Max Polke, Florian Zapf, Tanja Restin, Thomas Kraemer, Tina M Binz
{"title":"Evaluation of Therapeutic Opioids in Hair of Neonatal and Pediatric Patients.","authors":"Max Polke, Florian Zapf, Tanja Restin, Thomas Kraemer, Tina M Binz","doi":"10.1002/dta.3935","DOIUrl":null,"url":null,"abstract":"<p><p>Forensic hair analysis poses a valuable tool for assessing opioid exposure in children and neonates. However, reliable literature data on opioid concentrations in the hair of this population are mostly scarce, making the interpretation of such hair analysis results rather challenging. This noninterventional study aims to address this issue by investigating 118 hair samples of pediatric patients (median age: 50 days) from the University Children's Hospital Zurich. These patients were treated with medically approved novel synthetic opioids (fentanyl, remifentanil, sufentanil, or alfentanil) and traditional opioids (morphine, methadone, and hydromorphone) during their clinical treatment. Quantification of the opioids and selected metabolites was achieved by a previously validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) based method, which showed good sensitivity with lower limits of quantification (LLOQs) ranging from 0.1 to 1 pg/mg hair. Most analytes were successfully detected in patients' hair, with the majority being identified for the first time in this matrix. Significant correlations were found between the opioid concentrations in hair and the administered medication doses, indicating that hair analysis may reflect the extent of opioid exposure in this population. Furthermore, metabolite ratios similar to the ones commonly found in adult hair were identified, which are forensically important to differentiate between active intake of a drug and contamination. The metabolite ratio of β-hydroxyfentanyl to fentanyl was particularly well suited for children and neonatal patients. In conclusion, concentration ranges, metabolite ratios, and dose correlations of the studied opioids in pediatric hair were established, providing insights into opioid incorporation pathways.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drug Testing and Analysis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/dta.3935","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOCHEMICAL RESEARCH METHODS","Score":null,"Total":0}
引用次数: 0
Abstract
Forensic hair analysis poses a valuable tool for assessing opioid exposure in children and neonates. However, reliable literature data on opioid concentrations in the hair of this population are mostly scarce, making the interpretation of such hair analysis results rather challenging. This noninterventional study aims to address this issue by investigating 118 hair samples of pediatric patients (median age: 50 days) from the University Children's Hospital Zurich. These patients were treated with medically approved novel synthetic opioids (fentanyl, remifentanil, sufentanil, or alfentanil) and traditional opioids (morphine, methadone, and hydromorphone) during their clinical treatment. Quantification of the opioids and selected metabolites was achieved by a previously validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) based method, which showed good sensitivity with lower limits of quantification (LLOQs) ranging from 0.1 to 1 pg/mg hair. Most analytes were successfully detected in patients' hair, with the majority being identified for the first time in this matrix. Significant correlations were found between the opioid concentrations in hair and the administered medication doses, indicating that hair analysis may reflect the extent of opioid exposure in this population. Furthermore, metabolite ratios similar to the ones commonly found in adult hair were identified, which are forensically important to differentiate between active intake of a drug and contamination. The metabolite ratio of β-hydroxyfentanyl to fentanyl was particularly well suited for children and neonatal patients. In conclusion, concentration ranges, metabolite ratios, and dose correlations of the studied opioids in pediatric hair were established, providing insights into opioid incorporation pathways.
期刊介绍:
As the incidence of drugs escalates in 21st century living, their detection and analysis have become increasingly important. Sport, the workplace, crime investigation, homeland security, the pharmaceutical industry and the environment are just some of the high profile arenas in which analytical testing has provided an important investigative tool for uncovering the presence of extraneous substances.
In addition to the usual publishing fare of primary research articles, case reports and letters, Drug Testing and Analysis offers a unique combination of; ‘How to’ material such as ‘Tutorials’ and ‘Reviews’, Speculative pieces (‘Commentaries’ and ‘Perspectives'', providing a broader scientific and social context to the aspects of analytical testing), ‘Annual banned substance reviews’ (delivering a critical evaluation of the methods used in the characterization of established and newly outlawed compounds).
Rather than focus on the application of a single technique, Drug Testing and Analysis employs a unique multidisciplinary approach to the field of controversial compound determination. Papers discussing chromatography, mass spectrometry, immunological approaches, 1D/2D gel electrophoresis, to name just a few select methods, are welcomed where their application is related to any of the six key topics listed below.