/MS.

Anal Bioanal Chem. 2013 Feb 10;
de Castro A, Díaz A, Piñeiro B, Lendoiro E, Cruz A, López-Rivadulla M, Concheiro M

LC-MS/MS methods for the quantification of morphine, morphine-3-glucuronide, morphine-6-glucuronide, codeine, 6-acetylmorphine, cocaine, benzoylecgonine, ecgonine methyl ester, hydroxybenzoylecgonine, cocaethylene, amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), methadone, and 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine in human placenta and umbilical cord were developed and validated. Specimens (1?±?0.02 g) were homogenized with the Ultra-Turrax T8 disperser and centrifuged, and the supernatant was submitted to solid-phase extraction with Oasis MCX cartridges. Chromatographic separation was performed using an Atlantis T3 analytical column (100?×?2.1 mm, 3 ?m) and a gradient of 0.1 % formic acid and acetonitrile. Selectivity was verified in 10 different blank specimens. The method was linear from 1-5 to 100-500 ng/g, depending on the analyte. Limits of detection and quantification ranged from 0.5 to 2.5 ng/g and 1 to 5 ng/g, respectively. Method imprecision was ?15.3 %, except for MDMA at low quality control (18.1 %); accuracy, 87.1 to 114 %; extraction efficiency, 16.3 to 154.0 % (%CV?=?1.8-39.4 %); matrix effect, -75.7 to 449.9 % (%CV?=?3.5-50 %); and process efficiency, 8.7 to 316.0 %. The method was applied to authentic placenta and umbilical cord specimens from drug-user pregnant women.
HubMed – Methadone

Methadone, codeine and acute haemorrhagic necrotising pancreatitis: Which came first?

Forensic Sci Int. 2013 Feb 7;
Tormey WP, Sabah M, Moore TM

Acute haemorrhagic necrotising pancreatitis lead to the death at home of a young female who was on a methadone maintenance programme. Toxic levels of codeine with potentially lethal levels of methadone and morphine were found at post-mortem. Whether opiates caused the pancreatitis or were the consequence of self-medication for pain is impossible to differentiate. Forensic toxicology may pose the question but be unable to provide the answer.
HubMed – Methadone

Antisocial personality disorder is associated with receipt of physical disability benefits in substance abuse treatment patients.

Drug Alcohol Depend. 2013 Feb 6;
Byrne SA, Cherniack MG, Petry NM

BACKGROUND: Opioid dependence is growing at an alarming rate in the United States, and opioid dependent patients have substantial medical, as well as psychiatric, conditions that impact their ability to work. This study evaluated the association between antisocial personality disorder (ASPD) and receipt of physical disability payments in methadone maintenance patients. METHODS: Using data from 115 drug and alcohol abusing methadone maintained patients participating in two clinical trials, baseline characteristics of individuals receiving (n=22) and those not receiving (n=93) physical disability benefits were compared, and a logistic regression evaluated unique predictors of disability status. RESULTS: Both an ASPD diagnosis and severity of medical problems were significant predictors of disability receipt, ps<.05. After controlling for other variables that differed between groups, patients with ASPD were more than five times likelier to receive physical disability benefits than patients without ASPD (odds ratio=5.66; 95% confidence interval=1.58-20.28). CONCLUSIONS: These results demonstrate a role of ASPD in the receipt of disability benefits in substance abusers and suggest the need for greater understanding of the reasons for high rates of physical disability benefits in this population. HubMed – Methadone

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