Comprehensive evaluation of cocaine and its hydroxy metabolites in seized cocaine and a large cohort of hair samples (2024)

As cocaine (COC) is not only incorporated into hair via blood following ingestion but also by external contamination, hair samples are commonly tested for COC metabolites to prove ingestion. However, COC metabolites can also be present as degradation products in typical street COC samples. The present study investigates minor hydroxycocaine (OH-COC) metabolites p- and m-OH-COC together with p- and m-hydroxybenzoylecgonine (OH-BE) in seized COC (n = 200) and hair samples from routine case work (n = 2389). Analytical results of hair samples were interpreted using an established decision model for the differentiation between actual use and external contamination using metabolic ratios (metabolite to COC). They were further examined concerning background of request, hair color, body site of sample collection, sex, and metabolic ratios of the main metabolites [benzoylecgonine (BE), norcocaine (NC), and cocaethylene (CE)]. All seized COC samples were positive for p- and m-OH-COC with a maximum percentage of 0.025% and 0.052%, respectively; p- and m-OH-BE were detected in 55% and 56% of samples with a maximum percentage of 0.044% and 0.024%, respectively. Analytical results of 424 hair samples (17.7%) were interpreted as being predominantly from contamination; the majority of these samples were from traffic medicine cases (83.7%). Metabolic ratios of minor OH-COC metabolites were significantly higher in hair samples interpreted as originating from use than in samples interpreted as caused by contamination. Metabolic ratios for OH-COCs were significantly higher in forensic cases compared to abstinence controls and also in black hair compared to blond/gray hair. However, this was not the case for OH-BE metabolic ratios. No statistical difference was observed with regard to the donor's sex. OH-COC metabolic ratios increased significantly with increasing ratios of NC and CE to COC, respectively. The study demonstrates that OH-COC metabolites (including thresholds for their metabolic ratios) must be used for a reliable interpretation of positive COC results in hair samples. [Author's abstract]