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Detection of phentermine in hair samples from drug suspects
Forensic Science International 207 (2011) e5–e7
Contents lists available at ScienceDirect
Forensic Science International journal homepage: www.elsevier.com/locate/forsciint
Case report
Detection of phentermine in hair samples from drug suspects Sooyeun Lee a, Jihyun Kim a, Sanghwan In a, Hwakyung Choi a, Heesun Chung a, Kyu Hyuck Chung b,* a b
National Institute of Scientific Investigation, 331-1 Sinwol-7-dong, Yangcheon-gu, Seoul 158-707, Republic of Korea School of Pharmacy, Sungkyunkwan University 300 Cheoncheon-dong, Jangan-gu, Suwon, Gyeonggi-do 440-746, Republic of Korea
A R T I C L E I N F O
A B S T R A C T
Article history: Received 30 August 2010 Received in revised form 2 November 2010 Accepted 5 November 2010 Available online 3 December 2010
Phentermine (PT) has been widely used as an anti-obesity drug. This drug has to be used with caution due to its close resemblance with amphetamines in its structure and toxicity profile. Recently, PT is in distribution by illegal modes and is found to be available through sources such as the internet, thus their misuse and/or abuse is threatening to be a serious social issue. In the present study, 32 cases of drug suspects were observed for PT abuse, detected using hair samples for drug analysis. PT and other amphetamines, such as methamphetamine (MA), amphetamine (AP), 3,4-methylenedioxyamphetamine (MDMA) and 3,4-methylenedioxyamphetamine (MDA), were extracted using 1% HCl in methanol for 20 h at 38 8C. The extracts were derivatized with trifluoroacetic anhydride (TFAA) and analyzed using gas chromatography/mass spectrometry (GC/MS). Among the 32 cases of PT abuse, MA and its main metabolite, AP were identified in seven cases and MDMA and its main metabolite, MDA were detected in two other cases. ß 2010 Elsevier Ireland Ltd. All rights reserved.
Keywords: Phentermine Amphetamines Hair analysis
1. Introduction Phentermine (PT), an adrenergic reuptake inhibitor, has been widely used as an anti-obesity drug since it was approved by the U.S. Food and Drug Administration (FDA) for short-term treatment in 1959. Recently, it was also demonstrated that some psychostimulants like PT have some potential for the treatment of cocaine abuse. In Korea, PT is the most frequently prescribed anorectic agent since its introduction in 2004 [1–5]. PT is closely related to amphetamines in its structure and toxicity. The most common symptoms of toxicity include nervousness, tremor, confusion, headache, tachycardia, hypertension, hallucinations, psychotic episode, nausea, vomiting, rapid respiration, cardiac arrhythmias, hyperthermia, convulsions, coma and circulatory collapse [6]. Although PT is not known for its drug dependence and withdrawal effects under medical supervision and in a defined time window [7], it is listed under Schedule IV by U.S. Drug Enforcement Administration (DEA) [8] and its usage is under the control of Narcotics Control Law in Korea. Recently, PT is seen to be distributed illegally and easily available through medium like the internet, thus its misuse and/or abuse is becoming a serious social problem. Hair has been identified as an ideal analytical specimen for the identification of drug abuse. Results obtained from the analysis of hair specimens provide conclusive evidence of previous drug usage
as well as information on duration for which the drug has been used, depending on the growth rate of hair (ca. 1 cm/month), and severity of drug abuse. Therefore, hair results serve as a key evidence for legal decision making [9]. In the present study, PT abuse was proved by hair analysis in 32 cases of drug suspects. Among them, methamphetamine (MA) and it main metabolite, amphetamine (AP) were identified in seven cases and 3,4-methylenedioxyamphetamine (MDMA) and its main metabolite, 3,4-methylenedioxyamphetamine (MDA) were detected in two other cases. 2. Methods 2.1. Sample preparation All hair samples were analyzed using a fully validated method described previously. Both the limits of detection (LOD) and quantification (LOQ) were 0.10 ng/mg and the regression coefficient of the calibration curve was 0.9926 from 0.10 to 200 ng/mg. Intra- and inter-assay precision and accuracy were also satisfactory [10]. In summary, the hair samples were washed, cut, weighed accurately (ca. 10 mg) and agitated in 1% HCl in methanol for 20 h at 38 8C. Then, the hair extract was evaporated to dryness at 45 8C under N2 gas and the residue was derivatized with 100 ml of trifluoroacetic anhydride (TFAA)/ethyl acetate (1:1) and incubated at 65 8C for 15 min. The excess derivatizing reagent was removed under N2 gas at 45 8C and the residue was reconstituted in ethanol for gas chromatography–mass spectrometry (GC–MS) analysis. Amphetamine-d5 (AP-d5) was used as an internal standard for the quantitation of PT in hair. 2.2. GC/MS analysis
* Corresponding author. Tel.: +82 31 290 7714; fax: +82 31 292 8800. E-mail address: [email protected] (K.H. Chung). 0379-0738/$ – see front matter ß 2010 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.forsciint.2010.11.004
Analysis was performed using an Agilent 6890/5973 GC–MS system. The MS was operated in selected ion monitoring (SIM) mode. The TFAA derivatized ions for PT and AP-d5 were as follows: phentermine, m/z 154, 132, 114; AP-d5, m/z 144 [10].
S. Lee et al. / Forensic Science International 207 (2011) e5–e7
e6
3. Results and discussion PT concentrations in hair from 32 cases of drug suspects are displayed in Table 1. Of the 32 cases, 10 were males and 22 were females. Females predominated over males in the PT abuse cases, unlike in general drug abuse cases. This is probably due to the higher popularity of PT for a beauty diet among females. Some of the hair samples were segmented according to police request; therefore, 48 quantitative results were obtained in total. All the subjects were known or suspected MA, MDMA and/or PT users except one unknown case (Case 26). The age ranged from 23 to 53 years old in males and from 23 to 46 years old in females, respectively. As shown
in Table 2, the concentration range of PT was from 0.5 to 428.3 ng/mg (mean = 23.4 ng/mg, median = 4.1 ng/mg). Both MA and AP were identified in seven cases and either MDMA or both MDMA and MDA were detected in two other cases among the 32 case. The concentrations of MA and AP ranged from 3.2 to 34.5 ng/mg and from 0.2 to 1.4 ng/mg, respectively. Those of MDMA and MDA were from 0.8 to 5.9 ng/mg and from 0.4 to 0.7 ng/mg, respectively. As per the previous study PT was reported as one of central nervous system (CNS) stimulants used routinely by tractor-trailer drivers to keep themselves awake [11]. Kim et al. detected PT in hair from two cases, where both MA and AP were also identified. The concentration range of PT was from 0.13 to 1.92 ng/mg [12].
Table 1 Phentermine concentrations in hair from drug suspects. Case
a
Case history
Age
Gender
1 2 3 4 5 6 7 8a 9 10 11 12 13
Known MA user Suspected MA user Known MA and illegal PT user Suspected MDMA user Known MA user Known MA user Known MA user Suspected MA user Known MDMA user Known illegal PT user Known MA user Known MA user Known MA user
32 44 40 37 33 40 28 25 23 30 36 32 30
F M F M M F F F M M F M F
14
Known MA user
34
M
15 16 17a 18a 19a
Known MA user Suspected MA user Suspected MA and illegal PT user Suspected MA and illegal PT user Known illegal PT user
36 53 28 27 27
M M F F M
20a 21a 22a 23a 24a 25a 26a 27a
Suspected MA user Suspected MA user Suspected MA user Suspected MA user Suspected MA user Suspected MA user Unknown Known MDMA user
23 28 36 30 46 42 31 27
F F F F F F F F
28
Known MDMA user
30
F
29 30a
Known MA user Known MDMA user
27 23
F F
31a
Known illegal PT user
31
F
32a
Known MA user
29
F
Segment No.
– – – – – – – – – – – – 1 2 3 4 5 6 7 8 9 1 2 – – – – 1 2 3 4 – – – – – – 1 2 3 4 1 2 3 1 2 3 4 1 2 3 4 –
Hair length (cm)
14–30 1–6 10–60 9–13 5–12 23–58 3–10 5–40 1–7 1–8 12–33 3–5 0–3 3–6 6–9 9–12 12–15 15–18 18–21 21–24 24–43 0–3 3–9 0.5–1.5 5–6 8–37 15–65 0–3 3–6 6–9 9–12 10–50 6–50 10–28 10–25 5–40 11–35 4–7 0–3 3–6 3–9 9–12 0–3 3–6 6–11 9–32 0–3 3–6 6–9 9–12 0–3 3–6 6–9 9–12 11–27
Concentrations (ng/mg) PT
MA
AP
MDMA
MDA
10.8 325.7 3.9 7.6 26.8 5.8 7.8 22.3 1.6 3.1 10.4 50.1 2.6 2.2 3.8 2.6 1.5 0.9 0.6 ND ND 70.1 9.6 428.3 10.0 13.6 8.1 6.2 9.6 4.3 2.4 1.7 1.4 1.7 2.0 0.5 8.5 4.6 1.7 0.7 ND ND 1.1 0.6 ND 5.4 2.4
ND 9.4 ND ND 26.6 ND ND ND ND ND ND ND 6.3 8.2 7.4 3.2 4.2 ND ND ND ND 30.1 34.5 14.9 ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND 8.9 ND ND ND ND ND ND ND ND 29.7
ND 0.5 ND ND 1.4 ND ND ND ND ND ND ND 0.2 0.3 0.2 0.2 0.2 ND ND ND ND 0.6 0.9 1.1 ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND 0.4 ND ND ND ND ND ND ND ND 1.4
ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND 5.9 1.0 0.8 ND 4.9 1.5 1.3 ND ND ND ND ND ND ND ND ND ND
ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND 0.7 0.4 ND ND 0.7 ND ND ND ND ND ND ND ND ND ND ND ND
17.2 3.9 4.3 2.8 7.9
Segment numbers from 1 to 9 show segments from proximal to distal parts. PT, phentermine; MA, methamphetamine; AP, amphetamine; M, male; F, female. ND: not detected. a Hair samples were cut by 12 cm.
S. Lee et al. / Forensic Science International 207 (2011) e5–e7 Table 2 Summary of phentermine concentrations in hair from drug offenders or suspects (number of results = 48). Concentrations (ng/mg) Mean Standard deviation Median Minimum Maximum
23.4 76.3 4.1 0.5 428.3
The abuse of PT is mainly due to its popularity in enhancing the individual’s physical appearance. However, it is presumed that PT is also considered as an alternative or a synergist for amphetamines abuse. Even though no evidence of PT addiction has been reported, PT should be included in screening of drugs of abuse in hair in order to demonstrate its illegal abuse. Moreover, a synergistic effect due to coconsumption of MA or MDMA with PT needs to be examined. Since oxethazaine, one of topical mucous anesthetics, was demonstrated as the source of PT in urine [13,14], a study on the incorporation of PT into hair by ingestion of oxethazaine is also required. References [1] L.M. Kaplan, Pharmacological therapies for obesity, Gastroenterol. Clin. North Am. 34 (2005) 91–104.
e7
[2] E. Colman, Anorectics on trial: a half century of federal regulation of prescription appetite suppressants, Ann. Intern. Med. 143 (2005) 380–385. [3] L.H. Brauer, C.E. Johanson, C.R. Schuster, R.B. Rothman, H. de Wit, Evaluation of phentermine and fenfluramine, alone and in combination, in normal, healthy volunteers, Neuropsychopharmacology 14 (1996) 233–241. [4] R.B. Rothman, B.E. Blough, M.H. Baumann, Dopamine/serotonin releasers as medications for stimulant addictions, Prog. Brain Res. 172 (2008) 385–406. [5] K.K. Kim, H.J. Cho, H.C. Kang, B.B. Youn, K.R. Lee, Effects on weight reduction, and safety of short-term phentermine administration in Korean obese people, Yonsei Med. J. 47 (2006) 614–625. [6] R.C. Baselt, Disposition of Toxic Drugs and Chemicals in Man, fifth edition, Chemical Toxicology Institute, Forster City, CA, 2000, pp. 694–696. [7] E.J. Hendricks, F.L. Greenway, A study of abrupt phentermine cessation in patients in a weight management program, Am. J. Ther. March 2 (2010) [Epub ahead of print]. [8] http://www.justice.gov/dea/pubs/scheduling.html (accessed 11.11.10). [9] S. Lee, E. Han, Y. Park, H. Choi, H. Chung, Distribution of methamphetamine and amphetamine in drug abusers’ head hair, Forensic Sci. Int. 190 (2009) 16–18. [10] E. Han, S. Lee, J. Lee, S. Back, D. Kim, S. Woo, C. Kim, Y. Park, M. Lim, H. Chung, Simultaneous analysis of amphetamine type stimulants in hair by GC/MS, Annu. Rep. N.I.S.I. 39 (2007) 240–249. [11] F.J. Couper, M. Pemberton, A. Jarvis, M. Hughes, B.K. Logan, Prevalence of drug use in commercial tractor-trailer drivers, J. Forensic Sci. 47 (2002) 562–567. [12] J.Y. Kim, K.S. Jung, M.K. Kim, J.I. Lee, M.K. In, Simultaneous determination of psychotropic phenylalkylamine derivatives in human hair by gas chromatography/ mass spectrometry, Rapid Commun. Mass Spectrom. 21 (2007) 1705–1720. [13] W.H. Huang, C.H. Liu, R.H. Liu, Y.L. Tseng, Confirming urinary excretion of mephentermine and phentermine following the ingestion of oxethazaine by gas chromatography–mass spectrometry analysis, J. Anal. Toxicol. 34 (2010) 73–77. [14] M.C. Hsu, S.F. Lin, C.P. Kuan, W.L. Chu, K.H. Chan, G.P. Chang-Chien, Oxethazaine as the source of mephentermine and phentermine in athlete’s urine, Forensic Sci. Int. 185 (2009) e1–e5.
Contents lists available at ScienceDirect
Forensic Science International journal homepage: www.elsevier.com/locate/forsciint
Case report
Detection of phentermine in hair samples from drug suspects Sooyeun Lee a, Jihyun Kim a, Sanghwan In a, Hwakyung Choi a, Heesun Chung a, Kyu Hyuck Chung b,* a b
National Institute of Scientific Investigation, 331-1 Sinwol-7-dong, Yangcheon-gu, Seoul 158-707, Republic of Korea School of Pharmacy, Sungkyunkwan University 300 Cheoncheon-dong, Jangan-gu, Suwon, Gyeonggi-do 440-746, Republic of Korea
A R T I C L E I N F O
A B S T R A C T
Article history: Received 30 August 2010 Received in revised form 2 November 2010 Accepted 5 November 2010 Available online 3 December 2010
Phentermine (PT) has been widely used as an anti-obesity drug. This drug has to be used with caution due to its close resemblance with amphetamines in its structure and toxicity profile. Recently, PT is in distribution by illegal modes and is found to be available through sources such as the internet, thus their misuse and/or abuse is threatening to be a serious social issue. In the present study, 32 cases of drug suspects were observed for PT abuse, detected using hair samples for drug analysis. PT and other amphetamines, such as methamphetamine (MA), amphetamine (AP), 3,4-methylenedioxyamphetamine (MDMA) and 3,4-methylenedioxyamphetamine (MDA), were extracted using 1% HCl in methanol for 20 h at 38 8C. The extracts were derivatized with trifluoroacetic anhydride (TFAA) and analyzed using gas chromatography/mass spectrometry (GC/MS). Among the 32 cases of PT abuse, MA and its main metabolite, AP were identified in seven cases and MDMA and its main metabolite, MDA were detected in two other cases. ß 2010 Elsevier Ireland Ltd. All rights reserved.
Keywords: Phentermine Amphetamines Hair analysis
1. Introduction Phentermine (PT), an adrenergic reuptake inhibitor, has been widely used as an anti-obesity drug since it was approved by the U.S. Food and Drug Administration (FDA) for short-term treatment in 1959. Recently, it was also demonstrated that some psychostimulants like PT have some potential for the treatment of cocaine abuse. In Korea, PT is the most frequently prescribed anorectic agent since its introduction in 2004 [1–5]. PT is closely related to amphetamines in its structure and toxicity. The most common symptoms of toxicity include nervousness, tremor, confusion, headache, tachycardia, hypertension, hallucinations, psychotic episode, nausea, vomiting, rapid respiration, cardiac arrhythmias, hyperthermia, convulsions, coma and circulatory collapse [6]. Although PT is not known for its drug dependence and withdrawal effects under medical supervision and in a defined time window [7], it is listed under Schedule IV by U.S. Drug Enforcement Administration (DEA) [8] and its usage is under the control of Narcotics Control Law in Korea. Recently, PT is seen to be distributed illegally and easily available through medium like the internet, thus its misuse and/or abuse is becoming a serious social problem. Hair has been identified as an ideal analytical specimen for the identification of drug abuse. Results obtained from the analysis of hair specimens provide conclusive evidence of previous drug usage
as well as information on duration for which the drug has been used, depending on the growth rate of hair (ca. 1 cm/month), and severity of drug abuse. Therefore, hair results serve as a key evidence for legal decision making [9]. In the present study, PT abuse was proved by hair analysis in 32 cases of drug suspects. Among them, methamphetamine (MA) and it main metabolite, amphetamine (AP) were identified in seven cases and 3,4-methylenedioxyamphetamine (MDMA) and its main metabolite, 3,4-methylenedioxyamphetamine (MDA) were detected in two other cases. 2. Methods 2.1. Sample preparation All hair samples were analyzed using a fully validated method described previously. Both the limits of detection (LOD) and quantification (LOQ) were 0.10 ng/mg and the regression coefficient of the calibration curve was 0.9926 from 0.10 to 200 ng/mg. Intra- and inter-assay precision and accuracy were also satisfactory [10]. In summary, the hair samples were washed, cut, weighed accurately (ca. 10 mg) and agitated in 1% HCl in methanol for 20 h at 38 8C. Then, the hair extract was evaporated to dryness at 45 8C under N2 gas and the residue was derivatized with 100 ml of trifluoroacetic anhydride (TFAA)/ethyl acetate (1:1) and incubated at 65 8C for 15 min. The excess derivatizing reagent was removed under N2 gas at 45 8C and the residue was reconstituted in ethanol for gas chromatography–mass spectrometry (GC–MS) analysis. Amphetamine-d5 (AP-d5) was used as an internal standard for the quantitation of PT in hair. 2.2. GC/MS analysis
* Corresponding author. Tel.: +82 31 290 7714; fax: +82 31 292 8800. E-mail address: [email protected] (K.H. Chung). 0379-0738/$ – see front matter ß 2010 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.forsciint.2010.11.004
Analysis was performed using an Agilent 6890/5973 GC–MS system. The MS was operated in selected ion monitoring (SIM) mode. The TFAA derivatized ions for PT and AP-d5 were as follows: phentermine, m/z 154, 132, 114; AP-d5, m/z 144 [10].
S. Lee et al. / Forensic Science International 207 (2011) e5–e7
e6
3. Results and discussion PT concentrations in hair from 32 cases of drug suspects are displayed in Table 1. Of the 32 cases, 10 were males and 22 were females. Females predominated over males in the PT abuse cases, unlike in general drug abuse cases. This is probably due to the higher popularity of PT for a beauty diet among females. Some of the hair samples were segmented according to police request; therefore, 48 quantitative results were obtained in total. All the subjects were known or suspected MA, MDMA and/or PT users except one unknown case (Case 26). The age ranged from 23 to 53 years old in males and from 23 to 46 years old in females, respectively. As shown
in Table 2, the concentration range of PT was from 0.5 to 428.3 ng/mg (mean = 23.4 ng/mg, median = 4.1 ng/mg). Both MA and AP were identified in seven cases and either MDMA or both MDMA and MDA were detected in two other cases among the 32 case. The concentrations of MA and AP ranged from 3.2 to 34.5 ng/mg and from 0.2 to 1.4 ng/mg, respectively. Those of MDMA and MDA were from 0.8 to 5.9 ng/mg and from 0.4 to 0.7 ng/mg, respectively. As per the previous study PT was reported as one of central nervous system (CNS) stimulants used routinely by tractor-trailer drivers to keep themselves awake [11]. Kim et al. detected PT in hair from two cases, where both MA and AP were also identified. The concentration range of PT was from 0.13 to 1.92 ng/mg [12].
Table 1 Phentermine concentrations in hair from drug suspects. Case
a
Case history
Age
Gender
1 2 3 4 5 6 7 8a 9 10 11 12 13
Known MA user Suspected MA user Known MA and illegal PT user Suspected MDMA user Known MA user Known MA user Known MA user Suspected MA user Known MDMA user Known illegal PT user Known MA user Known MA user Known MA user
32 44 40 37 33 40 28 25 23 30 36 32 30
F M F M M F F F M M F M F
14
Known MA user
34
M
15 16 17a 18a 19a
Known MA user Suspected MA user Suspected MA and illegal PT user Suspected MA and illegal PT user Known illegal PT user
36 53 28 27 27
M M F F M
20a 21a 22a 23a 24a 25a 26a 27a
Suspected MA user Suspected MA user Suspected MA user Suspected MA user Suspected MA user Suspected MA user Unknown Known MDMA user
23 28 36 30 46 42 31 27
F F F F F F F F
28
Known MDMA user
30
F
29 30a
Known MA user Known MDMA user
27 23
F F
31a
Known illegal PT user
31
F
32a
Known MA user
29
F
Segment No.
– – – – – – – – – – – – 1 2 3 4 5 6 7 8 9 1 2 – – – – 1 2 3 4 – – – – – – 1 2 3 4 1 2 3 1 2 3 4 1 2 3 4 –
Hair length (cm)
14–30 1–6 10–60 9–13 5–12 23–58 3–10 5–40 1–7 1–8 12–33 3–5 0–3 3–6 6–9 9–12 12–15 15–18 18–21 21–24 24–43 0–3 3–9 0.5–1.5 5–6 8–37 15–65 0–3 3–6 6–9 9–12 10–50 6–50 10–28 10–25 5–40 11–35 4–7 0–3 3–6 3–9 9–12 0–3 3–6 6–11 9–32 0–3 3–6 6–9 9–12 0–3 3–6 6–9 9–12 11–27
Concentrations (ng/mg) PT
MA
AP
MDMA
MDA
10.8 325.7 3.9 7.6 26.8 5.8 7.8 22.3 1.6 3.1 10.4 50.1 2.6 2.2 3.8 2.6 1.5 0.9 0.6 ND ND 70.1 9.6 428.3 10.0 13.6 8.1 6.2 9.6 4.3 2.4 1.7 1.4 1.7 2.0 0.5 8.5 4.6 1.7 0.7 ND ND 1.1 0.6 ND 5.4 2.4
ND 9.4 ND ND 26.6 ND ND ND ND ND ND ND 6.3 8.2 7.4 3.2 4.2 ND ND ND ND 30.1 34.5 14.9 ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND 8.9 ND ND ND ND ND ND ND ND 29.7
ND 0.5 ND ND 1.4 ND ND ND ND ND ND ND 0.2 0.3 0.2 0.2 0.2 ND ND ND ND 0.6 0.9 1.1 ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND 0.4 ND ND ND ND ND ND ND ND 1.4
ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND 5.9 1.0 0.8 ND 4.9 1.5 1.3 ND ND ND ND ND ND ND ND ND ND
ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND 0.7 0.4 ND ND 0.7 ND ND ND ND ND ND ND ND ND ND ND ND
17.2 3.9 4.3 2.8 7.9
Segment numbers from 1 to 9 show segments from proximal to distal parts. PT, phentermine; MA, methamphetamine; AP, amphetamine; M, male; F, female. ND: not detected. a Hair samples were cut by 12 cm.
S. Lee et al. / Forensic Science International 207 (2011) e5–e7 Table 2 Summary of phentermine concentrations in hair from drug offenders or suspects (number of results = 48). Concentrations (ng/mg) Mean Standard deviation Median Minimum Maximum
23.4 76.3 4.1 0.5 428.3
The abuse of PT is mainly due to its popularity in enhancing the individual’s physical appearance. However, it is presumed that PT is also considered as an alternative or a synergist for amphetamines abuse. Even though no evidence of PT addiction has been reported, PT should be included in screening of drugs of abuse in hair in order to demonstrate its illegal abuse. Moreover, a synergistic effect due to coconsumption of MA or MDMA with PT needs to be examined. Since oxethazaine, one of topical mucous anesthetics, was demonstrated as the source of PT in urine [13,14], a study on the incorporation of PT into hair by ingestion of oxethazaine is also required. References [1] L.M. Kaplan, Pharmacological therapies for obesity, Gastroenterol. Clin. North Am. 34 (2005) 91–104.
e7
[2] E. Colman, Anorectics on trial: a half century of federal regulation of prescription appetite suppressants, Ann. Intern. Med. 143 (2005) 380–385. [3] L.H. Brauer, C.E. Johanson, C.R. Schuster, R.B. Rothman, H. de Wit, Evaluation of phentermine and fenfluramine, alone and in combination, in normal, healthy volunteers, Neuropsychopharmacology 14 (1996) 233–241. [4] R.B. Rothman, B.E. Blough, M.H. Baumann, Dopamine/serotonin releasers as medications for stimulant addictions, Prog. Brain Res. 172 (2008) 385–406. [5] K.K. Kim, H.J. Cho, H.C. Kang, B.B. Youn, K.R. Lee, Effects on weight reduction, and safety of short-term phentermine administration in Korean obese people, Yonsei Med. J. 47 (2006) 614–625. [6] R.C. Baselt, Disposition of Toxic Drugs and Chemicals in Man, fifth edition, Chemical Toxicology Institute, Forster City, CA, 2000, pp. 694–696. [7] E.J. Hendricks, F.L. Greenway, A study of abrupt phentermine cessation in patients in a weight management program, Am. J. Ther. March 2 (2010) [Epub ahead of print]. [8] http://www.justice.gov/dea/pubs/scheduling.html (accessed 11.11.10). [9] S. Lee, E. Han, Y. Park, H. Choi, H. Chung, Distribution of methamphetamine and amphetamine in drug abusers’ head hair, Forensic Sci. Int. 190 (2009) 16–18. [10] E. Han, S. Lee, J. Lee, S. Back, D. Kim, S. Woo, C. Kim, Y. Park, M. Lim, H. Chung, Simultaneous analysis of amphetamine type stimulants in hair by GC/MS, Annu. Rep. N.I.S.I. 39 (2007) 240–249. [11] F.J. Couper, M. Pemberton, A. Jarvis, M. Hughes, B.K. Logan, Prevalence of drug use in commercial tractor-trailer drivers, J. Forensic Sci. 47 (2002) 562–567. [12] J.Y. Kim, K.S. Jung, M.K. Kim, J.I. Lee, M.K. In, Simultaneous determination of psychotropic phenylalkylamine derivatives in human hair by gas chromatography/ mass spectrometry, Rapid Commun. Mass Spectrom. 21 (2007) 1705–1720. [13] W.H. Huang, C.H. Liu, R.H. Liu, Y.L. Tseng, Confirming urinary excretion of mephentermine and phentermine following the ingestion of oxethazaine by gas chromatography–mass spectrometry analysis, J. Anal. Toxicol. 34 (2010) 73–77. [14] M.C. Hsu, S.F. Lin, C.P. Kuan, W.L. Chu, K.H. Chan, G.P. Chang-Chien, Oxethazaine as the source of mephentermine and phentermine in athlete’s urine, Forensic Sci. Int. 185 (2009) e1–e5.