Monitoring pregnant women's illicit opiate and cocaine use with sweat testing

Ther Drug Monit. 2010 Feb;32(1):40-9. doi: 10.1097/FTD.0b013e3181c13aaf.


Dependence on illicit drugs during pregnancy is a major public health concern as there may be associated adverse maternal, fetal, and neonatal consequences. Sweat patches (n = 389) were collected from 39 pregnant volunteers who provided written informed consent for this Institutional Review Board-approved protocol and wore patches, replaced approximately weekly, from study entry until delivery. Patches were analyzed for opiates (heroin, 6-acetylmorphine, 6-acetylcodeine, morphine and codeine) and cocaine (cocaine, benzoylecgonine, ecgonine methyl ester, anhydroecgonine methyl ester) by solid phase extraction and gas chromatography mass spectrometry. Seventy-one percent (276) of collected sweat patches were > or =5 ng per patch (limit of quantification) for one or more analytes. Cocaine was present in 254 (65.3%) patches in concentrations ranging from 5.2 to 11,835 ng per patch with 154 of these high enough to satisfy the proposed Substance Abuse and Mental Health Services Administration guidelines for a confirmatory drug test (25 ng per patch). Interestingly, 6-acetylmorphine was the most prominent opiate analyte documented in 134 patches (34.4%) with 11.3% exceeding the proposed opiate Substance Abuse and Mental Health Services Administration cut-off (25 ng per patch). Heroin was identified in fewer patches (77), but in a similar concentration range (5.3-345.4 ng per patch). Polydrug use was evident by the presence of both cocaine and opiate metabolites in 136 (35.0%) patches. Sweat testing is an effective method for monitoring abstinence or illicit drug use relapse in this high-risk population of pregnant opiate- and/or cocaine-dependent women.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Cocaine-Related Disorders / complications
  • Cocaine-Related Disorders / diagnosis*
  • Female
  • Gas Chromatography-Mass Spectrometry / methods
  • Heroin Dependence / complications
  • Heroin Dependence / diagnosis
  • Humans
  • Illicit Drugs / adverse effects
  • Illicit Drugs / pharmacokinetics
  • Opioid-Related Disorders / complications
  • Opioid-Related Disorders / diagnosis*
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Solid Phase Extraction / methods
  • Substance Abuse Detection / methods*
  • Sweat / chemistry*
  • Young Adult


  • Illicit Drugs