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Disposition of Cocaine and Its Metabolites in Human Sweat after Controlled Cocaine Administration

¹ Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD.
² Johns Hopkins School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD.

^aAddress correspondence to this author at: Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 5500 Nathan Shock Dr., Baltimore, MD 21224. Fax 410-550-2971; e-mail mhuestis{at}intra.nida.nih.gov.

Background: Sweat testing is a noninvasive technique for monitoring drug exposure in treatment, criminal justice, and employment settings.

Methods: We evaluated cocaine excretion in 9 participants’ sweat after they received 3 low doses (75 mg/70 kg) of cocaine HCl subcutaneously within 1 week and, 3 weeks later, 3 high doses (150 mg/70 kg). Six additional participants completed portions of the study. PharmChek® sweat patches (n = 1390) were collected throughout a 3-week washout period, reflecting previously self-administered drugs, and during and after controlled dosing.

Results: Cocaine was the primary analyte detected with 24% of patches positive at the gas chromatography–mass spectrometry limit of quantification of 2.5 ng/patch and 7% of patches at the proposed Substance Abuse and Mental Health Services Administration cutoff of 25 ng/patch. Ecgonine methyl ester (EME) was detected more often and at generally higher concentrations than benzoylecgonine. In patches containing both metabolites, there was no statistically significant difference in the benzoylecgonine/EME ratio based on length of patch wear. During washout, 2 participants’ weekly patches tested positive (25 ng/patch) during the first week; one remained positive during week 2; and none were positive during week 3. Cocaine and EME were detectable within 2 h; benzoylecgonine was not detected until 4–8 h after low doses and slightly sooner after high doses. The majority of drug was excreted within 24 h. Over 70% of weekly patches worn during low doses were positive for cocaine (25 ng/patch), increasing to 100% during high doses.

Conclusion: Sweat testing is an effective and reliable method of monitoring cocaine exposure.

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