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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 25, Number 7, October, pp. 515-519
Detection of Opiate Use in a Methadone Maintenance Treatment
Population with the CEDIA® 6-Acetylmorphine and CEDIA DAU Opiate Assays
Alan C. Spanbauer[1], Scott Casseday[2], David Davoudzadeh[2],
Kenzie L. Preston[1], and Marilyn A. Huestis[1]
[1]Chemistry and Drug Metabolism, IRP, NIDA, NIH, Baltimore, Maryland and [2]Microgenics™
Corporation, Fremont, California
Heroin, with a plasma half-life of approximately 5 min, is rapidly
metabolized to 6-acetylmorphine (6-AM). 6-AM, a specific marker for heroin use,
which also has a short half-life of only 0.6 h, is detected in urine for only
a few hours after heroin exposure. Ingestion of poppy seeds and/or licit opiate
analgesics can produce positive urine opiate tests. This has complicated the
interpretation of positive opiate results and contributed to the decision to
raise opiate cutoff concentrations and to require 6-AM confirmation in federally
mandated workplace drug-testing programs. Microgenics Corp. has developed the
CEDIA 6-AM assay, a homogeneous enzyme immunoassay for semiquantitative determination
of 6-AM in human urine, in addition to its CEDIA DAU opiate assay. Urine specimens
were collected 3 times per week from 27 participants enrolled in a clinical
research trial evaluating a contingency management treatment program for heroin
and cocaine abuse. Of the 1377 urine specimens screened, 261 (18.9%) were positive
for opiates at Ž 300 ng/mL, 153 (11.1%) were positive for opiates at Ž 2000
ng/mL, and 55 (4.0%) were positive for 6-AM at Ž 10 ng/mL. For opiate-positive
screens Ž 300 and Ž 2000 ng/mL, 91.3% and 80.8% confirmed positive for morphine
or codeine at the respective gas chromatography–mass spectrometry (GC–MS)
cutoffs. All specimens screening positive for 6-AM also confirmed positive by
GC–MS at Ž 10 ng/mL. Increasing the opiate screening and confirmation cutoffs
for the federal workplace drug-testing program resulted in 8% fewer opiate-positive
tests; however, recent heroin use was not affected by this change.
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