Chemistry and Drug Metabolism, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd, Suite 200, Room 05A721, Baltimore, MD 21224, USA.
Forensic Sci Int. 2011 Mar 20;206(1-3):98-102. doi: 10.1016/j.forsciint.2010.06.031. Epub 2010 Jul 27.
Oral fluid testing is widely used for detecting drug exposure, but data describing methadone and metabolites in oral fluid during pharmacotherapy for opioid-dependence are relatively limited.
414 oral fluid specimens from 16 opioid-dependent pregnant women receiving daily methadone were analyzed for methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), and methadol by liquid chromatography-mass spectrometry.
All oral fluid specimens contained methadone greater than 1 ng/mL; 88% were positive for EDDP and 12% for methadol. Over 95% of oral fluid specimens exceeded the 20 ng/mL methadone cutoff set by the European Driving Under the Influence of Drugs, Alcohol and Medicines (DRUID) study. Methadone and EDDP oral fluid concentrations were highly variable within and between participants, did not predict methadone dose, but were negatively correlated with pH.
Methadone was readily identified in oral fluid at concentrations greater than 20 ng/mL following daily 30-110 mg/day methadone pharmacotherapy. As no specimens contained only EDDP or methadol, there was no advantage to including these analytes for identification of methadone exposure. As nearly all oral fluid specimens from methadone-maintained patients exceeded the DRUID guideline, the 20 ng/mL cutoff appears to be sensitive enough to detect daily methadone exposure; however, additional indicators of behavioral and/or motor impairment would be necessary to provide evidence of driving impairment.
口服液检测广泛用于检测药物暴露情况，但有关阿片类药物依赖患者接受美沙酮治疗期间口服液中美沙酮及其代谢物的数据相对有限。
对 16 名接受每日美沙酮治疗的阿片类药物依赖孕妇的 414 份口服液样本进行了液相色谱-质谱分析，以检测美沙酮、2-亚乙基-1,5-二甲基-3,3-二苯基吡咯烷（EDDP）和甲度冷丁。
所有口服液样本均含有大于 1 ng/mL 的美沙酮；88%的样本呈 EDDP 阳性，12%的样本呈甲度冷丁阳性。超过 95%的口服液样本超过了欧洲药物、酒精和药物影响驾驶能力研究（DRUID）设定的 20ng/mL 美沙酮截止值。美沙酮和 EDDP 的口服液浓度在参与者个体内和个体间均高度可变，与美沙酮剂量无关，但与 pH 值呈负相关。
在每日接受 30-110mg 美沙酮治疗后，口服液中美沙酮的浓度大于 20ng/mL 时，很容易被识别。由于没有样本仅含有 EDDP 或甲度冷丁，因此包含这些分析物来识别美沙酮暴露没有优势。由于几乎所有接受美沙酮维持治疗的患者的口服液样本均超过了 DRUID 指南，因此 20ng/mL 的截止值似乎足以检测到每日美沙酮暴露；然而，还需要其他行为和/或运动障碍的指标来提供驾驶障碍的证据。
