LMethamphetamine

The Vicks Inhaler® is the only over-the-counter drug that contains l-methamphetamine. Most amphetamines immunoassays are designed to detect d-methamphetamine. Despite being relatively stereospecific for d-methamphetamine, some amphetamines immunoassays can produce a positive result if /-methamphetamine is present in high concentrations (1,3). Standard GC-MS confirmation methodology cannot distinguish between the two enantiomers and will confirm the presence of methamphetamine that was first detected by the initial test and a clinical false-positive result will be reported. Enantiomeric analysis using chiral derivatization and chromatography is needed to verify that the confirmed methamphetamine result was due to Vicks Inhaler® (3,4). In this special procedure using optically active deriva-tizing reagents, d- and /-enantiomers are converted into diasteriomers, which then can be chromatographically separated prior to mass spectrometric analysis (5). If there is greater than 80% /-methamphetamine (not 100% because there may be a trace contaminant of d-methamphetamine in Vicks Inhaler®), the result is considered to be consistent with Vicks Inhaler® use (6).

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