Page 28 - Advances in Forensic Applications of Mass Spectrometry - Jehuda Yinon

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d -tetrahydrocannabivarin, was found to be a marker for marijuana or a
related product use. 193

1.4.1.1.4 Opioid (Narcotic) and Other Potent Analgesics. Opioid anal-
gesics, often called narcotics, are widely used to reduce severe pain, especially
in a postoperative state and in the final state of cancer diseases. These are
also abused because of their euphoriant and anxiolytic effects. While opioid
medicaments are usually misused by medical staff, heroin is widely abused
by drug addicts. If heroin is not available the addicts often take opioid
medicaments. For legal reasons, the use of heroin must analytically be dif-
ferentiated from an intake of other opioids. Therefore, 6-monoacetylmor-
phine, the only heroin specific metabolite, must be detected in biosamples.
Several papers have been published on the detection of 6-monoacetylmor-
phine, employing SPE or LLE and derivatization by TFA, PFP, propionyla-
tion, or by TMS. 1
Screening procedures have been described for the detection of most of
the opioids and other potent analgesics after acid or enzymatic hydrolysis
with LLE or SPE at pH 8 to 9, followed by TMS or AC. 1,194–197 The latter
procedure is part of a very comprehensive screening procedure (cf. 1.4.2.2)
and the only one which also covers most of the synthetic opioids. The anti-
tussive pholcodine was found to cross-react with opiate immunoassays, but
it lacks opioid potency. Pholcodine is partly hydrolyzed to morphine by
hydrochloric acid, so careful enzymatic hydrolysis must be used if differen-
tiation in urine is needed. 198–200 In recent years, buprenorphine and oxyco-
done testing became more and more of interest. Since a few years ago,
buprenorphine has been used, besides methadone and levomethadol, for
heroin substitution therapy as an effective means of decreasing illicit heroin
use, crime, HIV risk, and death, and in improving employment and social
201
adjustment. Urine testing can be performed by GC/MS, 83,202,203 while blood
testing requires LC/MS, especially for precise quantification. 204–206
Oxycodone has very high abuse potential because it is highly effective
when taken orally, is often easily available, and has a high degree of consistent
potency. Opiate tests might be negative for oxycodone. Therefore, urine
specimens must be analyzed specifically for oxycodone, preferably by GC/MS
after enzymatic hydrolysis, LLE or SPE, and derivatization by AC, TMS, PFP,
or HFB. 1,194,207–210
Recently, an improved GC/MS method for the simultaneous identifica-
194
tion and quantification of opiates in urine was reported. In this method,
methoxyamine was used after enzymatic hydrolysis to form methoxime
derivatives of the keto-opiates, which were extracted using solid-phase col-
umns and derivatized with propionic anhydride/pyridine. This method dem-
onstrated acceptable precision, lack of cross-interference from other opioids,

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