Cone Edward J, Caplan Yale H, Black David L, Robert Timothy, Moser Frank
Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
J Anal Toxicol. 2008 Oct;32(8):530-43. doi: 10.1093/jat/32.8.530.
Chronic pain patients are frequently maintained on one or more powerful opioid medications in combination with other psychoactive medications. Urine tests provide objective information regarding patient compliance status. Little information is available on testing this unique population. The goal of this study was to characterize drug disposition patterns in urine specimens collected from a large population of pain patients. Confirmation data for 10,922 positive specimens were collated into 11 drug Classes. The number of drug/metabolites tested (#) and number of confirmed positive specimens were as follows: amphetamines (7), 160; barbiturates (5), 308; benzodiazepines (6), 2397; cannabinoids (1), 967; carisoprodol (2), 611; cocaine (1), 310; fentanyl (1), 458; meperidine (2), 58; methadone (2), 1209; opiates (7), 8996; and propoxyphene (2), 385. Subdivision into 19 distinct drug Groups allowed characterization of drug use patterns. Of the 10,922 positive specimens, 15,859 results were reported as positive in various drug Classes, and 27,197 drug/metabolites were measured by gas chromatography-mass spectrometry. The frequency of illicit drug use (cannabis, cocaine, ecstasy) was 10.8%. Being the first study of this type, these data present a large array of information on licit and illicit drug use, drug detection frequencies, drug/metabolite patterns, and multi-drug use combinations in pain patients.
慢性疼痛患者经常同时服用一种或多种强效阿片类药物以及其他精神活性药物。尿液检测可提供有关患者依从性状况的客观信息。关于检测这一特殊人群的信息很少。本研究的目的是描述从大量疼痛患者收集的尿液标本中的药物处置模式。10922份阳性标本的确认数据被整理为11类药物。检测的药物/代谢物数量（#）和确认的阳性标本数量如下：苯丙胺类（7种），160例；巴比妥类（5种），308例；苯二氮䓬类（6种），2397例；大麻素类（1种），967例；卡立普多（2种），611例；可卡因（1种），310例；芬太尼（1种），458例；哌替啶（2种），58例；美沙酮（2种），1209例；阿片类（7种），8996例；丙氧芬（2种），385例。细分为19个不同的药物组有助于描述药物使用模式。在10922份阳性标本中，15859份结果在各类药物中报告为阳性，通过气相色谱-质谱法检测了27197种药物/代谢物。非法药物使用（大麻、可卡因、摇头丸）的频率为10.8%。作为此类的第一项研究，这些数据提供了大量关于疼痛患者合法和非法药物使用、药物检测频率、药物/代谢物模式以及多药使用组合的信息。
