Thursday, September 20, 2007

Coca Tea and Alkaloid's Testing

Coca Tea Consumption Causes Positive Urine Cocaine Assay

Mazor SS, Wills BK, Brace LD, Gussow LM, Erickson TB. University of Illinois at Chicago Medical Center, Toxikon Consortium, Chicago, IL.

Background: Coca tea, or mate de coca MacMate, is commonly consumed in South America and is thought to contain cocaine plant material.
Methods: Institutional IRB approval was obtained. Coca tea was prepared using commercial mate de coca tea bags from Bolivia. One gallon of water was boiled and 12 tea bags steeped in the water for 20 min. Five healthy volunteers ingested between one and five 8-ounce cups of coca tea over 15 min. None of the volunteers reported sympathomimetic symptoms after consuming the tea. Urine samples were collected from each of the subjects preingestion (control) and 2, 12, 24, and 36 h postingestion. Urine toxicology assays for benzoylecgonine were performed by fluorescence polarization immunoassay using Abbott AxSymTM system. Results: The NIDA recommended cutoff for urine benzoylecgonine level is 300 ng/mL. Most reference laboratories use this cutoff when reporting positive urine cocaine screening. Each subject’s urine cocaine assay was positive (level exceeding 300 ng/mL) by 2 h postingestion, and three out of five remained positive at 36 h. Mean benzoylecgonine urine concentrations in all postconsumption samples were 1,777 ng/mL (95% CI:1,060–2,495). In two subjects, 12 h levels exceeded 5,000 ng/mL.
Conclusion: Coca tea ingestion causes a positive urine assay for cocaine. Health care professionals should consider a history of coca tea ingestion when interpreting urine toxicology results.

New Etiology of Cocaine True Positive Drug Screen: Does South American Coca Tea Really Contain Cocaine?

Perrone J, Solari S, Milone M, Miller S, Nanji, A, Shaw LM. Departments of Emergency Medicine and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Background: Mate de coca tea is a popular South American drink brewed from leaves of the coca (Erythroxolon coca) plant. Andean natives recommend the tea to visitors for decreasing symptoms of altitude illness, especially in Peru and Bolivia. It is also now available in the United States via the Internet as an anorexiant. Although alleged to contain cocaine, the medical literature does not describe this phenomenon well.
Case Report: A 30-yr-old woman contacted our hospital toxicology laboratory requesting analysis of a ‘‘Bolivian weight-loss tea’’ that she has been drinking. She recently had a urine drug test by her employer that revealed a+benzoylecgonine implying recent cocaine use. The patient adamantly denied cocaine use, but suggested that her Windsor Mate Coca Tea purchased over the Internet might be the cause of her urine drug screen testing positive for cocaine metabolites. Intact samples of Windsor Mate Coca Tea were obtained. A tea was prepared and then analyzed by gas chromatography-mass spectroscopy for cocaine and metabolites. A significant peak for cocaine was seen. Further quantification revealed 6.4 mgs cocaine/gram of tea, 0.02 mgs benzoylecgonine/gram of tea and traces of ecgonine methyl ester.
Conclusion: South American coca tea may contain measurable quantities of cocaine and may be sufficient in vivo to cause a positive urine drug screen. Given the perceived sensitivity and specificity of forensic cocaine testing, this new finding may complicate interpretation of positive cocaine tests in the future.

Cinnamoylecgonine in the Urine of Cocaine Users

Wiener SW, Ravikumar PR, Hoffman RS, Nelson LS. NYC Poison Control Center, NY, NY.

Background: Ingestion of Mate de coca (coca leaf tea) as a source of clinical false-positive urine cocaine screening has recently been raised as a concern. Analysis of alkaloids present in coca tea revealed cinnamoylmethylecgonine (CME) (also known as cinnamoylcocaine) as a significant component; a CME derivative is also detectable in the urine of coca tea drinkers. Although small amounts of CME were found when samples of cocaine seizures were analyzed, it is unclear whether there would be sufficient quantities to enable detection in the urine of cocaine users. It has been suggested that the presence of this alkaloid might help distinguish between true cocaine users and drinkers of coca tea because the preparation of cocaine for illicit commercial sale may preferentially decrease the amount of contaminants such as CME.
We demonstrate the presence of cinnamoylecgonine (CE), a hydrolysis product of CME, in the urine of cocaine users.
Methods: Ten waste urine samples that had tested positive for benzoylecgonine on EMIT screening were obtained. A total of 2 mL aliquots were mixed with an ammoniacal buffer at pH 9.5, and alkaloids were extracted with methylene chloride and isopropanol (9:1). CE and BE were derivatized with pentafluoropropanol and pentafluoropropionic anhydride (1:2), heated to 90_C for 30 min, cooled and evaporated off at 45_C. Samples were dissolved in 40 mL ethyl acetate, and 2 mL of each were injected into the GC/MS. Spectra were analyzed for the BE and CE derivatives, pentafluoropropylbenzoylecgonine and pentafluoropropylcinnamoylecgonine.
Results: Eight of 10 samples tested positive by GC/MS for the presence of CE. The presence of BE was also confirmed by GC/MS in all samples. Quantitative analysis of CE was not possible because a standard was not available.
Conclusion: CE is detectable in the urine of cocaine users. It would not be useful in distinguishing cocaine users from drinkers of Mate de coca.



Anonymous said...

Nice. Thank god they dont take the goods out, it wouldn't be fair for people outside Latin America to get coca tea without the alkaloids responsible for it's excellent nutrition qualities.

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