a Department of Population Health , New York University Langone Medical Center , New York , NY , USA.
b Centro Regionale Antidoping e di Tossicologia "A. Bertinaria" , Orbassano , Turin , Italy.
Am J Drug Alcohol Abuse. 2019;45(1):90-96. doi: 10.1080/00952990.2018.1550652. Epub 2019 Jan 2.
Deaths from fentanyl exposure continue to increase in the US. Fentanyl test strips are now available to test urine for presence of fentanyl, but additional testing methods are needed to determine past exposure and to determine exposure to specific analogs.
To investigate exposure to such analogs through hair testing.
Forty individuals in inpatient detoxification (7.5% female) reporting past-month heroin use were surveyed and provided a hair sample to be tested at a later date. While results could not be provided to patients, they were asked how they would respond if informed that their hair tested positive for fentanyl. UHPLC-MS/MS was used to test for past exposure to fentanyl, six other novel synthetic opioids, and fentanyl biomarkers/metabolites.
27.5% reported known fentanyl use in the past year and 67.5% reported suspected exposure. 97.5% (39 of 40) tested positive for fentanyl, 90.0% tested positive for 4-ANPP (a biomarker) and norfentanyl (a metabolite); 82.5% tested positive for acetyl-fentanyl, 47.5% tested positive for furanyl-fentanyl, and 7.5% tested positive for U-47700. Most participants (82.5%) reported they would warn others about fentanyl if they learned their hair tested positive; 75.0% reported they would try to stop using heroin, and 65.0% reported they would ensure that someone nearby has naloxone to reverse a potential overdose.
Hair testing is useful in detecting past exposure to fentanyl, its analogs, and other novel synthetic opioids. Further research is needed to determine whether individuals who use heroin learning about exposure affects drug-taking and treatment-seeking behavior.
在美国，因芬太尼暴露而死亡的人数持续增加。现在可以使用芬太尼检测试纸来检测尿液中是否存在芬太尼，但还需要其他检测方法来确定过去的暴露情况，并确定是否接触过特定的类似物。
通过毛发检测来研究接触此类类似物的情况。
对 40 名正在接受住院戒毒治疗的个体（女性占 7.5%）进行了调查，并在日后提供了毛发样本进行检测。虽然无法向患者提供检测结果，但询问了他们如果得知自己的毛发检测出芬太尼呈阳性时会如何反应。采用 UHPLC-MS/MS 检测过去是否接触过芬太尼、其他六种新型合成阿片类药物以及芬太尼生物标志物/代谢物。
27.5%的人报告称在过去一年中曾使用过已知的芬太尼，67.5%的人报告称怀疑接触过芬太尼。97.5%（40 人中有 39 人）的毛发检测出芬太尼呈阳性，90.0%的毛发检测出 4-ANPP（一种生物标志物）和去甲芬太尼（一种代谢物）呈阳性；82.5%的毛发检测出乙酰芬太尼呈阳性，47.5%的毛发检测出呋喃芬太尼呈阳性，7.5%的毛发检测出 U-47700 呈阳性。大多数参与者（82.5%）表示，如果他们得知自己的毛发检测呈阳性，会警告其他人注意芬太尼；75.0%的人表示会试图停止使用海洛因，65.0%的人表示会确保附近有人备有纳洛酮来逆转潜在的过量用药。
毛发检测在检测过去接触芬太尼、其类似物和其他新型合成阿片类药物方面非常有用。需要进一步研究以确定接触过芬太尼的海洛因使用者是否会影响他们的用药和寻求治疗的行为。
