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Testing hair for fentanyl exposure: a method to inform harm reduction behavior among individuals who use heroin.
Am J Drug Alcohol Abuse. 2019; 45(1):90-96.AJ

Abstract

BACKGROUND

Deaths from fentanyl exposure continue to increase in the US. Fentanyl test strips are now available to test urine for presence of fentanyl, but additional testing methods are needed to determine past exposure and to determine exposure to specific analogs.

OBJECTIVES

To investigate exposure to such analogs through hair testing.

METHODS

Forty individuals in inpatient detoxification (7.5% female) reporting past-month heroin use were surveyed and provided a hair sample to be tested at a later date. While results could not be provided to patients, they were asked how they would respond if informed that their hair tested positive for fentanyl. UHPLC-MS/MS was used to test for past exposure to fentanyl, six other novel synthetic opioids, and fentanyl biomarkers/metabolites.

RESULTS

27.5% reported known fentanyl use in the past year and 67.5% reported suspected exposure. 97.5% (39 of 40) tested positive for fentanyl, 90.0% tested positive for 4-ANPP (a biomarker) and norfentanyl (a metabolite); 82.5% tested positive for acetyl-fentanyl, 47.5% tested positive for furanyl-fentanyl, and 7.5% tested positive for U-47700. Most participants (82.5%) reported they would warn others about fentanyl if they learned their hair tested positive; 75.0% reported they would try to stop using heroin, and 65.0% reported they would ensure that someone nearby has naloxone to reverse a potential overdose.

CONCLUSIONS

Hair testing is useful in detecting past exposure to fentanyl, its analogs, and other novel synthetic opioids. Further research is needed to determine whether individuals who use heroin learning about exposure affects drug-taking and treatment-seeking behavior.

Authors+Show Affiliations

a Department of Population Health , New York University Langone Medical Center , New York , NY , USA.b Centro Regionale Antidoping e di Tossicologia "A. Bertinaria" , Orbassano , Turin , Italy. c Dipartimento di Chimica , Università di Torino , Turin , Italy.c Dipartimento di Chimica , Università di Torino , Turin , Italy.b Centro Regionale Antidoping e di Tossicologia "A. Bertinaria" , Orbassano , Turin , Italy. c Dipartimento di Chimica , Università di Torino , Turin , Italy.a Department of Population Health , New York University Langone Medical Center , New York , NY , USA.a Department of Population Health , New York University Langone Medical Center , New York , NY , USA. d Division of General Internal Medicine , New York University School of Medicine , New York , NY , USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

30601034

Citation

Palamar, Joseph J., et al. "Testing Hair for Fentanyl Exposure: a Method to Inform Harm Reduction Behavior Among Individuals Who Use Heroin." The American Journal of Drug and Alcohol Abuse, vol. 45, no. 1, 2019, pp. 90-96.
Palamar JJ, Salomone A, Bigiarini R, et al. Testing hair for fentanyl exposure: a method to inform harm reduction behavior among individuals who use heroin. Am J Drug Alcohol Abuse. 2019;45(1):90-96.
Palamar, J. J., Salomone, A., Bigiarini, R., Vincenti, M., Acosta, P., & Tofighi, B. (2019). Testing hair for fentanyl exposure: a method to inform harm reduction behavior among individuals who use heroin. The American Journal of Drug and Alcohol Abuse, 45(1), 90-96. https://doi.org/10.1080/00952990.2018.1550652
Palamar JJ, et al. Testing Hair for Fentanyl Exposure: a Method to Inform Harm Reduction Behavior Among Individuals Who Use Heroin. Am J Drug Alcohol Abuse. 2019;45(1):90-96. PubMed PMID: 30601034.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Testing hair for fentanyl exposure: a method to inform harm reduction behavior among individuals who use heroin. AU - Palamar,Joseph J, AU - Salomone,Alberto, AU - Bigiarini,Rachele, AU - Vincenti,Marco, AU - Acosta,Patricia, AU - Tofighi,Babak, Y1 - 2019/01/02/ PY - 2019/1/3/pubmed PY - 2020/3/28/medline PY - 2019/1/3/entrez KW - Heroin KW - adulterants KW - drug testing KW - fentanyl KW - hair testing KW - harm reduction SP - 90 EP - 96 JF - The American journal of drug and alcohol abuse JO - Am J Drug Alcohol Abuse VL - 45 IS - 1 N2 - BACKGROUND: Deaths from fentanyl exposure continue to increase in the US. Fentanyl test strips are now available to test urine for presence of fentanyl, but additional testing methods are needed to determine past exposure and to determine exposure to specific analogs. OBJECTIVES: To investigate exposure to such analogs through hair testing. METHODS: Forty individuals in inpatient detoxification (7.5% female) reporting past-month heroin use were surveyed and provided a hair sample to be tested at a later date. While results could not be provided to patients, they were asked how they would respond if informed that their hair tested positive for fentanyl. UHPLC-MS/MS was used to test for past exposure to fentanyl, six other novel synthetic opioids, and fentanyl biomarkers/metabolites. RESULTS: 27.5% reported known fentanyl use in the past year and 67.5% reported suspected exposure. 97.5% (39 of 40) tested positive for fentanyl, 90.0% tested positive for 4-ANPP (a biomarker) and norfentanyl (a metabolite); 82.5% tested positive for acetyl-fentanyl, 47.5% tested positive for furanyl-fentanyl, and 7.5% tested positive for U-47700. Most participants (82.5%) reported they would warn others about fentanyl if they learned their hair tested positive; 75.0% reported they would try to stop using heroin, and 65.0% reported they would ensure that someone nearby has naloxone to reverse a potential overdose. CONCLUSIONS: Hair testing is useful in detecting past exposure to fentanyl, its analogs, and other novel synthetic opioids. Further research is needed to determine whether individuals who use heroin learning about exposure affects drug-taking and treatment-seeking behavior. SN - 1097-9891 UR - https://www.unboundmedicine.com/medline/citation/30601034/Testing_hair_for_fentanyl_exposure:_a_method_to_inform_harm_reduction_behavior_among_individuals_who_use_heroin_ L2 - https://www.tandfonline.com/doi/full/10.1080/00952990.2018.1550652 DB - PRIME DP - Unbound Medicine ER -