EXPERIENCE WITH HAIR TESTING IN THE CLINICAL BIOCHEMISTRY LABORATORY OF CA-GRANDA-NIGUARDA-HOSPITAL, MILAN, ITALY

In our laboratory, analysis of human hair for drugs of abuse detection was first performed in 1980. In the last 10 years we have processed a bout 2000 subjects/year ('living subjects' only). In the last 3 years we have also introduced hair analysis of cocaine: at first only in cli nical applications, but for the last 2 years this analysis is now rout ine. Our application of hair analysis includes: clinical toxicology, m edico-legal and administrative agencies. Requests come for example fro m several Committees for Driving Licenses, Addiction Treatment Centers and Legal Authorities. Hair samples are currently collected from the occipital area at the back of the head, which appears to show less var iability in hair growth rate. At present we perform hair analysis usin g highly sensitive radioimmunoassay screening methods for the detectio n of parent drug and/or metabolites. All positive cases of cocaine and opiates abuse are confirmed by gas chromatography-mass spectrometry i n electron impact or chemical ionization mode. Positive cases for opia tes are also analysed using a specific morphine radioimmunoassay kit. Data show that, when the opiates/morphine ratio is higher than 6, we a re dealing with consumption of codeine and/or dihydrocodeine. In our r outine work last year there were 177 (263 samples) positive opiates su bjects out of 2244 patients; positive cocaine subjects were 290 (362 s amples) out of 2001 patients. Guidelines for hair analysis in Lombardi a have been established based on the experience of our laboratory. Fur thermore it will be possible to apply a unique protocol for all Commit tees for Driving Licenses, involving hair testing in addition to urine assay. (C) 1997 Elsevier Science Ireland Ltd.