RESUMO
Background: Nonmedical use of prescription drugs for recreational purposes is a major health problem that raises high concerns for public health. Recently, several laboratory studies have reported the misuse of pentazocine, an agonist-antagonist opioid in combination with antihistamines in opioid addicts. Illicit self-administration of prescription drugs has been increasingly reported in India. Urinalysis as an adjunct to self-report plays a key role in providing additional information in the treatment of drug users. This paper aims to discuss a simple, convenient, and rapid capillary column gas-liquid chromatography method for simultaneous detection of pentazocine, pheniramine, and cotinine in urine. Methods: The sample was extracted with chloroform and isopropanol (3:1,v/v) and evaporated to dryness. After reconstitution with methanol, it was directly subjected to gas chromatography analysis. Method performance was evaluated and validated in terms of sensitivity, precision, the limit of detection (LOD), and the limit of quantification (LOQ). Findings: The linearity obtained was in the range of 50-1000 ng/ml with a correlation coefficient (r) above 0.999 for each drug. Good LOQ (50ng/ml) was obtained with each drug. Also, the developed method was effective in analyzing samples from patients with suspected abuse of these drugs. Conclusion: The technique was found to be simple, robust, sensitive, and precise in the simultaneous analysis of drugs (pentazocine, pheniramine, and cotinine). This method was proved to be useful and cost-effective in treating and monitoring patients seeking help for addiction in clinical settings.
RESUMO
BACKGROUND: Strict adherence to pharmacological dosage regimens is a prerequisite to the success of most treatments, particularly for patients in drug abuse programs. The compliance of tramadol, an atypical non-scheduled narcotic analgesic, using objective method has not been adequately studied in an Indian setting. AIM: To evaluate the compliance and pattern of drug use among opioid-dependent subjects prescribed tramadol based on urinalysis. METHOD: Fifty male opioid-dependent patients (ICD 10), seeking treatment at a tertiary de-addiction treatment centre of North India on tramadol prescription for atleast past four weeks were included. Self-reported substance use was recorded using semi-structured proforma. Ten ml of urine was collected for the assessment of compliance of tramadol of other substance use (morphine, buprenorphine, dextropropoxyphene, pentazocine, cannabis, benzodiazepines, pheniramine). All these drugs were analyzed using the immunoassay-based Cassette test and Gas Chromatography in human urine. RESULT: Mean age of the participants was 42.8 years and the mean duration of opioid use was 15.9years. The urine specimen of all subjects tested positive for tramadol. Urinalysis revealed benzodiazepines, cannabis, and pheniramine to be the most common substances of use in this population. It was seen that agreement of self-reporting and urine test results was good for morphine (κ = 0.558) and cannabis (κ = 0.312) and was poor for buprenorphine, pentazocine, and pheniramine. CONCLUSION: The study demonstrates the continued use of several illicit or non-prescribed medications in a medication-assisted opioid treatment population. The results affirm the reliability of urinalysis as an adjunct for testing compliance in such a population.
