Enzymatic assay for urine lactose in the assessment of recent intravenous abuse of buprenorphine

Autor: Leea Hellevi Muhonen, Teemu Gunnar, Terhi Keltanen, Pertti Heikman, Ilkka Ojanperä
Přispěvatelé: Department of Forensic Medicine, University of Helsinki, HUS Psychiatry, Department of Psychiatry, University Management, Forensic Medicine
Rok vydání: 2019
Předmět:
Male
intravenous abuse
Pharmaceutical Science
Lactose
Urine
TABLETS
Pharmacology
01 natural sciences
Analytical Chemistry
chemistry.chemical_compound
0302 clinical medicine
INTESTINAL PERMEABILITY
DEPENDENCE
Raffinose
MAINTENANCE TREATMENT MEDICATIONS
Substance Abuse
Intravenous
Spectroscopy
SUCROSE
Middle Aged
3. Good health
Buprenorphine
Substance abuse
Substance Abuse Detection
317 Pharmacy
Female
DIVERSION
medicine.drug
Adult
Narcotics
Excipient
Excipients
03 medical and health sciences
Young Adult
medicine
Environmental Chemistry
METHADONE
DRUGS
Humans
030216 legal & forensic medicine
Enzyme Assays
Intestinal permeability
010401 analytical chemistry
medicine.disease
0104 chemical sciences
DISACCHARIDES
chemistry
opioid dependence
RAFFINOSE
1182 Biochemistry
cell and molecular biology
enzymatic assay
urine lactose
Methadone
Zdroj: Drug testing and analysisREFERENCES. 11(9)
ISSN: 1942-7611
Popis: Urine samples were analyzed for lactose to investigate if elevated lactose concentrations indicate recent (48 hours) intravenous abuse of substances containing lactose as an excipient. Elevated lactose levels were found in samples given by patients who had recently injected substances intravenously, verified by fresh injection marks. Urine lactose assay can support clinical and toxicological findings when assessing substance abuse.Laboratory methods for differentiating intravenous substance abuse from medical oral or sublingual use are lacking. The disaccharides lactose and sucrose are common excipients in both medical preparations and illicit drugs. If substances are abused intravenously, the disaccharides are excreted unchanged in urine. This study evaluated whether urine lactose indicates recent intravenous abuse of substances with special reference to buprenorphine (BPN). Samples were attained from 21 patients in assessment for opioid maintenance treatment (OMT) and from 29 patients already enrolled in OMT. Patients were divided in two groups. Group 1 patients reported intravenous abuse of BPN within 48 hours and Group 2 more than 48 hours since the last injection. The urine samples were assayed for lactose using an enzymatic method. To verify intravenous abuse, examination of needle marks and mass spectrometric analysis of abused substances was performed. Urine lactose concentration was significantly higher in Group 1 (86 mg/L) than in Group 2 (24 mg/L). All samples with lactose concentration more than 140 mg/L were given by the Group 1 patients, who all had recent injection marks. A significant inverse correlation was found between the time from last injection and the urine lactose concentration within the 48-hour post-injection period. Elevated lactose concentrations in urine could indicate intravenous abuse of substances containing lactose. The co-occurrence of higher than 140 mg/L of lactose in urine by means of enzymatic assay verified by fresh puncture sites is a potential indicator of recent intravenous abuse of BPN.
Databáze: OpenAIRE
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