Detection of drugs of abuse in exhaled breath from users following recovery from intoxication

J Anal Toxicol. 2012 Nov-Dec;36(9):638-46. doi: 10.1093/jat/bks079. Epub 2012 Oct 7.

Abstract

It has recently been demonstrated that amphetamine, methadone and tetrahydrocannabinol are detectable in exhaled breath following intake. Exhaled breath, therefore, constitutes a new possible matrix for drugs-of-abuse testing. The present work aims to further explore this possibility by a study on patients treated for acute intoxication with abused drugs. Fifty-nine patients (44 males, age range 24-74) were included in the study, and breath, plasma and urine samples were collected following recovery, together with interview data. Analyses of breath and plasma samples were conducted with liquid chromatography-mass spectrometry methods. Urine was screened using immunochemical reagents and positive findings confirmed with liquid chromatography-mass spectrometry methods. The following analytes were investigated: methadone, amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine, codeine, 6-acetylmorphine, diazepam, oxazepam, morphine, benzoylecgonine, cocaine, buprenorphine and tetrahydrocannabinol. In 53 of the studied cases, recent intake of an abused substance prior to admission was reported. In 35 of these (66%), the breath analysis gave a positive finding. Identifications were based on correct chromatographic retention time and product ion ratios obtained in selected reaction monitoring mode. Generally, data from breath, plasma, urine and self-report were in agreement. Detected substances in breath included amphetamine, methamphetamine, buprenorphine, 6-acetylmorphine, morphine, codeine, methadone, tetrahydrocannabinol, diazepam, oxazepam and cocaine. Problem analytes with low detection rates were benzodiazepines and tetrahydrocannabinol. This study gives further support to the possibility of developing exhaled breath into a new matrix for drugs-of-abuse testing by extending the number of analytes that are documented to be detectable in breath.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Amphetamine / blood
  • Amphetamine / urine
  • Breath Tests / methods
  • Buprenorphine / blood
  • Buprenorphine / urine
  • Chromatography, Liquid
  • Cocaine / analogs & derivatives
  • Cocaine / blood
  • Cocaine / urine
  • Codeine / blood
  • Codeine / urine
  • Drug Overdose / diagnosis*
  • Exhalation*
  • Female
  • Humans
  • Male
  • Mass Spectrometry
  • Methadone / blood
  • Methadone / urine
  • Methamphetamine / blood
  • Methamphetamine / urine
  • Middle Aged
  • Morphine / blood
  • Morphine / urine
  • Morphine Derivatives / blood
  • Morphine Derivatives / urine
  • Reproducibility of Results
  • Substance Abuse Detection / methods*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Morphine Derivatives
  • Buprenorphine
  • Methamphetamine
  • benzoylecgonine
  • Morphine
  • Amphetamine
  • Cocaine
  • 6-O-monoacetylmorphine
  • Methadone
  • Codeine