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Tytuł:
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Comparison of Oral Fluid and Urine for Detection of Fentanyl Use Using Liquid Chromatography with Tandem Mass Spectrometry.
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Autorzy:
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Mahowald GK; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Khaliq TP; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Griggs D; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
O M; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Flood JG; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Uljon S; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
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Źródło:
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The journal of applied laboratory medicine [J Appl Lab Med] 2021 Nov 01; Vol. 6 (6), pp. 1533-1540.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2020- : Oxford : Oxford University Press
Original Publication: [Washington, DC] : American Association for Clinical Chemistry, [2016]-[2019]
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MeSH Terms:
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Fentanyl*
Tandem Mass Spectrometry*
Chromatography, Liquid ; Humans ; Limit of Detection ; Urinalysis
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Contributed Indexing:
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Keywords: comparison; fentanyl; mass spectrometry; norfentanyl; oral fluid; paired samples; urine
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Substance Nomenclature:
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UF599785JZ (Fentanyl)
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Entry Date(s):
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Date Created: 20210730 Date Completed: 20211129 Latest Revision: 20211129
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Update Code:
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20240105
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DOI:
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10.1093/jalm/jfab068
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PMID:
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34327523
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Background: We compared oral fluid (OF) and urine (UR) for detection of fentanyl (FEN) use in addiction medicine-psychiatry (AMP) clinics.
Methods: We measured FEN and norfentanyl (NRFEN) in UR with a limit of detection (LOD) of 2.0 µg/L and FEN in OF with an LOD of 0.5 µg/L by LC-MS/MS in 311 paired samples and compared the 2 matrices when higher OF and UR LODs were used.
Results: Urine (UR) detected more FEN use than OF using a LOD of 2.0 µg/L and 0.5 µg/L, respectively. FEN and/or NRFEN were detected in 44 and 59 UR specimens, respectively, and FEN in 46 OF specimens (43 OF+UR+, 3 OF+UR-, 16 OF-UR+, and 249 OF-UR-). In UR there were no instances with FEN positive and NORFEN negative. UR creatinine was <20 mg/dL in the 3 OF+UR- specimen pairs. The median OF/UR analyte concentration ratios in positive sample pairs were 0.23 for OF FEN/UR FEN and 0.02 for OF FEN/UR NRFEN.
Conclusions: We demonstrate that UR detects more FEN use than OF in an AMP setting when UR FEN and UR NORFEN LODs of 2.0 µg/L are used. OF is less sensitive than UR in detecting FEN use, but is still valuable for cases with low UR creatinine and/or suspected adulteration or substitution of UR. The UR vs OF comparison statistics are greatly impacted by even minimal adjustments of the LOD.
(© American Association for Clinical Chemistry 2021. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
