This study aimed to determine whether hydromorphone and codeine can be detected in oral fluid specimens following administration of Substitol™, a slow-release formulation of morphine. This is of interest for those monitoring treatment compliance using drug testing. Oral fluid specimens collected for compliance assessment in routine clinical practice or as part of a clinical trial were subjected to quantitative analysis of hydromorphone, morphine, codeine, and 6-acetylmorphine using highly sensitive mass spectrometric methods. Oral fluid was collected using a Greiner Bio-One saliva collection system. Patients undergoing substitution treatment with Substitol™, methadone, or buprenorphine were included, together with patients undergoing pain treatment with hydromorphone. Hydromorphone was detected in 642 of the 663 (97%) samples from substitol-treated patients. Concentrations were not higher in methadone- and buprenorphine-treated patients who relapsed into heroin use, or in patients on hydromorphone therapy. Codeine was detected in 29% of the samples. These concentrations were lower than those in patients who had relapsed to heroin use. Clinical administration of morphine can lead to detectable concentrations of both hydromorphone and codeine in oral fluids. This should be taken into consideration when using drug testing in oral fluid samples for compliance assessment in this patient group.

中文翻译：

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接受 Substitol™（硫酸吗啡）替代治疗的患者的口腔液样本中的氢吗啡酮和可待因浓度

本研究旨在确定在服用吗啡缓释制剂 Substitol™ 后，是否可以在口腔液样本中检测到氢吗啡酮和可待因。这对于那些使用药物测试来监测治疗依从性的人来说是有意义的。在常规临床实践中或作为临床试验的一部分收集用于依从性评估的口腔液样本，使用高灵敏度质谱法对氢吗啡酮、吗啡、可待因和 6-乙酰吗啡进行定量分析。使用 Greiner Bio-One 唾液收集系统收集口腔液。包括接受 Substitol™、美沙酮或丁丙诺啡替代治疗的患者，以及接受氢吗啡酮疼痛治疗的患者。在来自 substitol 治疗患者的 663 份 (97%) 样本中，有 642 份检测到氢吗啡酮。重新使用海洛因的接受美沙酮和丁丙诺啡治疗的患者或接受氢吗啡酮治疗的患者的浓度并不高。在 29% 的样本中检测到可待因。这些浓度低于复发使用海洛因的患者的浓度。吗啡的临床给药可导致口腔液中氢吗啡酮和可待因的可检测浓度。在该患者组中使用口腔液样本中的药物测试进行依从性评估时，应考虑到这一点。这些浓度低于复发使用海洛因的患者的浓度。吗啡的临床给药可导致口腔液中氢吗啡酮和可待因的可检测浓度。在该患者组中使用口腔液样本中的药物测试进行依从性评估时，应考虑到这一点。这些浓度低于复发使用海洛因的患者的浓度。吗啡的临床给药可导致口腔液中氢吗啡酮和可待因的可检测浓度。在该患者组中使用口腔液样本中的药物测试进行依从性评估时，应考虑到这一点。