Methadone analysis

Esteban J, de la Cruz Pellin M, Gimeno C, Barril J, Mora E, Gimenez J, Vilenova E. Detection of clinical interactions between methadone and anti-retroviral compounds using an enantioselective capillary electrophoresis for methadone analysis. Toxicol Lett 2004 151 243-9. 

Dams R, Murphy CM, Choo RE, Lambert WE, De Leenheer AP, et al. 2003. LC-atmospheric pressure chemical ioniza-tion-MS/MS analysis of multiple illicit drugs, methadone, and their metabolites in oral fluid foUowing protein precipitation. Anal Chem 75 798. 

FIGURE 4 Chiral CE ESI/MS analysis of five amphetamine derivatives and two pharmaceutical compounds. Total ion current (TIC) and extracted ion currents (XIC) of amphetamine (A), methamphetamine (MA), methylenedioxyamphetamine (MDA), methylenedioxymethamphetamine (MDMA), and methylenedioxyethylamphetamine (MDEA), and tramadol (TMD) and methadone (MTD) in plasma after LLE with electrokinetic injection. 

Ben Amar M Potvin S (2007). Cannabis and psychosis what is the link Journal of Psychoactive Drugs, 39, 131-142 Bennett GA, Davies E Thomas P (2003). Is oral fluid analysis as accurate as urinalysis in detecting drug use in a treatment setting Drug and Alcohol Dependence, 72, 265-9 Bertschy G (1995). Methadone maintenance treatment an update. European Archives of Psychiatry and Clinical Neuroscience, 245, 114-24... 

Dijkgraaf M, van der Zanden B, de Borgie C, Blanken P, Van Ree J Van den Brink W (2005). Cost utility analysis of co-prescribed heroin compared with methadone maintenance treatment in heroin addicts in two randomized trials. British Medical Journal, 330, 1297... 

Farre M, Mas A, Torrens M, Moreno V Cami J (2002). Retention rate and illicit opioid use during methadone maintenance interventions a meta-analysis. Drug Alcohol Dependence, 65, 283-90... 

Kosten TR, Rounsaville BJ Kleber HD (1985). Parental alcoholism in opioid addicts. Journal of Nervous and Mental Disease, 173, 461-9 Kott A, Habel E Nottingham W (2001). Analysis of behavioral patterns in five cohorts of patients retained in methadone maintenance programs. The Mount Sinai Journal of Medicine, 68, 46-54 Krabbe PF, Koning JPF, Heinen N, Laheij RJF, Victory Van Cauter RM De Jong CAJ... 

Marsch LA (1998). The efficacy of methadone maintenance interventions in reducing ilhcit opiate use, HIV risk behaviour and criminahty a meta-analysis. Addiction, 93, 515-32... 

Sample preparation procedures for GC are generially more involved. For example, for methadone hydrochloride, 0.5jV sodium hydroxide is added to give the free base, followed by extraction with methylene chloride. An internal standard is added after the extract is dried with anhydrous sodium sulfate [3, p. 970]. The assay of interleukin-la formulated with human serum albumin does not require any sample treatment prior to analysis by capillary electrophoresis [44]. 

T. H. Beasley and H. W. Ziegler, High-performance liquid chromatographic analysis of methadone HC1 oral solution, J. Pharm. Sci., 66 1749 (1977). 

Rook EJ, Hillebrand MJX, Rosing H, van Ree J, Beijnen JH (2005) The quantitative analysis of heroin, methadone, and their metabolites and the simultaneous detection of cocaine, ace-tylcodeine and their metabolites in human plasma by high-performance liquid chromatography coupled with tandem mass spectrometry. J Chromatogr B 824 213-221... 

Figure 7 Multianalyte CE-IA of four drugs of abuse. Left panel (A) shows elec-tropherograms of samples with different dilutions right panel (B) shows control analysis in real urine samples. Peak identification M, methadone C, cocaine metabolite benzoylecgonine A, amphetamine/methamphetamine IS, internal standard. (Reprinted from Ref. 42.)...

A review of 139 methadone-related deaths between 1998 and 2002 in Palm Beach County supported those of previous investigations and suggested that it is not possible to establish a definitive lethal methadone blood concentration range. Methadone-related death is usually associated with the use of other drugs and toxicological analysis in such cases should be contextualized by the clinical circumstances surrounding the event and even a few months before the incident occurred (50). 

An analysis of the balance of benefit to harm during methadone maintenance treatment for diamorphine dependence has shown lower mortality and morbidity with improvement in quality of life (7). The risks of methadone treatment include an increased risk of opiate overdosage during induction into treatment, and adverse effects of methadone in some patients. However, with careful management the benefits of prescribing methadone outweigh the risks. 

The validity of self-reported opiate and cocaine use has been studied in 175 veterans enrolled in a methadone treatment program (8). Urine analysis showed higher rates of substance use than the patients themselves reported. The authors encouraged the development of more objective measures for assessing patient progress and the performance of the methadone program. 

From a literature search and subsequent analysis of data on the relation between methadone prescribing and mortality, it was concluded that (46) ... 

Bell J, Zador D. A risk-benefit analysis of methadone maintenance treatment. Drag Saf 2000 22(3) 179-90. 

In Table 8 the drugs are listed which have been found in hair, not belonging to one of the groups above. Ishiyama et al. detected tricyclic antidepressants in hair and discussed the possibility to determine definitely if patients are under a longterm treatment of medicines. Pentazocine was abused by a medical doctor and could be detected by hair analysis. In patients under methadone treatment, hair analysis perhaps may show a dose-related concentration. Kintz et al. ° detected several... 

In this context, hair analysis is particularly interesting because it allows the practitioner to control the methadone intake and to determine a simultaneous consumption of other drugs. 

Of the three cases tested (see Table 8), two are positive for methadone. The chromatograms of Figure 14 show that the technique remains sufficiently selective and that, in the extraction conditions optimised for opiates, analysis of methadone is also possible. 

Supercritical phase extraction is the chosen method for extracting drugs, including opiates, cocaine, and methadone from a solid matrix such as hair. In its present state, supercritical phase extraction can be used with these three groups of drugs. In the near future, however, it is probable that this method will be applicable to other drugs and even to other medical substances. At that time, SFE will probably become the reference method for hair analysis. 

Comparing SFE with other classical extraction methods, we have observed that, either the method is more efficient (basic/acid hydrolysis, extraction with methanol), or that it gives comparable results (enzymatic hydrolysis). The results obtained for cocaine and for methadone, although necessitating complementary studies, remain very encouraging. Lastly, if we take into account the ease of the method and its economic implication, this technique should be adopted without delay in laboratories involved in this type of analysis. 

Similarly, Marsh et al. and Marsh and Evans incubated hair samples in 0.1 M HCl and neutralized with 1 M NaOH before diluting further with pH 7, 1 M phosphate buffer. The final preparation was assayed by the Diagnostic Products Corporation (DPC) morphine-specific and methadone RIAs. Franceschin et al. also incubated samples overnight in a solution of 0.1 M HCl. After neutralizing with 1 M NaOH, analytes were extracted for FPIA analysis. 

Balabanova and WolP reported the use of RIA for the analysis of methadone in hair. Although cross-reactivity data were not provided, it was stated that the results obtained by RIA reflected the sum concentration of methadone and its metabolites. The results were compared with GC/MS, and acceptable correlation was observed." ... 

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