Detection of legal highs in the urine of methadone-treated patient by LC-MS

Basic Clin Pharmacol Toxicol. 2019 Sep;125(3):253-258. doi: 10.1111/bcpt.13270. Epub 2019 Jun 26.

Abstract

Urine tests are the commonly accepted methods to control abstinence and adherence to treatment of patients who undergo methadone maintenance treatment (MMT). Depending on various national guidelines and accessibility of techniques, only selected psychoactive substances are routinely tested in urine of MMT patients. In general, they belong to the few groups of compounds: THC, cocaine, amphetamines, opiates, PCP and benzodiazepines. It is, however, well known that patients enrolled in such replacement programmes take psychoactive substances that are not routinely detected by the toxicology laboratories, to escape unexpected tests. Here, we report semiquantitative detection of legal highs taken by the MMT patient, using high-pressure liquid chromatography coupled to the flowing atmospheric pressure afterglow ion source (LC-FAPA-MS). To demonstrate effectivity of this technique, the data were confirmed by quantitative analysis using LC-ESI-MS/MS. In the analysed sample of MMT patient, a mixture of psychoactive compounds was found, namely 3-MMC (3-methylmethcathinone), pentedrone and methcathinone and determined at the concentrations of 670; 50 and 0.2 µg/mL, respectively. Such fast analytical technique may be useful for the efficient control of substances taken intentionally by MMT patients.

Keywords: FAPA; legal highs; mass spectrometry; methadone maintenance treatment.

Publication types

  • Evaluation Study

MeSH terms

  • Chromatography, High Pressure Liquid / methods
  • Female
  • Humans
  • Limit of Detection
  • Methadone / therapeutic use*
  • Methamphetamine / analogs & derivatives
  • Methamphetamine / urine
  • Methylamines / urine
  • Middle Aged
  • Opiate Substitution Treatment / methods*
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / urine
  • Patient Compliance
  • Pentanones / urine
  • Propiophenones / urine
  • Psychotropic Drugs / urine*
  • Substance Abuse Detection / methods*
  • Tandem Mass Spectrometry / methods

Substances

  • Methylamines
  • Pentanones
  • Propiophenones
  • Psychotropic Drugs
  • pentedrone
  • monomethylpropion
  • Methamphetamine
  • 3-methylmethcathinone
  • Methadone