Factors influencing the in situ formation of Δ9-THC from cannabidiol during GC-MS analysis.

Gas chromatography-mass spectrometry (GC-MS) is widely used for the identification of cannabinoids in seized plant material. Conditions used for instrumental analysis should maximize decarboxylation, while minimizing the in situ production of Δ9-THC inside the GC inlet. In this study, decarboxylation of the acidic Δ9-THC precursor and in situ degradation of cannabidiol (CBD) were investigated using seven commercial GC liners with different deactivation chemistries and geometries. While the inlet temperature was previously optimized at 250°C in a previously validated assay, we systematically examined the temperature-dependent decarboxylation of tetrahydrocannabinolic acid-A (Δ9-THCA-A) and cyclization of CBD between 230°C and 310°C using different liners using favorable and unfavorable conditions. Significant differences in decarboxylation rate and CBD cyclization were observed between different liner types. While no temperature-dependent differences in decarboxylation rate were observed within liner type, liner-dependent differences were observed (α = 0.05), particularly between those with different geometry. In contrast, temperature and liner-dependent differences were observed for in situ formation of Δ9-THC (α = 0.05). This was influenced by liner geometry and to a smaller extent by surface deactivation. Effects were exacerbated with liner usage. While significant differences were observed using new and used GC liners, differences between liners of the same type but different lot numbers were not observed. Inter-instrument differences using the same liner were also evaluated and had minimal effect. Liner- and temperature-dependent effects were also confirmed using more than 20 cannabis plant extracts. Careful selection of liner, inlet conditions, and regular preventive maintenance can mitigate the risks associated with in situ formation Δ9-THC from CBD.

Comprehensive toxicological screening of common drugs of abuse, new psychoactive substances and cannabinoids in blood using supported liquid extraction and liquid chromatography-quadrupole time-of-flight mass spectrometry.

Immunoassay (IA) is currently the most widely used technique for toxicological screening in drug-impaired driving investigations. However, practical limitations in the scope of testing, and the emergence of new psychoactive substances (NPSs), have highlighted the need for alternative approaches, particularly mass spectrometry-based screening. High-resolution mass spectrometry broadens the scope of testing to include NPSs and increases analyte specificity compared to IA. In addition, it provides a platform with increased flexibility and adaptability to incorporate emerging drugs of interest due to the transient drug market. In this study, a comprehensive screening procedure was developed to identify >200 drugs of interest, including cannabinoids and NPSs in whole blood. Supported liquid extraction and liquid chromatography-quadrupole time-of-flight mass spectrometry using All Ions data acquisition were used. The method was validated in accordance with published recommendations, and all compounds of interest were identified at recommended cutoffs for driving under the influence of drug investigations. Cannabinoids, including 11-nor-9-carboxy-∆9-tetrahydrocannabinol, fentanyl analogs, buprenorphine, novel synthetic opioids and synthetic cannabinoids, were identified at low- to sub-nanogram/milliliter concentrations in whole blood using both positive and negative electrospray ionization acquisition methods.

Lipophilicity of fentalogs: Comparison of experimental and computationally derived data.

Although fentanyl and a small number of derivatives used for medical or veterinary procedures are well characterized, physiochemical properties have not been determined for many of the newer fentanyl analogs. Partition coefficients (Log P) were determined for 19 fentalogs using the shake-flask method and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Experimentally determined partition coefficients were compared with computationally derived data using six independent software sources (ACD/LogP, LogKOWWIN v 1.69, miLogP 2.2, OsirisP, XLOGP 3.0, ALogPS 2.1). Fentalogs with a wide variety of structural modifications were intentionally selected, yielding Log P values ranging from 1.21 to 4.90. Comparison of experimental and computationally derived Log P values were highly correlated (R2 0.854-0.967). Overall, substructure-based modeling using fragmental methods or property-based topological approaches aligned more closely with experimentally determined Log P values. LC-MS/MS was also used to estimate pKa values for fentalogs with no previously reported data. Lipophilicity and pKa are important considerations for analytical detection and toxicological interpretation. In silico methods allow the determination of physicochemical information prior to certified reference materials being readily available for in vitro or in vivo studies. Computationally derived data can provide insight regarding physiochemical characteristics of future fentalogs and other classes of synthetic analogs that have yet to emerge.

Evaluation of tetrahydrocannabinolic acid (THCA) synthase polymorphisms for distinguishing between marijuana and hemp.

The Controlled Substances Act (CSA) classifies marijuana (Cannabis sativa) as a Schedule I illicit drug. However, the recent Agriculture Improvement Act of 2018 (U.S. Farm Bill) removed hemp from the definition of marijuana in the CSA, making it a legal crop. As a result, many hemp products are now available, including strains of hemp buds high in other cannabinoids such as cannabidiol (CBD) or cannabigerol (CBG). The genetic inheritance of chemical phenotype (chemotype) has been widely studied, with the tetrahydrocannabinolic acid (THCA) synthase gene at the forefront. Previous studies have speculated that there are two forms of the THCA gene, one that produces an active enzyme (present in marijuana) and one that cannot produce a functional enzyme (present in hemp). A DNA analysis method is desirable for determining crop type in sample types inconducive to chemical analysis, such as immature crops, trace residues, small leaf fragments, seeds, and root material. This study optimized and evaluated a previously reported single nucleotide polymorphism (SNP) assay for determining C. sativa crop type. Furthermore, the presence or absence of 15 cannabinoids, including THC and THCA, was reported in cannabis reference materials and 15 legal hemp flower samples. The SNP assay correctly identified crop type in most samples. However, several marijuana samples were classified as hemp, and several hemp seeds were classified as marijuana. Two strains of legal CBG hemp flowers were also classified as marijuana, indicating that factors other than the genetic variation of the THCA synthase gene should be considered when determining crop type.

Recommendations for Toxicological Investigation of Drug-Impaired Driving and Motor Vehicle Fatalities-2021 Update.

This report describes updates to the National Safety Council's Alcohol, Drugs and Impairment Division's recommendations for drug testing in driving under the influence of drug (DUID) cases and motor vehicle fatalities. The updates are based on a survey of drug testing practices in laboratories in the USA and Canada, a comprehensive review of the prior recommendations and data and research on drugs most frequently detected in DUID cases. A consensus meeting was held with representative forensic science practitioners and the authors of this report to update recommendations. No changes were made to the Tier I scope; however, there were changes to cutoffs of some analytes for blood, urine and oral fluid. Due to increased prevalence in DUID cases, trazodone and difluoroethane were added to the Tier II scope. For clarification, Tier I cutoffs reflect free concentrations, and hydrolysis is recommended but not required. The consensus panel concluded that urine is an inferior matrix to blood and oral fluid as it may represent historical use or exposure unrelated to observed impairment; therefore, future iterations of these recommendations will not include urine as a recommended matrix. Laboratories currently testing urine should work with traffic safety partners to encourage the use of blood and oral fluid as more appropriate specimens and adjust their capabilities to provide that testing.

Drug-mediated ion suppression and mitigation of interferences using liquid chromatography-quadrupole/time of flight mass spectrometry (LC-Q/TOF-MS) and liquid chromatography tandem mass spectrometry (LC-MS/MS).

Liquid-chromatography mass spectrometry (LC-MS) is a powerful bioanalytical tool that is gaining widespread use in operational forensic toxicology laboratories. However, changes in ionization efficiency caused by endogenous or exogenous species must be carefully considered. While different modes of ionization can be used, electrospray ionization (ESI) can be especially prone to this phenomenon due to capacity-limited ionization. This decreased ionization efficiency can influence the accuracy and sensitivity of analytical methods. While quantitative matrix effects are evaluated routinely during method development and validation, drug-mediated ion suppression is not always assessed quantitatively, or in sufficient depth. Although stable isotope labeled internal standards (SIL-IS) can mitigate this issue, they are not always commercially available, particularly for new or emerging substances. In this study, the hypnotic drug suvorexant was used as a model compound for the investigation of such interferences. The potential for significant bias in quantitative analysis was demonstrated using this previously validated assay. In this study, quantitative biases due to ionization suppression are discussed, and techniques to overcome this challenge are presented. Decreases in specimen and injection volume were shown to significantly reduce quantitative bias due to drug-mediated suppression. This straight-forward approach can improve the robustness of analytical methodology, which is particularly important when quantitative measurements are relied upon for medicolegal and other purposes.

CYP450-Mediated metabolism of suvorexant and investigation of metabolites in forensic case specimens.

Suvorexant (Belsomra®) is a sedative hypnotic that was approved for use in 2015. It has a novel mechanism of action and was the first dual orexin receptor antagonist (DORA) to be approved for the treatment of sleep disorders. Sedative hypnotics often feature prominently in forensic investigations such as impaired driving and drug-facilitated sexual assault (DFSA) cases. As such, suvorexant is a drug of interest and its identification in forensic toxicology investigations is of significance. However, limited studies have been published to date and the disposition or importance of its metabolites has been largely uninvestigated. In this report, we investigate the enzymes responsible for metabolism and explore the prevalence of metabolites in blood from a series of thirteen forensic investigations. Recombinant cytochrome P450 enzymes (rCYPs) were used to generate phase I metabolites for suvorexant in vitro, and metabolites were identified using liquid chromatography-quadrupole/time-of-flight-mass spectrometry (LC-Q/TOF-MS). Four rCYP isoenzymes (3A4, 2C19, 2D6, and 2C9) were found to contribute to suvorexant metabolism. The only metabolite identified in blood or plasma arose from hydroxylation of the benzyl triazole moiety (M9). This metabolite was identified in seventeen blood and plasma specimens from twelve medicolegal death investigations and one impaired driving investigation. In the absence of a commercially available reference material, the metabolite was confirmed using rCYP-generated in vitro controls using high resolution mass spectrometry.

Identification of metabolites and potential biomarkers of kratom in urine.

Mitragyna speciosa (kratom) is a drug that is increasingly used recreationally and "therapeutically", in the absence of medical supervision. The drug has been associated with a growing number of fatalities, and although its medicinal properties as an atypical opioid require further study, there are legitimate concerns regarding its unregulated use. Mitragynine is the most widely reported alkaloid within the plant, although more than forty other alkaloids have been identified. 7-Hydroxymitragynine is reported to have greater abuse liability due to its increased potency relative to mitragynine. In this report, biomarkers for mitragynine were investigated using liquid chromatography-quadrupole/time of flight mass spectrometry (LC-Q/TOF-MS). Speciociliatine and speciogynine were identified as alternative biomarkers, often exceeding the concentration of mitragynine in unhydrolyzed urine. 9-O-Demethylmitragynine and 7-hydroxymitragynine were identified in unhydrolyzed urine in 75% and 63% of the cases. Deconjugation of phase II metabolites using chemical hydrolysis was not suitable due to degradation of the Mitragyna alkaloids. Enzymatic hydrolysis was evaluated using three traditional glucuronidases, four sulfatases and four recombinant enzymes. Although enzymatic hydrolysis increased the concentration of 16-carboxymitragynine, it had nominal benefit for other metabolites. Deconjugation of urine was not necessary due to the abundance of parent drug (mitragynine), its diastereoisomers (speciociliatine and speciogynine) or metabolites (9-O-demethylmitragynine and 7-hydroxymitragynine).

CYP450-Mediated Metabolism of Mitragynine and Investigation of Metabolites in Human Urine.

Mitragyna speciosa (Kratom) has emerged as a recreational drug and a substance of medicinal intrigue. Although the drug was initially used recreationally for its sedating and euphoric effects, more recently its use has been associated with the non-medically supervised treatment of opioid abstinence syndrome. Mitragynine is the principal pharmacologically active alkaloid in kratom. Although metabolites of mitragynine have been identified, the cytochrome P450 (CYP450) enzymes responsible for its biotransformation are still under investigation. The goal of this study was to contribute further knowledge regarding CYP450 activity as it relates to mitragynine. Recombinant cytochrome P450 enzymes (rCYPs) were used to investigate the isoforms involved in its metabolism. Biotransformational products were identified using liquid chromatography-quadrupole/time of flight-mass spectrometry. Four rCYP enzymes (2C18, 2C19, 2D6 and 3A4) were found to contribute to the metabolism of mitragynine. 7-Hydroxymitragynine (which has an affinity for the mu-opioid receptor >10-folds that of morphine) was produced exclusively by 3A4. 9-O-demethylmitragynine, the most abundant metabolite in vitro (and the most prevalent metabolite in urine among kratom users) was produced by 2C19, 3A4 and 2D6. 16-Carboxymitragynine was produced by rCYPs 2D6, 2C19 and 2C18. 2C19 was solely responsible for the formation of 9-O-demethyl-16-carboxymitragynine. In vitro rCYP studies were compared with phase I metabolites in urine from cases involving mitragynine.

Temperature and pH-Dependent Stability of Mitragyna Alkaloids.

Mitragynine (MG) is the principal psychoactive alkaloid in kratom. The drug produces a variety of dose-dependent effects that appeal to recreational drug users and individuals seeking therapeutic benefits in the absence of medical supervision. In light of documented intoxications, hospitalizations and fatalities, MG and other alkaloids from Mitragyna speciosa are of growing importance to the forensic toxicology community. However, the chemical stability of these compounds has not been thoroughly described. In this report, the stability of MG, 7-hydroxymitragynine (MG-OH), speciociliatine (SC), speciogynine (SG) and paynantheine (PY) are investigated. Short-term stability of the Mitragyna alkaloids was determined over a range of pH (2-10) and temperature (4-80°C) over 8 hours. Liquid chromatography--quadrupole/time-of-flight mass spectrometry was used to estimate half-lives and identify degradation products where possible. The stability of MG and other alkaloids was highly dependent on pH and temperature. All of the Mitragyna alkaloids studied were acid labile. Under alkaline conditions, MG undergoes chemical hydrolysis of the methyl ester to produce 16-carboxymitragynine. MG-OH was the most unstable alkaloid studied, with significant drug loss at 8 hours experienced at temperatures of 40°C and above. No significant drug losses were observed for MG in aqueous solution (pH 2-10) at 4, 20 or 40°C. Diastereoisomers of MG (SC and SG) demonstrated even greater stability. These findings are discussed within the context of the identification of Mitragyna alkaloids in toxicological specimens.

Identification of Suvorexant in Blood Using LC-MS-MS: Important Considerations for Matrix Effects and Quantitative Interferences in Targeted Assays.

Suvorexant (Belsomra®) is a novel dual orexin receptor antagonist used for the treatment of insomnia. The prevalence of suvorexant in forensic samples is relatively unknown, which demonstrates the need for robust analytical assays for the detection of this sedative hypnotic in forensic toxicology laboratories. In this study, suvorexant was isolated from whole blood using a simple acidic/neutral liquid-liquid extraction followed by analysis by liquid chromatography tandem mass spectrometry (LC-MS/MS). Matrix effects were evaluated qualitatively and quantitatively using various extraction solvents, proprietary lipid clean-up devices and source conditions. The method was validated in terms of limit of detection, limit of quantitation, precision, bias, calibration model, carryover, matrix effects and drug interferences. Electrospray is a competitive ionization process whereby compounds in the droplet compete for a limited number of charged sites at the surface. As such, it is capacity-limited, and LC-MS-based techniques must be carefully evaluated to ensure that matrix effects or coeluting drugs do not impact quantitative assay performance. In this report, we describe efforts to ameliorate such effects in the absence of an isotopically labeled internal standard. Matrix effects are highly variable and heavily dependent on the physico-chemical properties of the substance. Although there is no universal solution to their resolution, conditions at the electrospray interface can mitigate these issues. Using this approach, the LC-MS/MS assay was fully validated and limits of detection and quantitation of 0.1 and 0.5 ng/mL suvorexant were achieved in blood.

Spontaneous, Grassroots Initiative Brings Niagara Health's New Purpose, Vision and Values to Life.

The purpose (or mission) of Niagara Health is Extraordinary Caring. Every Person. Every Time. Staff and physicians across the large, multi-site hospital organization are challenged to embrace this purpose in all of their day-to-day interactions. One Niagara Health team with no direct role in patient care (IT) spontaneously and independently created an Acts of Kindness campaign. They set a goal for the number of Acts of Kindness they would do and tracked the results. This simple response inspired 32 additional teams to launch similar initiatives, with more than 30,000 Acts of Kindness recorded and celebrated as of August 2019.

Stability and Hydrolysis of Desomorphine-Glucuronide.

Desomorphine, the principal opioid in Krokodil, has an analgesic potency approximately ten-times that of morphine. Similar to other opioids, during phase II metabolism it undergoes conjugation with glucuronic acid to form desomorphine-glucuronide. Although hydrolysis of conjugated species is sometimes required prior to analysis, desomorphine-glucuronide has not been fully investigated. In this study, six hydrolysis procedures were optimized and evaluated. Deconjugation efficiencies using chemical and enzymatic hydrolysis were evaluated and stability in aqueous solution was assessed. Acid hydrolysis was compared with five ß-glucuronidase sources (BGTurbo™, IMCSzyme™, Escherichia coli, Helix pomatia and Patella vulgata). At optimal conditions, each hydrolysis method produced complete hydrolysis (≥96%). However, under simulated challenging conditions, P. vulgata was the most efficient ß-glucuronidase for the hydrolysis of desomorphine-glucuronide. Both BGTurbo™ and IMCSzyme™ offered fast hydrolysis with no need for sample cleanup prior to liquid chromatography-quadrupole/time of flight-mass spectrometry (LC-Q/TOF-MS) analysis. Hydrolysates using E. coli, H. pomatia and P. vulgata underwent additional sample treatment using ß-Gone™ cartridges. Additionally, the stability of free and conjugated drug was evaluated at elevated temperature (60°C) in aqueous solutions between pH 4 and 10. No degradation was observed for either desomorphine or desomorphine-glucuronide under any of the conditions tested.

Quantitative analysis of desomorphine in blood and urine using solid phase extraction and gas chromatography-mass spectrometry.

Desomorphine, a semi-synthetic opioid, is a component of the street drug Krokodil. Despite continued reports of Krokodil use, confirmation via toxicological testing remains scarce. The lack of confirmed desomorphine reports may be in part due to the limited published analytical methodology capable of detecting desomorphine at forensically relevant concentrations. In an effort to assist with identification efforts, a robust analytical method was developed and validated. Solid phase extraction (SPE) and gas chromatography-mass spectrometry (GC-MS) were used to determine desomorphine in blood and urine using a deuterated analog as the internal standard. Data was acquired using selected ion monitoring (SIM) mode. Extraction efficiencies in blood and urine were 69% and 90%, respectively. The limits of quantitation in blood and urine were 5 ng/mL and 8 ng/mL, ten-fold lower than previously published methods. Intra- and inter-assay CVs were 2-4% (n = 3) and 3-7% (n = 15), respectively. The method was fully validated in accordance with published guidelines for forensic use. Furthermore, it provides a means by which desomorphine can be identified in toxicology specimens at forensically relevant concentrations, without the need for derivatization.

Analysis of Desomorphine in Urine Using Liquid Chromatography-Tandem Mass Spectrometry.

Desomorphine is a primary component of the drug Krokodil. While reports of Krokodil use continue to appear in the literature, analytically confirmed cases remain quite scarce. This might be attributed to trends in geographical use, and limited published analytical methodology to detect its use. A sensitive analytical method to detect desomorphine was developed and validated to assist with identification efforts. Solid phase extraction and liquid chromatography-tandem mass spectrometry were used to quantitatively identify desomorphine in urine. An isotopically labeled analog was used as the internal standard. Assay performance was evaluated in accordance with published guidelines. The extraction efficiency for desomorphine in urine was 90%, and limits of detection and quantitation were 0.5 ng/mL. The calibration range of the assay was 0.5-500 ng/mL. Bias ranged from -1% to 2% (n = 15), and the intra- and inter-assay CVs were 2-3% (n = 3) and 32-6% (n = 15), respectively. Ion suppression was -20% and -10% at low and high concentrations, respectively. Interferences were assessed using common drugs, including 24 opioids and structurally related compounds. Using this approach, the quantitative analysis of desomorphine in urine is described at forensically relevant concentrations.

Quantification of suvorexant in blood using liquid chromatography-quadrupole/time of flight (LC-Q/TOF) mass spectrometry.

Suvorexant is a novel drug for the treatment of insomnia that is marketed under the trade name Belsomra®. Unlike other hypnotics, suvorexant is a dual orexin receptor antagonist that is believed to have a lower abuse potential compared to other therapeutics. Although sedative hypnotics feature prominently in forensic toxicology investigations, there have been limited reports that describe the analysis of suvorexant in biological samples. Following a 10-mg oral dose, peak concentrations are typically <200 ng/mL. A highly sensitive assay is required because forensic toxicology laboratories are often required to identify a drug several hours after a single dose. A new analytical procedure for the quantification of suvorexant in whole blood was developed that will aid in the identification of this new drug in forensic toxicology casework. A simple acidic/neutral liquid-liquid extraction (LLE) was used to isolate suvorexant from whole blood followed by liquid chromatography-quadrupole/time of flight (LC-Q/TOF) mass spectrometry analysis using positive electrospray ionization (ESI). The extraction efficiencies of various solvents in blood were evaluated in addition to limit of detection, limit of quantitation, precision, accuracy and bias, calibration model, matrix effects, interferences, and carryover. The recovery of suvorexant was evaluated using four different extraction solvents (N-butyl chloride, ether/toluene (1:1), hexane/ethyl acetate (9:1), and methyl tert-butyl ether (MTBE). Although no significant differences in analytical recovery were observed, N-butyl chloride demonstrated improved reproducibility, efficiency and convenience. A weighted (1/x) quadratic calibration model was selected over a range of 2-200 ng/mL (R2 = 0.995). Using only 0.5 mL whole blood, limits of detection and quantification were 0.5 ng/mL. Intra-assay (n = 5) and inter-assay (n = 15) precision (% CV) were ≤ 13% and bias ranged from -5 to 2% at concentrations of 5, 50, and 160 ng/mL. Matrix effects were 16% (9% CV) and 15% (8% CV) for 20 ng/mL and 100 ng/mL (n = 20), respectively. No qualitative interferences or carryover were observed; however, a quantitative interference with the internal standard (estazolam-D5) could be attributed to sertraline when present at a 10-fold higher concentration. In the absence of a commercially available deuterated internal standard, the potential for quantitative interferences using LC-based methods are discussed.

In vitro metabolism of desomorphine.

Desomorphine is reported to be the principal pharmacologically active opioid in Krokodil, a homemade injectable drug that is perceived to be a cheaper alternative to heroin. There have been limited studies regarding its pharmacology or detection in biological matrices. The goal of this study was to contribute further knowledge regarding its metabolism. Recombinant human cytochrome P450 enzymes (rCYPs) and recombinant uridine 5'-diphospho-glucuronosyltransferases (rUGTs) were used to investigate the biotransformational pathways involved. Samples were analyzed by liquid chromatography/quadrupole-time of flight-mass spectrometry (LC-Q/TOF-MS). Seven rCYP (rCYP2B6, rCYP2C8, rCYP2C9, rCYP2C18, rCYP2C19, rCYP2D6 and rCYP3A4) enzymes were found to contribute to desomorphine metabolism and eight phase I metabolites were identified, including nordesomorphine, desomorphine-N-oxide, norhydroxydesomorphine, and five hydroxylated species. Inhibition assays were used to confirm individual rCYP isoenzyme activity. Nine rUGTs (rUGT1A1, rUGT1A3, rUGT1A8, rUGT1A9, rUGT1A10, rUGT2B4, rUGT2B7, rUGT2B15, and rUGT2B17) were found to contribute to the formation of desomorphine-glucuronide.

Cathinone stability in authentic urine specimens.

PURPOSE: Synthetic cathinones are encountered in a variety of antemortem and postmortem forensic toxicology investigations. Earlier experimental studies using fortified urine have evaluated analyte, temperature and pH-dependent variables associated with their stability. The purpose of this study was to compare experimental findings with those obtained using authentic urine from cathinone users. METHODS: In this report we compare cathinone concentrations in 180 authentic unpreserved urine specimens, following known periods of refrigerated storage. These findings are compared with previously published experimental data using fortified drug-free urine. Liquid chromatography quadrupole time-of-flight mass spectrometry (LC-Q/TOF-MS) was used to target 22 cathinones. Quantitative results were compared in urine specimens (pH 4.5-10) following 5-17 months of storage. RESULTS: The 180 specimens resulted in 164 quantitative findings involving α-PVP, ethylone, methylone, MDPV and pentylone. Initial drug concentrations ranged from 25ng/mL to over 100,000ng/mL. Upon reanalysis, the percentage of drug remaining (0-119%) was correlated with storage time and specimen pH. The ability to reconfirm original results was not correlated with storage time. Instead, specimen pH was far more predictive. The relationship between initial and final drug concentration was highly pH-dependent, yielding significant correlations for α-PVP, ethylone and methylone, particularly under acidic conditions. CONCLUSIONS: These results are in good agreement with experimental findings and highlight the critical importance of specimen pH, rather than conventional time dependent variables, when considering cathinone stability in biological samples. The potential for pre-analytical changes in cathinone concentrations must be carefully considered when interpreting their results.

Identification of five Mitragyna alkaloids in urine using liquid chromatography-quadrupole/time of flight mass spectrometry.

Mitragyna speciosa (Kratom) is a psychoactive plant that has recently emerged as a recreational drug. Mitragyna alkaloids are not within the scope of traditional forensic toxicology screening methods, which may contribute to under-reporting. Solid phase extraction (SPE) and liquid chromatography-quadrupole/time of flight mass spectrometry (LC-Q/TOF-MS) were used to identify five alkaloids in urine. Target analytes included the two known psychoactive compounds, mitragynine and 7-hydroxymitragynine, in addition to speciociliatine, speciogynine, and paynantheine. Two deuterated internal standards (mitragynine-D3 and 7-hydroxymitragynine-D3) were employed. Using traditional reversed phase chromatography all compounds and isomers were separated in 10 min. The procedure was validated in accordance with the Scientific Working Group for Forensic Toxicology (SWGTOX) Standard Practices for Method Validation. Extraction efficiencies were 63-96% and limits of quantitation were 0.5-1 ng/mL. Precision, bias and matrix effects were all within acceptable thresholds, with the exception of 7-hydroxymitragynine, which is notably unstable and unsuitable for quantitative analysis. In this paper we present a simultaneous quantitative analytical method for mitragynine, speciociliatine, speciogynine and paynantheine, and a qualitative assay for 7-hydroxymitragynine in urine using high resolution mass spectrometry (HRMS).