{"title":"False-Positive EtG Immunoassay Screening After Exposure to Aliphatic Alcohols. LC-HRAM-Orbitrap-MS Detection of C1-C6 EtG Homologs in Urine, Chest, and Pubic Hair Samples.","authors":"Camilla Vigato, Flavio Zancanaro, Novella Ghezzo, Giampietro Frison","doi":"10.1002/dta.70064","DOIUrl":"10.1002/dta.70064","url":null,"abstract":"<p><p>A subject, admitted to an addiction treatment unit, was occupationally exposed to solvent mixtures and paint thinners containing aliphatic alcohols, while being a coachbuilder. He repeatedly tested positive for ethyl glucuronide (EtG) in weekly urine immunoassays performed in a hospital laboratory. However, he denied any alcohol consumption. Therefore, presumptive positive urine samples, as well as chest and pubic hair samples, were submitted to targeted liquid chromatography-high-resolution accurate mass-Orbitrap-mass spectrometry (LC-HRAM-Orbitrap-MS) analysis, after derivatization of analytes with N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide (EDC). MS acquisition was carried out in full scan positive-ion mode, followed by data-dependent MS<sup>2</sup> and parallel reaction monitoring confirmation modes, according to an inclusion list of accurate mass values calculated from the elemental composition of MH<sup>+</sup> ion species of several derivatized EtG homologs. All urine samples turned out to be EtG negative. Instead, methyl, propyl, butyl, and hexyl glucuronides were detected at varying levels depending on the exposure and/or inhalation conditions (product types, amounts, etc.), and urine sampling times. As expected, chest hair and pubic hair were EtG negative too, whereas the same other alcohol glucuronides were detected in both matrices, with higher abundances in pubic hair. Cross-reaction of EtG homologs, in this case due to exposure to chemicals containing several aliphatic alcohols, explains the false-positive urine immunoassay results. Furthermore, LC-HRAM-Orbitrap-MS analyses show that EtG homologs, like EtG, can be incorporated and detected in a variety of hair samples.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":"699-708"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147508183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yiannis S Angelis, Olga Goula, Polyxeni Kiousi, Panagiotis Sakellariou
{"title":"Evaluation of Different Detection and Identification Methods of Intact Tetrahydro-Methyltestosterone Sulfate Metabolites in Doping Control.","authors":"Yiannis S Angelis, Olga Goula, Polyxeni Kiousi, Panagiotis Sakellariou","doi":"10.1002/dta.70060","DOIUrl":"10.1002/dta.70060","url":null,"abstract":"<p><p>Tetrahydro sulfate metabolites are well-established long-term biomarkers of methyltestosterone use that can be detected intact by LC-MS/MS. However, their identification using product ion spectra under collision-induced dissociation conditions in negative ion mode is an analytical challenge under the provisions of the WADA TD2023IDCR. In this study, six out of eight potential tetrahydro-methyltestosterone sulfate metabolites were microscale-synthesized to facilitate both the structural elucidation of the detected metabolites and the development of direct identification methods. Their identification was based on their GC-MS/(MS) analysis after TMS derivatization or LC-HRMS/(MS) analysis following derivatization of the free 17β-hydroxy group with carbonyldiimidazole (CDI), producing 17β-OH-imidazole carbamate derivatives. The resulting derivatives were detectable in both negative and positive ion modes, enabling their identification through characteristic product ion spectra. Urine samples from two 17α-methyltestosterone excretion studies were analyzed using these methods, and detection/identification time windows of intact sulfate metabolites were estimated under TD2023IDCR and compared with those obtained from GC-MS/(MS) analysis of the glucuronide fraction after hydrolysis. Overall, the inclusion of the tetrahydro-methyltestosterone sulfate metabolites significantly extends the detection time window for methyltestosterone abuse. Still, the established identification time window was similar to, or shorter than, that derived from the glucuronide fraction analysis.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":"678-689"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophia Krombholz, Linus Korsmeier, Andreas Thomas, Mario Thevis
{"title":"Analysis and Characterization of Kisspeptin and Its Analogues in Serum and Urine Samples by Liquid Chromatography-High-Resolution Mass Spectrometry for Doping Control Purposes.","authors":"Sophia Krombholz, Linus Korsmeier, Andreas Thomas, Mario Thevis","doi":"10.1002/dta.70081","DOIUrl":"https://doi.org/10.1002/dta.70081","url":null,"abstract":"<p><p>The use of testosterone-stimulating peptides for doping purposes is prohibited for male athletes by the World Anti-Doping Agency (WADA). Among these substances is kisspeptin (KP-54), its isoforms (KP-14, KP-13, and KP-10), and synthetic receptor agonists such as TAK-448. Thus, they have been included in the WADA Prohibited List in 2024. To enable effective detection of kisspeptin misuse, reliable analytical methods are required. Consequently, this study aimed to develop liquid chromatography-high-resolution mass spectrometry-based (LC-MS) methods for the detection of kisspeptin and its analogues in human serum and urine. In addition, peptide stability in different biological matrices was investigated, and metabolic stability was characterized in vitro. Extraction methods based on cation-exchange solid-phase extraction were optimized, enabling a selective and sensitive LC-MS analysis with limits of identification (LOI) ranging from 0.8 ng/mL (KP-54) to 10 pg/mL (TAK-448). Analysis of a reference population comprising n = 20 serum samples and n = 100 urine samples revealed no detectable signals of endogenous kisspeptins and/or its degradation products. All native kisspeptins investigated showed poor stability in urine and blood; however, several degradation products could be identified. These metabolites could serve as complementary target analytes and improve the detectability of kisspeptins in doping control samples. Overall, the study provides an important foundation for the confirmatory analysis of kisspeptins in doping controls and delivers in vitro insights into their metabolic behavior. Analysis of samples collected after administration of the peptides remains necessary to further assess the detectability and metabolic profiles in authentic samples.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Comparison of Three Analytical Procedures for Oxandrolone Long-Term Metabolite Determination in Urine Samples.","authors":"B Stojanovic, S Pfeffer, G Gmeiner","doi":"10.1002/dta.70080","DOIUrl":"https://doi.org/10.1002/dta.70080","url":null,"abstract":"<p><p>In contemporary antidoping analysis, doping control laboratories are confronted with a wide range of evolving analytical challenges. Continuous methodological refinement is required in this dynamic field, particularly with respect to analytical strategies for the detection and confirmation of prohibited substances. The present study focuses on the comparative evaluation of three analytical strategies for the determination of long-term metabolites (LTMs) of the anabolic androgenic steroid (AAS) oxandrolone (Oxa) in human urine. The identification and implementation of LTMs in routine doping control have substantially enhanced the detection capabilities of antidoping laboratories, leading to an increased number of adverse analytical findings, particularly for AAS compounds. The primary objective of this work was to develop and validate novel confirmatory analytical procedures for Oxa LTMs and to compare their performance with that of an already established method. The investigated approaches comprise the following: (1) gas chromatography-mass spectrometry (GC-MS) following enzymatic hydrolysis of phase II metabolites and subsequent silylation, (2) liquid chromatography-high-resolution mass spectrometry (LC-HRMS) of methylated phase II metabolites, and (3) LC-HRMS analysis of hydrolyzed phase II metabolites. The first two approaches are reported here for the first time in the context of LTM analysis in antidoping applications. These methodologies represent innovative analytical strategies that may be transferable to other target analytes and thereby contribute to further improvements in sports drug testing.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A Y Simão, T Rosado, M Barroso, M Andraus, E Gallardo
{"title":"Recreational Drug Use at a Music Festival: A Dual Approach Using Hair Biomarkers Analysis and Participant Self-Reported Drug Use.","authors":"A Y Simão, T Rosado, M Barroso, M Andraus, E Gallardo","doi":"10.1002/dta.70076","DOIUrl":"https://doi.org/10.1002/dta.70076","url":null,"abstract":"<p><p>The growing prevalence of substance use and its associated health consequences highlights the need for reliable approaches to assess consumption patterns and validate self-reported data. This study, conducted at an international music festival in Portugal, aimed to characterise substance use by integrating objective toxicological findings with self-reported information. Quantitative hair analysis was combined with survey data from 249 participants recruited in 2022 and 2023. Hair samples were analysed by liquid chromatography-tandem mass spectrometry to detect psychoactive substances and metabolites. Self-reported use was assessed across multiple timeframes, from same-day consumption to use within the previous year. Alcohol (96%) and cannabinoids (90%) were the most frequently self-reported substances overall, based on lifetime self-reported use. Overall, 50% of participants tested positive for at least one compound in the analysed hair samples, with cocaine, MDMA and ketamine being the most commonly detected substances (24.5%, 24.1% and 22.9%, respectively). Some participants who denied consumption tested positive, particularly for MDMA and ketamine. Self-reported non-use was inversely associated with hair positivity for MDMA (OR = 0.25, 95% CI: 0.09-0.65) and ketamine (OR = 0.19, 95% CI: 0.09-0.40), compared with self-reported users. Discrepancies were also observed for cannabinoids, highlighting limitations of self-reported data. Strong correlations were identified between cocaine and benzoylecgonine, and between cannabis-related analytes (cannabidiol and THC), supporting the consistency of the toxicological results. Integrating self-reported data with objective biological measures improved data reliability, revealed polydrug use patterns and supported substance use monitoring in high-risk populations such as music festival attendees in this high-exposure festival setting.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haidyn G Stark, Jesus J Sanchez, Nathalie Hill-Kapturczak, John D Roache, Brett C Ginsburg
{"title":"Examining Phosphatidylethanol (PEth) Formation Rates Within and Between Subjects in Ex Vivo Whole Blood.","authors":"Haidyn G Stark, Jesus J Sanchez, Nathalie Hill-Kapturczak, John D Roache, Brett C Ginsburg","doi":"10.1002/dta.70079","DOIUrl":"https://doi.org/10.1002/dta.70079","url":null,"abstract":"<p><p>Interpretation of phosphatidylethanol (PEth) is complicated by between-subject variation in the PEth concentrations after matched ethanol exposure. Previous research suggests differences in PEth formation rates may explain this variability but lacks within-subject assessments. This study assesses the extent of variability in PEth formation rates in ex vivo whole blood across a range of ethanol concentrations, with repeated ethanol exposures in blood collected 1 month apart, and the relationship of phosphatidylcholine concentration and PEth formation rate. Whole blood from 10 participants was collected via venipuncture. For each participant, blood was divided into separate samples and incubated with ethanol concentrations ranging 0-236.7 mg/dL at 37°C. Aliquots were removed from each sample every hour for 5 h. PEth 16:0/18:1 concentrations were measured using high performance liquid chromatography with tandem mass spectrometry. PEth formation rates were determined as the slope of linear regressions of PEth concentration over time. The experiment was repeated 1 month later for each participant. The relationship between PEth formation rate and phosphatidylcholine concentration was evaluated with linear regression analysis. PEth formation rate increased with increasing ethanol concentration, with variability between participants, but was consistent within-subject. Different PEth formation rates at the same ethanol concentration were observed in four individuals across two blood collection timepoints. No relationship was observed between phosphatidylcholine concentrations and formation rates, consistent within participants. PEth formation rate varies between individuals and within some individuals. PEth concentrations should be used to monitor an individual's ethanol use over time rather than compared between individuals.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annette Zschiesche, Birgit Schneider, Ilona Nordhorn, Carsten Baessmann, Laura M Huppertz, Jürgen Kempf
{"title":"A Novel Workflow for Fast Elucidation of Drug Metabolites for Screening-Combining In Silico Metabolite Prediction With Trapped Ion Mobility QTOF-MS.","authors":"Annette Zschiesche, Birgit Schneider, Ilona Nordhorn, Carsten Baessmann, Laura M Huppertz, Jürgen Kempf","doi":"10.1002/dta.70062","DOIUrl":"https://doi.org/10.1002/dta.70062","url":null,"abstract":"<p><p>Urine is one of the preferred matrices for standard toxicological analysis, which makes the inclusion of drug metabolites in targeted and untargeted screening mandatory. Mass spectrometry is key for substance identification, but updating methods for emerging substances like new psychoactive substances (NPS) is challenging due to the limited availability of reference standards for metabolites. This is particularly problematic for drugs that are barely or not detectable at all in urine. Insufficient metabolic knowledge and lack of spectral data carry the risk of false negatives. This study evaluates a non-targeted workflow using ultrahigh-performance liquid chromatography-trapped ion mobility spectrometry time-of-flight mass spectrometry (UHPLC-timsTOF-MS) and dedicated processing software (MetaboScape), integrating in silico metabolite prediction (BioTransformer), fragmentation (MetFrag), collision cross-section (CCS) prediction, and library searching. Quetiapine was selected as a model compound. Phase I metabolites were generated via pooled human liver microsomes (pHLMs) and analyzed by UHPLC-timsTOF-MS. Features were extracted and annotated with MetaboScape. The workflow successfully annotated 20 phase I metabolites in the pHLM assay, with 13 confirmed by library matching and 18 by BioTransformer. These metabolites were added to a targeted UHPLC-QTOF-MS method for analysis of 30 quetiapine-positive ante- and post-mortem urine samples from forensic casework. This revealed N-, O-dealkyl and carboxylated metabolites as the most abundant biomarkers in human urine. This integrated approach enables rapid and reliable metabolite detection, supports biomarker discovery, and facilitates routine screening updates, especially for substances without reference standards. Although not intended for exhaustive metabolic characterization, it offers practical applicability in evolving drug landscapes.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katja Walpurgis, Andreas Thomas, Jasmin Thelen, Bettina Majer, Maneera Al-Jaber, Wadha Abushareeda, Mario Thevis
{"title":"Detection of the GH Analogue Redalsomatropin Alfa in Sports Drug Testing: Immunological Approaches and LC-HRMS/MS.","authors":"Katja Walpurgis, Andreas Thomas, Jasmin Thelen, Bettina Majer, Maneera Al-Jaber, Wadha Abushareeda, Mario Thevis","doi":"10.1002/dta.70075","DOIUrl":"https://doi.org/10.1002/dta.70075","url":null,"abstract":"<p><p>Human growth hormone (hGH) is a peptide hormone exerting different growth-promoting and metabolic functions through binding to the GH receptor (GHR). Due to the presumed lipolytic and anabolic effects, the misuse of recombinant 22-kDa hGH in sports is prohibited both in- and out-of-competition, and also synthetic long-acting GH analogues were added to the WADA Prohibited List in 2022. Within this research project, the detectability of redalsomatropin alfa (JR-142) with the immunoassays routinely employed by anti-doping laboratories for rhGH testing was evaluated. The drug candidate represents a recombinant fusion protein of 22-kDa hGH (191 amino acids) and human serum albumin (HSA, 585 amino acids) and is currently undergoing Phase III of its clinical development. Due to the attachment of HSA to the C-terminus of 22-kDa hGH, only \"Kit 2\" of the routinely employed immunoassay was found to recognize the drug, and the cross-reactivity was significantly reduced when compared to native hGH. As the misuse of redalsomatropin alfa in sports can therefore remain undetected when using this assay alone, the drug was implemented into the existing qualitative initial testing procedure (ITP) for the hGH analogue somatrogon employing affinity purification with GHR-Fc-conjugated magnetic beads for sample extraction and tryptic digestion in combination with LC-HRMS/MS for protein identification. Method validation demonstrated that the assay allows for a sensitive and specific detection of the fusion protein down to concentrations of 50 ng/mL. Moreover, these findings show that this LC-HRMS/MS assay can be further expanded to simultaneously test for multiple long-acting growth hormones (LAGHs).</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fabian Picht, Valentin Cepus, Rona Hohlfeld, Julian Klingbeil, Marco Weber
{"title":"Identification and Characterization of the Designer Opioid N-Pyrrolidino Fluetonitazene in Nasal Spray.","authors":"Fabian Picht, Valentin Cepus, Rona Hohlfeld, Julian Klingbeil, Marco Weber","doi":"10.1002/dta.70074","DOIUrl":"https://doi.org/10.1002/dta.70074","url":null,"abstract":"<p><p>Detection of drugs in non-biological samples serves as a fundamental basis for identifying emerging trends in the field of new psychoactive substances and provides valuable information for optimizing analytical methods within the field of chemical analysis. Nitazenes belong to this group of compounds and have been reported to cause poisonings. N-pyrrolidino fluetonitazene, also known as fluetonitazepyne (2-(4-(2-fluoroethoxy)benzyl)-5-nitro-1-(2-(pyrrolidin-1-yl)ethyl)-1H-benzo[d]imidazole), is another emerging synthetic opioid that may contribute to the challenges faced globally. This article describes the identification and characterization of N-pyrrolidino fluetonitazene in a rarely reported medium for opioids: nasal spray. The sample investigated here was collected from a patient treated at the University Medicine Halle following first-time recreational use of a nasal spray and was submitted in an amber plastic bottle containing a small volume of a yellowish viscous liquid. The analytical techniques used for identifying this compound included gas chromatography-mass spectrometry, liquid chromatography-quadrupole time-of-flight mass spectrometry, nuclear magnetic resonance spectroscopy, and Fourier transform infrared spectroscopy.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Del Mar Ramirez Fernandez, Vincent Cirimele, Evi Ruyssinckx, Vincent Di Fazio, Werner Jacobs, Grégory Schmit, Sarah M R Wille
{"title":"Challenges in the Interpretation of Isolated THC-COOH Detection in Hair: Forensic and Clinical Implications.","authors":"Maria Del Mar Ramirez Fernandez, Vincent Cirimele, Evi Ruyssinckx, Vincent Di Fazio, Werner Jacobs, Grégory Schmit, Sarah M R Wille","doi":"10.1002/dta.70072","DOIUrl":"https://doi.org/10.1002/dta.70072","url":null,"abstract":"<p><p>Cannabis detection in hair typically relies on Δ9-tetrahydrocannabinol (THC), but interpretation is limited by its lipophilicity, external contamination, and washout. The metabolite 11-nor-9-carboxy-THC (THC-COOH) is considered a more specific biomarker, though often present at much lower concentrations than THC. Cases with THC-COOH detected without THC present an interpretative challenge. This study investigated the prevalence, segmental distribution, and significance of hair samples positive for THC-COOH in the absence of THC in a forensic cohort monitored for driving license regranting. Hair (n = 639), blood (n = 198), and urine (n = 221) were collected. Hair was segmented (0-3 cm proximal, 3-6 cm distal) and analyzed using validated UPLC-MS/MS for THC, CBN, CBD, and THC-COOH. Cutoffs were THC ≥ 50 pg/mg and THC-COOH ≥ 0.2 pg/mg. Self-reported use was recorded and compared to biological results using phi (φ) coefficients. Of 639 hair samples, 276 were negative, 207 positive for both THC and THC-COOH, 76 positive for THC-COOH only, and 52 positive for THC only. THC-COOH-only cases included 29 with both segments positive. Median proximal hair concentrations (pg/mg) were THC-COOH 3, THC 340, CBD 270, CBN 170, higher than distal segments. Concordance with self-report improved when THC-COOH was considered when detected alone (φ up to 0.54). Wash tests of THC-COOH-only hair (n = 100) were negative, confirming endogenous origin. THC-COOH detection in hair, even without THC, is valid evidence of cannabis use. Multi-matrix analysis and recognition of THC-COOH as a primary marker improve abstinence monitoring and support updates to forensic guidelines.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}