Detection of accompanying substances, impurities and combinations of active ingredients in the context of narcotics abuse

Abstract

Consumption of illicit substances is accompanied with severe health risks. Even more so if they are adulterated with others. With the development of new pharmacological active compounds suitable for mimicking or enhancing the drug’s effects on the body, new patterns emerged in recent years. Identifying those and including them in analytical methods applied on human urine samples to find most commonly used substances was the goal of this thesis. The main focus was chosen to be on heroin and cocaine in particular as both substances make up a large amount of Europe’s total drug market. As possible candidates, levamisole, aminorex, lidocaine and procaine were found during literature research, included in routine analytics and added to LC-MS/MS methods for identification. Limits of this method were found to be 0.56 ng/mL for detection of levamisole and 1.47 ng/mL for its quantitation, a LOD of 0.99 ng/mL and LOQ of 2.96 ng/mL for aminorex, while lidocaine could be detected at 0.66 ng/mL and quantified at 2.14 ng/mL and lastly procaine only being applied for quantitative analysis above its LOD of 0.96 ng/mL and LOQ of 3.07 ng/mL. Patient samples were measured and screened for the presence of any of the new substances, resulting in a total of 244 levamisole positive samples, five of these containing aminorex as well. 66 samples contained lidocaine and 105 procaine, however both were found in both cocaine positive and negative samples. In parallel, an evaluation of past samples measured in the lab from January 2024 to date was performed to verify whether some of these or other substances named as possible adulterants had previously been detected. The amount of cocaine positive samples containing levamisole with the augmented method, confirmed recently published trends. Only one case of a levamisole positive sample was found in past samples, highlighting the potential analytical gain of its addition. Heroin was expected to contain synthetic opioids like fentanyl and nitazene as these gained popularity. The majority of samples tied to illicit opioid consumption contained 4-ANPP, a precurser of fentanyl known to be used in its illicit synthesis pathways.