Identifying methamphetamine exposure in children
Marisol S Castaneto1, Allan J Barnes, Karl B Scheidweiler
1*Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD; †Psychemedics Corporation, Culver City, CA; ‡Data, Benchmark and Evaluation Section, Maternal, Child and Adolescent Health Division, California Department of Public Health, Sacramento, CA; and §Student Health Service, California State University, Chico, CA.
Insights
Hair analysis is the most sensitive method for detecting methamphetamine (MAMP) and related drug exposure in children, surpassing urine and oral fluid tests. This is crucial for identifying drug-endangered children and ensuring their safety and well-being.
Area of Science:
- Forensic Toxicology
- Environmental Health
- Pediatric Health
Background:
- Methamphetamine (MAMP) use poses significant risks to children, including developmental and health issues.
- Environmental exposure to MAMP necessitates medical evaluation and drug testing for affected children.
- Identifying the optimal biological matrix for detecting MAMP and related amphetamines in exposed children is critical for child protection.
Purpose of the Study:
- To determine the most effective biological matrix for detecting MAMP, amphetamine (AMP), methylenedioxymethamphetamine (MDMA), methylenedioxyamphetamine (MDA), and 3,4-methylenedioxyethylamphetamine (MDEA) in children with environmental exposure.
- To compare the sensitivity of urine, oral fluid (OF), and hair analysis for these substances.
Main Methods:
- Medical evaluation of 91 children with documented environmental MAMP exposure.
- Quantification of MAMP, AMP, MDMA, MDA, and MDEA in urine, OF, and hair samples.
- Utilized gas chromatography mass spectrometry for urine and OF, and liquid chromatography tandem mass spectrometry for hair analysis.
Main Results:
- Overall drug detection rates were 6.9% in OF, 22.1% in urine, and 77.8% in hair.
- 79% of children tested positive for at least one drug in one or more matrices.
- MAMP was the primary analyte detected across all three matrices; positive OF and urine results were highly correlated with positive hair tests.
Conclusions:
- Hair analysis demonstrated superior sensitivity for detecting MAMP, AMP, and MDMA environmental exposure in children compared to urine or OF.
- While a negative urine or hair test does not definitively rule out exposure, hair testing offers the highest sensitivity for identifying drug-exposed children.
- These findings support the use of hair analysis as a primary tool in evaluating drug exposure in environmentally exposed children.
Objective:
Methamphetamine (MAMP) use, distribution, and manufacture remain a serious public health and safety problem in the United States, and children environmentally exposed to MAMP face a myriad of developmental, social, and health risks, including severe abuse and neglect necessitating child protection involvement. It is recommended that drug-endangered children receive medical evaluation and care with documentation of overall physical and mental conditions and have urine drug testing. The primary aim of this study was to determine the best biological matrix to detect MAMP, amphetamine (AMP), methylenedioxymethamphetamine (MDMA), methylenedioxyamphetamine (MDA), and 3,4-methylenedioxyethylamphetamine (MDEA) in environmentally exposed children.
Methods:
Ninety-one children, environmentally exposed to household MAMP intake, were medically evaluated at the Child and Adolescent Abuse Resource and Evaluation Diagnostic and Treatment Center at the University of California, Davis Children's Hospital. MAMP, AMP, MDMA, MDA, and MDEA were quantified in urine and oral fluid (OF) by gas chromatography mass spectrometry and in hair by liquid chromatography tandem mass spectrometry.
Results:
Overall drug detection rates in OF, urine, and hair were 6.9%, 22.1%, and 77.8%, respectively. Seventy children (79%) tested positive for 1 or more drugs in 1 or more matrices. MAMP was the primary analyte detected in all 3 biological matrices. All positive OF (n = 5), and 18 of 19 positive urine specimens also had a positive hair test.
Conclusions:
Hair analysis offered a more sensitive tool for identifying MAMP, AMP, and MDMA environmental exposure in children than urine or OF testing. A negative urine or hair test does not exclude the possibility of drug exposure, but hair testing provided the greatest sensitivity for identifying drug-exposed children.
