利用EMIT-st及TOXI-LAB法分析海洛因、嗎啡、甲基安非他命、古柯鹼及大麻服食者之尿液

EVALUATION FOR THE ANALYSIS OF HEROIN, MORPHINE, METHAMPHETAMINE, COCAINE AND CANNABIS IN URINE BY EMIT-st, TO XI-LAB METHODS

依統計資料顯示，我國現今濫用藥物以甲基安非他命及海洛因最多，大麻及古柯鹼則有逐年增加之趨勢，是否服用此四類藥物係檢驗吸食者尿液中之代謝物：甲基安非他命、嗎啡、11-nor-Δ9-THC-9-COOH及Benzoylecgonine為主；而常用於藥物濫用者尿液之檢驗方法很多，本計劃之內容主要以評估廣被使用之Emit-st及TOXI-LAB法，以了解其適用性。經評估地方衛生單位廣泛使用的Emit-st及TOXI-LAB法後顯示，其最低檢測值大抵與廠商所提供的資料及美國National Institute on Drug A buse （NIDA）之標準相符，在使用TOXI-LAB A法分析尿液中之甲基安非他命時，應注意感冒製劑中之Chlorpheniramine、Phenylpropanolamine等成分與甲基安非他命有近似之Rf值，應再使用乙醛法確認，以避免誤讀。使用Emit-st偵測尿液中之甲基安非他命時，高濃度之Phenylpropanolamine及Ephedrine可引起交叉反應（Cross reaction）亦值得注意；評估明礬對尿液中甲基安非他命檢驗結果之影響時，發現含5.0%濃度以上的明礬對1.2μg/mL甲基安非他命鹽酸鹽的尿液有偽陰性之結果，且尿液中之pH值降低至4.0以下。海洛因之吸食者於尿液中完全代謝成Morphine或其共軛物，尿液中Morphine在TOXI-LAB A法中靈敏度較差，改用硝酸銀法後可提高專一性避免Codeine等成分之干擾，而改良後TOXI-LAB LTD固相萃取法可提高靈敏度一倍，於Emit法時因其測鴉片類成分，故Codeine之存在會影響Morphine之檢測。尿液中大麻代謝物於TOXI-LAB A法大麻檢測系統中結果良好，可達確認步驟臨界值，於Emit-st法中可達初步篩檢臨界值。尿液中古柯鹼代謝物於Emit-st法中可達初步篩檢臨界值，於TOXI-LAB法中檢測度極差不建議使用。

Recent statistics have shown that Methamphetamine(MA) and Heroin are two major abused drugs in Taiwan, with Marijuana and Cocaine showing trends of increase. Analysis of their metabolites including as MA, Morphine, 11-nor-Δ9- THC-9-COOH and Benzoylecgonine, using Emit-st and TOXI-LAB perfor-med and evaluated by local hygienic organizations, indicate that the detection limits of these methods are the same as those provided by the vender, as well as NIDA's specifications. Attention hawever should be paid to the interferences caused by Chlorpheniramine and Phenylpropanola- mine, each of which gave the same Rf value as MA, during the urinary analysis of MA by TOXI-LAB A method. Results should be further confirmed by 'Acetaldehyde Method' to avoid any errors. When Emit-st was used for the MA analysis of urine samples containing high concentrations of Phenylpropanolamine and Ephedrine, cross-reactions were also observed. Furthermore a low pH below 4.0 was found in urine samples containing 1.2 µg/mL MA in the presence of Alum above 5%, so that false-negative results were obtained. TOXILAB A method was also used for the urinary analysis of Heroin addicts and it was found that Heroin can be completely metabolized to Morphine and Morphine's conjugates. Generally, TOXI-LAB A method was not sensitive enough, it is recommended that the Silver Nitrate method should be used to avoid the possible cross-reaction resul- ting from Codeine. According to our observations the modified TOXI-LAB LTD solid phase extraction method can increase the sensitivity to one-fold. However, when Emit-st was used to the analysis of Opiate drugs, Codeine was found to interfere in the detection of Morphine. Good results which complied with NIDA's cut-off values can be obtained when both TOXI-LAB Marijuana system and Emit-st method were used to detect urinary Marijuana. Nevertheless, TOXILAB method is not suitable for the analysis of Cocaine.