A simple and reliable procedure for the determination of psychoactive drugs in oral fluid by gas chromatography-mass spectrometry.

A simple and reliable gas chromatography-mass spectrometry method for identifying and quantifying psychoactive drugs in oral fluid is described. Substances under investigation were: psychostimulant drugs (amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine, 3,4-methylenedioxiamphetamine, 3,4-methylenedioxy-N-ethylamphetamine, phentermine), cocaine and metabolites (benzoylecgonine, cocaethylene, and ecgonine methyl esther), cannabinoids (delta-9-tetrahydrocannabinol, 11-nor-9-carboxy-delta-9-tetrahydrocannabinol, 11-hydroxy-delta-9-tetrahydrocannabinol, cannabinol and cannabidiol), opiates (6-monoacetylmorphine, morphine and codeine), hypnotics (flurazepam, flunitrazepam, dipotassium chlorazepate, alprazolam, diazepam and oxazepam), antidepressant drugs (amitryptiline, paroxetine and sertraline), antipsychotic drugs (haloperidol, chlorpromazine and fluphenazine) chlormethiazole, loratidine, hydroxyzine, diphenhydramine, valproic acid and gabapentin. After the addition of deuterated analogues of morphine, 3,4-methylenedioxymethamphetamine, (+/-)-11-nor-9-carboxy-delta-9-tetrahydrocannabinol and clonazepam as internal standards, all the compounds were simultaneously extracted from oral fluid by solid-phase extraction procedure. Acid compounds were eluted with acetone while basic and neutral compounds with dichloromethane:isopropanol:ammonium (80:20:2, v/v/v). Chromatography was performed on a methylsilicone capillary column and analytes, derivatized with N-Methyl-N-(trimethylsilyl)trifluoroacetamide, were determined in the selected-ion-monitoring (SIM) mode. Mean recovery ranged between 44.5 and 97.7 % and quantification limit between 0.9 and 44.2 ng/ml oral fluid for the different analytes. The developed analytical methodology was applied to investigate the presence of psychoactive drugs in oral fluid from injured individuals attending the emergency room (MACIUS project).