|SOFT - TIAFT 1998||Scientific Session 2||Wednesday October 7, 1998|
|CONCORDANCE OF 6-ACETYLMORPHINE WITH FREE AND TOTAL MORPHINE IN URINE AFTER INTRAVENOUS, INTRAMUSCULAR AND INTRANASAL HEROIN ADMINISTRATION|
|William D. Darwin, Edward J. Cone, Amanda J. Jenkins, Michael L. Smith*, Jacqueline Summers*, Eric Shimomura* and Buddha D. Paul*|
Addiction Research Center, IRP, NIDA, NIH, Baltimore, MD, USA
Heroin is metabolized and excreted rapidly in urine as 6-acetylmorphine (6-AM), free morphine and conjugated morphine. Because other sources of opiates (codeine, poppy seeds) can produce morphine but not 6-AM, 6-AM is a useful marker for heroin exposure. We evaluated the relationship of 6-AM to free morphine and total morphine in urine following intravenous (3.0, 6.0 & 12.0 mg; N = 8 subjects, 624 specimens), intramuscular (6.0 mg; N = 6 subjects, 115 specimens), and intranasal (6.0 & 12.0 mg; N = 6 subjects, 337 specimens) heroin administration under controlled dosing conditions. Subjects provided informed consent and resided on a closed research ward under medical surveillance during dosing. All specimens were analyzed by GC-MS by Department of Defense protocols. The table compares the number of specimens identified in each cutoff category.
Of the 45 6-AM positives (> 10 ng/mL), 84.4% had a total morphine concentration >2000 ng/mL and 95.6% had a free morphine concentration >100 ng/mL. Of the 78 samples of total morphine >2000 ng/mL and 91 samples of free morphine >100 ng/mL, 40 (51.3%) of the total morphine and 48 (52.7%) of the free morphine were negative for 6-AM (<10 ng/mL). Although 6-AM served as a reliable marker when present, there were many specimens containing >300 ng/mL of total morphine that tested negative (<10 ng/mL) for this marker.