Opiates

Fogerson et al. (83) used PharmChek patches for sweat collection and EIA and GC-MS for opiate analysis on human subjects injected with known doses of codeine and heroin. The investigators found that sweat primarily contains parent opiates heroin and codeine and lipophilic metabolite 6-MAM. The EIA in which morphine was used as a calibrating analyte showed cross-reactivity with codeine of 588%, with hydrocodone of 143%, with diacetylmorphine of 28% and with 6-MAM of 30%. Using 215 patches from 95 subjects and receiver operator characteristics curves, the optimal cut-off was established at 10ng/mL morphine equivalents. At this cutoff concentration, the assay had a diagnostic sensitivity of 86.9% and a diagnostic specificity of 92.8% as compared to GC-MS. The positive predictive value at a prevalence of 50% was 86%.

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