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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 26, Number 8, November/December,
pp.561-566
Acetylcodeine as a Urinary Marker to Differentiate the
Use of Street Heroin and Pharmaceutical Heroin
Rudolf Brenneisen*, Felix Hasler, and Daniel Würsch
Department of Clinical Research, Laboratory of Phytopharmacology, Bioanalytics
and Pharmacokinetics, University of Bern, CH-3010 Bern, Switzerland
Acetylcodeine (ACOD) is a synthesis byproduct present in street
heroin but not in pharmaceutical diacetylmorphine (DAM) as used in the Swiss
program Heroin-Assisted Treatment for Opiate Dependent Drug Users (HAT). ACOD
was evaluated and validated as an urine marker to detect the consumption of
street heroin by HAT participants. A gas chromatography–mass spectrometry
method allowing the quantitation of ACOD concentrations as low as 0.2 ng/mL
urine has been developed. In opiate-naïve subjects, intravenous (i.v.)
ACOD showed a plasma elimination half-life of 237 ± 18 min, urine peak
concentrations 2 h after administration, and a detection window of 8 h. Only
0.4 ± 0.1% was excreted unchanged, with codeine (COD) as the main metabolite.
ACOD may be formed by transacetylation when i.v. DAM and oral codeine are co-administered.
To avoid false-positive results, the calculation of COD/ACOD ratios is recommended.
In a study with 105 HAT participants, 14% of the tested urines were ACOD positive.
Only a low correlation was found between the anonymously self-declared consumption
of street heroin and the ACOD positive rate.
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