Major public health concern is raised by the evidence that common drugs like heroin are now frequently laced or replaced with highly potent novel synthetic opioids (NSOs). The objective of this study was to explore the prevalence and patterns of NSOs in a cohort of Swiss opioid users by hair analysis. Hair analysis is considered an ideal tool for retrospective consumption monitoring. Hair samples from 439 opioid users in Zurich were analyzed. Study inclusion required a previous positive hair test result for heroin metabolites, oxycodone, fentanyl, methadone, or tramadol. The samples were extracted with a two‐step extraction procedure, followed by a targeted LC–MS/MS (QTRAP® 6500+) analysis in multiple reaction monitoring mode for a total of 25 NSOs. The method underwent full validation and demonstrated good selectivity and sensitivity with limits of detection (LOD) as low as 0.1 pg/mg. The analyzed sample cohort demonstrated a positivity rate for NSOs of 2.5%, including the following NSOs: butyrylfentanyl, acrylfentanyl, furanylfentanyl, methoxyacetylfentanyl, ocfentanil, U‐47700, isobutyrylfentanyl and benzylfentanyl. Furthermore, we were able to identify specific consumption patterns among drug users. The results indicate that hair analysis is a valuable tool for investigating the prevalence of NSOs in drug‐using populations, which seems to be low in the case of Swiss opioid users. Nevertheless, the results highlight the need for sensitive analytical detection methods in forensic toxicology to identify and monitor substance distribution in different populations.

中文翻译：

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液相色谱-串联质谱 (LC-MS/MS) 方法的开发和验证，包括头发中的 25 种新型合成阿片类药物，以及对瑞士阿片类药物消费者群体的后续分析

有证据表明，海洛因等常见药物现在经常被高效新型合成阿片类药物 (NSO) 掺入或替代，这引起了重大的公共卫生问题。本研究的目的是通过头发分析来探讨瑞士阿片类药物使用者群体中 NSO 的患病率和模式。头发分析被认为是回顾性消费监测的理想工具。对苏黎世 439 名阿片类药物使用者的头发样本进行了分析。研究纳入要求之前的海洛因代谢物、羟考酮、芬太尼、美沙酮或曲马多毛发检测结果呈阳性。采用两步提取程序提取样品，然后在多反应监测模式下对总共 25 个 NSO 进行靶向 LC-MS/MS (QTRAP® 6500+) 分析。该方法经过全面验证，表现出良好的选择性和灵敏度，检测限 (LOD) 低至 0.1 pg/mg。分析的样本队列显示 NSO 的阳性率为 2.5%，包括以下 NSO：丁酰芬太尼、丙烯酰芬太尼、呋喃基芬太尼、甲氧基乙酰芬太尼、奥芬太尼、U-47700、异丁酰芬太尼和苄基芬太尼。此外，我们还能够确定吸毒者的具体消费模式。结果表明，头发分析是调查吸毒人群中 NSO 患病率的重要工具，而瑞士阿片类药物使用者的 NSO 患病率似乎较低。然而，结果强调了法医毒理学中需要灵敏的分析检测方法来识别和监测不同人群中的物质分布。