Comparison of Oral Fluid and Urine for Detection of Fentanyl Use Using Liquid Chromatography with Tandem Mass Spectrometry.

Autor:	Mahowald GK; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA., Khaliq TP; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA., Griggs D; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA., O M; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA., Flood JG; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA., Uljon S; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Jazyk:	angličtina
Zdroj:	The journal of applied laboratory medicine [J Appl Lab Med] 2021 Nov 01; Vol. 6 (6), pp. 1533-1540.
DOI:	10.1093/jalm/jfab068
Abstrakt:	Background: We compared oral fluid (OF) and urine (UR) for detection of fentanyl (FEN) use in addiction medicine-psychiatry (AMP) clinics. Methods: We measured FEN and norfentanyl (NRFEN) in UR with a limit of detection (LOD) of 2.0 µg/L and FEN in OF with an LOD of 0.5 µg/L by LC-MS/MS in 311 paired samples and compared the 2 matrices when higher OF and UR LODs were used. Results: Urine (UR) detected more FEN use than OF using a LOD of 2.0 µg/L and 0.5 µg/L, respectively. FEN and/or NRFEN were detected in 44 and 59 UR specimens, respectively, and FEN in 46 OF specimens (43 OF+UR+, 3 OF+UR-, 16 OF-UR+, and 249 OF-UR-). In UR there were no instances with FEN positive and NORFEN negative. UR creatinine was <20 mg/dL in the 3 OF+UR- specimen pairs. The median OF/UR analyte concentration ratios in positive sample pairs were 0.23 for OF FEN/UR FEN and 0.02 for OF FEN/UR NRFEN. Conclusions: We demonstrate that UR detects more FEN use than OF in an AMP setting when UR FEN and UR NORFEN LODs of 2.0 µg/L are used. OF is less sensitive than UR in detecting FEN use, but is still valuable for cases with low UR creatinine and/or suspected adulteration or substitution of UR. The UR vs OF comparison statistics are greatly impacted by even minimal adjustments of the LOD. (© American Association for Clinical Chemistry 2021. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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