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Opioid Disposition in Human Sweat after Controlled Oral Codeine Administration

¹ Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, 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, NIDA, NIH, 5500 Nathan Shock Dr., Baltimore, MD 21224. Fax 410-550-2971; e-mail mhuestis{at}intra.nida.nih.gov.

Background: Characterization of opioid excretion in sweat is important for accurate interpretation of sweat tests in drug treatment, criminal justice, and workplace drug testing programs.

Methods: Participants (n = 20) received placebo, 3 low (60 mg/70 kg) or 3 high (120 mg/70 kg) codeine sulfate doses (used as a model for opioid excretion) within 1 week. Codeine and metabolites in sweat were collected with PharmChek® Sweat Patches; hourly patches were applied for 1 to 15 h (n = 775) and weekly patches for 7 days (n = 118). Patches were analyzed by solid-phase extraction and gas chromatography–mass spectrometry for codeine, norcodeine, morphine, normorphine, and 6-acetylmorphine. Limits of quantification were 2.5 ng/patch (codeine and morphine) and 5 ng/patch (other analytes).

Results: Codeine was the only analyte identified in 12.6% of hourly patches and 83.3% of weekly sweat patches worn during dosing. Weekly patch concentrations (SD) were 38.6 (59.9) ng/patch [median (range), 15.9 (0–225.1) ng/patch] for low and 34.1 (32.7) ng/patch [24.0 (0–96.2) ng/patch] for high codeine doses. Codeine detected 1 week after dosing was 4.6 (5.3) ng/patch [median (range), 4.0 (0–17.1) ng/patch; n = 11] after low and 7.7 (7.1) ng/patch [6.9 (0–20.5) ng/patch; n = 10] after high doses. In total, 2.6% of hourly, 38.5% of low-dose, and 45.5% of high-dose weekly patches contained codeine at the proposed Substance Abuse and Mental Health Services Administration cutoff.

Conclusions: Codeine was the only analyte detected, at highly variable concentrations, up to 2 weeks after dosing. These results are consistent, considering the complex processes of codeine deposition in sweat. Sweat testing is a useful alternative technique for qualitative monitoring of opioid use.

The following articles in journals at HighWire Press have cited this article:

				A. J. Barnes, M. L. Smith, S. L. Kacinko, E. W. Schwilke, E. J. Cone, E. T. Moolchan, and M. A. Huestis Excretion of Methamphetamine and Amphetamine in Human Sweat Following Controlled Oral Methamphetamine Administration Clin. Chem., January 1, 2008; 54(1): 172 - 180. [Abstract] [Full Text] [PDF]