Understanding 6-AM & 6-MAM: The Metabolite of Heroin

Understanding 6-AM & 6-MAM: The Metabolite of Heroin

One question I am asked fairly often is regarding the primary metabolite of Heroin; known as 6-AM or 6-MAM. These are synonymous for 6-Acetylmorphine and 6-Monoacetylmorphine (actually all 4 mean exactly the same thing!). For the sake of brevity, in this post I will call it by its most popular moniker: 6-MAM.

 

Heroin itself has an extremely weak affinity to the μ-opioid receptors, meaning that Heroin itself will essentially not produce any euphoric or pain-relieving effects. However, once it enters the bloodstream, it is immediately metabolized into 6-MAM, which is what actually causes the effects of the drug. Heroin is also metabolized quickly into the less-active 3-Monoacetylmorphine (3-MAM), and less quickly into Morphine. Some forms of Heroin do contain some 6-MAM (most notable would be Black Tar Heroin), but for the most part it is only detectable once the Heroin has been metabolized in the body. As an aside: with regards to drug screening, we are really only concerned with active metabolites, since immunoassays rely on an active chemical reaction to function at all!

 

 

 

 

*Metabolization of Heroin to 6-MAM

 

Because 6-MAM is unique to Heroin, many are asking about the availability (as well as the quality and reliability) of an instant test for it so they can make sure they are detecting any Heroin use. While it is available, and the reliability and accuracy are outstanding on the 6-MAM instant test, I typically counsel against testing 6-MAM for a few reasons:

  1. 6-MAM is only detectable in urine for a short time, with barely a 12-hour window of detection.
  2. While 6-MAM has a very short window of detection, the Morphine that is also created as a metabolite takes much longer to purge from one’s system, giving us about a 3-day window of which it can be detected on a standard Opiate panel.
  3. From what we are hearing, so much of the Heroin on the streets these days contains very little (if any) Heroin at all, and it is mostly Fentanyl mixed with other filler. 

So, if you absolutely need to know that the positive Opiate that you are seeing came from Heroin use (as opposed to Morphine or Codeine use), then the 6-MAM panel can provide that information. However, do realize that the window of detection is going to severely limit your ability to detect this substance.

 

A Huge End of the Year Thank You!

A Huge End of the Year Thank You!

As 2019 draws to a close, and while visions of sugar plums dance in our heads, we at National Test Systems want to take a moment to reflect on what an incredible year we’ve had, and to thank you tremendously for being a part of it.

This year was a big push with regards to our NTS University program. We’ve had the pleasure of spending afternoons with hundreds of you who, like me, are looking to expand your wealth of knowledge to make your daily drug testing duties a little easier (or like I always say, “at least a little more insightful”). We truly hope you have enjoyed the experience as much as we have. So, if you have taken time out of your busy schedules this year to read our blog, attend (or watch the recording of) one of our webinars, or participate in a live training session, we thank you from the bottom of our hearts – we hope you have found this information beneficial.

We had some other exciting milestones this year. The release of one of the first reliable Kratom instant tests on the market is certainly a stand-out moment. We’ve also added tests for Gabapentin and others in 2019. We’ve refined the quality of our instant dips and cups even further this year, boasting some of the highest precision and accuracy in the industry. We’ve fine-tuned our order processing and shipping processes, allowing us unprecedented accuracy in getting you the products that you ordered, and in a timely fashion. We have even added more laboratory options to better suit the individual needs of your company or program. While not every step was a monumental leap, sometimes it is the smaller steps that can make all the difference.

The bottom line: none of this would be possible without you. Without your feedback, your guidance, your engagement, and your caring. Without all the help you have provided for us, we would have been unable to grow and to live up to everything that you need us to be. Because of this, we want to offer you a huge THANK YOU for your support.

So, from all of us, to all of you, have a very Happy New Year…let’s make 2020 the best one yet!

Abused Prescription Drugs That We Often Overlook

In this installment of our NTS University Educational Webinar series, we will discuss prescription drugs that may not be on your radar as drugs of abuse, but should be. Join our Chief Product Officer, Eric Malis, to make sure you are aware of these, sometimes “overlooked”, drugs of abuse.

 

A Word on Specimen Types

A Word on Specimen Types

Today we are going to discuss the different specimen types that can be used to test for drugs. We do offer testing for all the specimen types that I will cover. It is helpful to know what to expect from each specimen type in regard to window of detection (both onset and outset), susceptibility to adulteration, collection woes, and general benefits or shortcomings. So, take a few minutes to read and decide for yourself if you are testing the specimen type that works best for your program or facility.

 

Blood

Blood is probably one of our least favorite specimen types. Firstly, it is relatively hard to collect, requiring a trained medical practitioner at least. The second reason it is at the bottom of the list is its short window of detection; substances can only be detected when they are in the bloodstream (while the donor is under the influence). This is actually a plus when we are talking about workplace injuries (as an example) when we want to find out if someone is impaired at the time, but we (collectively) are more likely to be concerned with recent prior drug use. Lastly, there are essentially no onsite/instant tests for drugs of abuse that use blood as a specimen type. However, on the plus side, it is impossible to adulterate a blood specimen.

 

Hair Follicle

 

Hair follicle specimen are not as difficult to collect as blood; there is no medical knowledge necessary. Hair testing also has no gender concerns with witnessing collection. As with blood, however, it is only available as a laboratory test. Another shortcoming with hair is the limited number of drugs that are being tested (only tests: AMP, COC, THC, OPI, OXY, PCP). While hair provides a very long window of detection - detecting drugs for up to 90 day after use - it also has a long onset, meaning drugs will not begin to be detected until about 7 days after use. As for adulteration, there are many products on the internet that claim to “detoxify” your hair to remove any drugs that may be present, but I have not found any evidence that these products are effective. 

 

Sweat Patch

 

Sweat patch testing is a relatively new offering and it is somewhat unique in its window of detection. The patch is typically worn for 10 days (or more), and drugs take about 2-3 days to come to the surface of the skin, so if positive it would most likely be from use 2-3 days before the patch was applied, or used in the first 7 (out of 10) days the patch was worn. The downside here is that if a participant knows the patch is coming off Monday, they could use drugs Saturday or Sunday without the use being detected.  It is a very simple specimen to collect with no gender concerns as it is placed on the arm. There is no known method of adulteration for the sweat patch. As with hair, it is only available as a laboratory test, and also like hair, it is a limited range of drugs that are detected, adding only MET to the list of detectable hair substances.

 

Surface/Powder

 

This one is sort of the oddball here; it is not a test for drug use, it is a test to see what substance a person may have in their possession. It will also test surfaces for possible contamination by drugs (i.e. a person’s desktop or computer keyboard). This is most often used by law enforcement in the field (it is sometimes called a “field test”), perhaps testing a baggie found on a person or in their vehicle. It can also be helpful for corrections or any other residential facility where drug residue might be found in someone’s cell, or other space where only a limited number of people might have access. Much like a drug test, however, it must be a “target” substance – in other words you must use the right test to get a positive or negative hit on that particular substance. Since so many illicit (or misused) drugs can be a “white powder”, you might not happen to have tested for the correct white powder!

 

Saliva

 

Saliva testing has become more popular as the accuracy and precision of the instant/onsite saliva tests have improved immensely over the years. One appeal of saliva testing is that there are no gender concerns for witnessed collections, not even a bathroom is needed; it is also a fairly simple collection and testing procedure. However, while it is much easier to collect (and less invasive) than blood, it shares the same limitation of the window of detection; drugs will not be detectable in saliva for more than 24 hours after use. As with blood, this window of detection makes the most sense when impaired driving and workplace injuries are the concern.

 

Urine

 

Urine remains our favorite specimen type. While there are gender concerns for witnessed collections, and adulteration is more possible than with other specimen types. The window of detection, the huge number of substances able to be tested, and relatively lower cost still outweigh the negatives. Witnessed collections can be a challenge, but not one too challenging to be more than a mild inconvenience in most cases. Adulteration is a concern, but modern adulterant testing is thorough enough to be an excellent deterrent. On the other hand, the window of detection shows recent use, going back days (or weeks, depending on the substance), which fits almost universally with what we are trying to determine. There are instant tests available for more than 25 drugs of abuse and lab tests available for more than 40; this is a huge improvement over any of the other specimen types listed. Lastly, the cost is going to be the lowest out of all the specimen types, making it more feasible to follow a regular testing schedule.