Detection of Fentanyl Analogs and Synthetic Opioids in Real Hair Samples

Abstract The detection of new psychoactive substances (NPS) in hair has become extensively researched in recent years. Although most NPS fall into the classes of synthetic cannabinoids and designer cathinones, novel synthetic opioids (NSO) have appeared with increasing frequency in the illicit drug supply. While the detection of NSO in hair is now well documented, interpretation of results presents several controversial issues, as is quite common in hair analysis. In this study, an ultra-high-performance liquid chromatography-tandem mass spectrometry method able to detect 13 synthetic opioids (including fentanyl analogs) and metabolites in hair was applied to 293 real samples. Samples were collected in the USA between November 2016 and August 2018 from subjects who had reported heroin use in the past year or had already tested positive to hair testing for common opiates. The range, mean and median concentrations were calculated for each analyte, in order to draw a preliminary direction for a possible cut-off to discriminate between exposure to either low or high quantities of the drug. Over two-thirds (68%) of samples tested positive for fentanyl at concentrations between LOQ and 8600 pg/mg. The mean value was 382 pg/mg and the median was 95 pg/mg. The metabolites norfentanyl and 4-ANPP were also quantified and were found between LOQ and 320 pg/mg and between LOQ and 1400 pg/mg, respectively. The concentration ratios norfentanyl/fentanyl, 4-ANPP/fentanyl and norfentanyl/4-ANPP were also tested as potential markers of active use and to discriminate the intake of fentanyl from other analogs. The common occurrence of samples positive for multiple drugs may suggest that use is equally prevalent among consumers, which is not the case, as correlations based on quantitative results demonstrated. We believe this set of experimental observations provides a useful starting point for a wide discussion aimed to better understand positive hair testing for fentanyl and its analogs in hair samples.

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Improvements in Toxicology Testing to Identify Fentanyl Analogs and Other Novel Synthetic Opioids in Fatal Drug Overdoses, Connecticut, January 2016–June 2019

Public Health Reports ◽

10.1177/00333549211042829 ◽

2021 ◽

Vol 136 (1_suppl) ◽

pp. 80S-86S

Author(s):

Heather A. Clinton ◽

Shobha Thangada ◽

James R. Gill ◽

Amy Mirizzi ◽

Susan B. Logan

Keyword(s):

Drug Overdose ◽

Drug Market ◽

Medical Examiner ◽

Testing Methods ◽

Synthetic Opioids ◽

Postmortem Toxicology ◽

Drug Overdoses ◽

Fentanyl Analogs ◽

Novel Synthetic Opioids ◽

Overdose Deaths

Objectives Drug overdose deaths in Connecticut increasingly involve a growing number of fentanyl analogs and other novel nonfentanyl synthetic opioids (ie, novel synthetics). Current postmortem toxicology testing methods often lack the sophistication needed to detect these compounds. We examined how improved toxicology testing of fatal drug overdoses can determine the prevalence and rapidly evolving trends of novel synthetics. Methods From 2016 to June 2019, the Connecticut Office of the Chief Medical Examiner increased its scope of toxicology testing of suspected drug overdose deaths in Connecticut from basic to enhanced toxicology testing to detect novel synthetics. The toxicology laboratory also expanded its testing panels during this time. We analyzed toxicology results to identify and quantify the involvement of novel synthetics over time. Results From 2016 to June 2019, 3204 drug overdose deaths received enhanced toxicology testing; novel synthetics were detected in 174 (5.4%) instances. Ten different novel synthetics were detected with 205 total occurrences. Of 174 overdose deaths with a novel synthetic detected, most had 1 (n = 146, 83.9%) or 2 (n = 26, 14.9%) novel synthetics detected, with a maximum of 4 novel synthetics detected. Para-fluorobutyrylfentanyl/FIBF, furanylfentanyl, and U-47700 were most identified overall, but specific novel synthetics came in and out of prominence during the study period, and the variety of novel synthetics detected changed from year to year. Conclusions Enhanced toxicology testing for drug overdose deaths is effective in detecting novel synthetics that are not identified through basic toxicology testing. Identifying emerging novel synthetics allows for a timely and focused response to potential drug outbreaks and illustrates the changing drug market.

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Novel Synthetic Opioids: The Pathologist’s Point of View

Brain Sciences ◽

10.3390/brainsci8090170 ◽

2018 ◽

Vol 8 (9) ◽

pp. 170 ◽

Cited By ~ 22

Author(s):

Paolo Frisoni ◽

Erica Bacchio ◽

Sabrine Bilel ◽

Anna Talarico ◽

Rosa Gaudio ◽

...

Keyword(s):

Synthetic Cannabinoids ◽

Point Of View ◽

New Psychoactive Substances ◽

Psychoactive Substances ◽

Synthetic Drugs ◽

Synthetic Opioids ◽

Opioid Intoxication ◽

Fentanyl Analogs ◽

The Central Nervous System ◽

Novel Synthetic Opioids

Background: New Psychoactive Substances (NPS) constitute a broad range of hundreds of natural and synthetic drugs, including synthetic opioids, synthetic cannabinoids, synthetic cathinones, and other NPS classes, which were not controlled from 1961 to 1971 by the United Nations drug control conventions. Among these, synthetic opioids represent a major threat to public health. Methods: A literature search was carried out using public databases (such as PubMed, Google Scholar, and Scopus) to survey fentanyl-, fentanyl analogs-, and other synthetic opioid-related deaths. Keywords including “fentanyl”, “fentanyl analogs”, “death”, “overdose”, “intoxication”, “synthetic opioids”, “Novel Psychoactive Substances”, “MT-45”, “AH-7921”, and “U-47700” were used for the inquiry. Results: From our literature examination, we inferred the frequent implication of fentanyls and synthetic opioids in side effects, which primarily affected the central nervous system and the cardiovascular and pulmonary systems. The data showed a great variety of substances and lethal concentrations. Multidrug-related deaths appeared very common, in most reported cases. Conclusions: The investigation of the contribution of novel synthetic opioid intoxication to death should be based on a multidisciplinary approach aimed at framing each case and directing the investigation towards targeted toxicological analyses.

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Quantification of Classic, Prescription and Synthetic Opioids in Hair by LC–MS-MS

Journal of Analytical Toxicology ◽

10.1093/jat/bkaa152 ◽

2020 ◽

Author(s):

Natalia A Platosz ◽

Tina M Binz ◽

Markus R Baumgartner ◽

Elena Lendoiro ◽

Ana de Castro ◽

...

Keyword(s):

Solid Phase ◽

Multiple Reaction Monitoring ◽

Forensic Toxicology ◽

Reversed Phase ◽

Opioid Use Disorder ◽

Specific Method ◽

Opioid Use ◽

Synthetic Opioids ◽

Hair Samples ◽

The Usa

Abstract The current use and misuse of synthetic and prescription opioids in the USA has reached epidemic status. According to the US Department of Health and Human Services, every day more than 130 people in the USA die after overdosing on opioids, and 2.1 million had an opioid use disorder in 2018. Hair is becoming an alternative matrix of increasing interest in forensic toxicology to investigate drug use and abuse patterns due to its long window of detection. The focus of this project was to develop and validate a method that simultaneously detects and quantifies 27 classic, prescription and synthetic opioids in hair by liquid chromatography–tandem mass spectrometry (LC–MS-MS). Hair samples were decontaminated and pulverized in a bead mill. Twenty-five milligrams of hair powder were incubated in a buffer overnight. Mixed mode cation exchange solid phase extraction was carried out before undergoing reversed-phase chromatographic separation, successfully resolving isobaric opioids. We used two multiple reaction monitoring transitions in positive mode to identify each analyte. The linearity range was 1–500 pg/mg for fentanyl and synthetic opioids and 10–500 pg/mg for prescription and classic opioids. Imprecision was <17.5% and bias ranged from −13.6 to 12.0%. Majority of compounds showed extraction efficiency >50%, and ion suppression from −89.2 to −26.6% (CV < 19%, n = 10). This method was applied to 64 authentic cases, identifying 13 compounds from our panel. A sensitive and specific method was developed for the identification and quantification of 27 classic, prescription and synthetic opioids in hair by LC–MS-MS.

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Analysis of fentanyl analogs and novel synthetic opioids in blood, serum/plasma, and urine in forensic casework

Drug Testing and Analysis ◽

10.1002/dta.2393 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1358-1367 ◽

Cited By ~ 28

Author(s):

Marykathryn Tynon Moody ◽

Stephanie Diaz ◽

Parul Shah ◽

Donna Papsun ◽

Barry K. Logan

Keyword(s):

Blood Serum ◽

Forensic Casework ◽

Synthetic Opioids ◽

Fentanyl Analogs ◽

Novel Synthetic Opioids

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Listed for sale: Analyzing data on fentanyl, fentanyl analogs and other novel synthetic opioids on one cryptomarket

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2020.108115 ◽

2020 ◽

Vol 213 ◽

pp. 108115

Author(s):

Francois R. Lamy ◽

Raminta Daniulaityte ◽

Monica J. Barratt ◽

Usha Lokala ◽

Amit Sheth ◽

...

Keyword(s):

Synthetic Opioids ◽

Fentanyl Analogs ◽

Novel Synthetic Opioids

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Prevalence and concentrations of new designer stimulants, synthetic opioids, benzodiazepines, and hallucinogens in postmortem hair samples: A 13‐year retrospective study

Drug Testing and Analysis ◽

10.1002/dta.3150 ◽

2021 ◽

Author(s):

André Niebel ◽

Lena Westendorf ◽

Franziska Krumbiegel ◽

Sven Hartwig ◽

Maria Kristina Parr ◽

...

Keyword(s):

Retrospective Study ◽

Synthetic Opioids ◽

Hair Samples

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Human-hair analysis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100124835 ◽

1992 ◽

Vol 50 (1) ◽

pp. 886-887

Author(s):

Brenda E. Lambert ◽

Ernest C. Hammond

Keyword(s):

Human Hair ◽

Hair Analysis ◽

Hair Shaft ◽

White Female ◽

Chemical Processing ◽

X Ray ◽

Hair Samples ◽

Wave Technique ◽

Permanent Wave ◽

Scanning Electron

The purpose of this study was to examine the external structure of four human hair shaft samples with the scanning Electron Microscope (SEM) and to obtain information regarding the chemical composition of hair by using the attached x ray microanalysis unit.The hair samples were obtained from two female subjects. Sample A was taken from a black female and had not undergone any type of chemical processing. Sample B, C, D were taken from a white female, and were natural, processed, and unpigmented, i.e. “gray”, respectively. Sample C had been bleached, tinted, and chemically altered using a permanent wave technique.

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Gender determination of caucasoid hair using image analysis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100146928 ◽

1993 ◽

Vol 51 ◽

pp. 216-217

Author(s):

T.B. Ball ◽

W.M. Hess

Keyword(s):

Image Analysis ◽

Cross Sections ◽

Scalp Hair ◽

The Body ◽

Equivalent Diameter ◽

Cross Sectional ◽

Hair Samples ◽

Length Width ◽

Morphological Differences

It has been demonstrated that cross sections of bundles of hair can be effectively studied using image analysis. These studies can help to elucidate morphological differences of hair from one region of the body to another. The purpose of the present investigation was to use image analysis to determine whether morphological differences could be demonstrated between male and female human Caucasian terminal scalp hair.Hair samples were taken from the back of the head from 18 caucasoid males and 13 caucasoid females (Figs. 1-2). Bundles of 50 hairs were processed for cross-sectional examination and then analyzed using Prism Image Analysis software on a Macintosh llci computer. Twenty morphological parameters of size and shape were evaluated for each hair cross-section. The size parameters evaluated were area, convex area, perimeter, convex perimeter, length, breadth, fiber length, width, equivalent diameter, and inscribed radius. The shape parameters considered were formfactor, roundness, convexity, solidity, compactness, aspect ratio, elongation, curl, and fractal dimension.

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