online-SPE UPLC-MS/MS对医院污水中毒品监测结果及毒情评估

Monitoring results of illicit drugs in hospital sewage by online-SPE UPLC-MS/MS and its enlightenment to drug abuse assessment

目的 污水分析法在毒情评估时,医院使用的吗啡、可待因类、麻黄碱类等药物可以经污水管网排放至污水处理厂中,为了避免毒品滥用量被高估,让禁毒或者政府部门对毒情产生误判,对医院污水中的毒品进行监测和结果分析。方法 采用在线固相萃取-液相色谱串联质谱法对87家医院的171个污水样品中13种毒品及其代谢物和人口标记物可替宁进行检测,得到了各目标物的浓度水平,并对毒品浓度的相关性和污水处理前后的毒品去除率进行了分析。结果 在监测的毒品及其代谢物中,吗啡的检出率和浓度都是最高的,远远高于全国污水厂的平均水平,吗啡的浓度与可替宁、可待因的浓度也呈现一定的正向相关性。大部分医院污水中的毒品有着较高的去除率,但是仍然存在医院的污水处理不到位的情况,可能会导致吗啡等物质的滥用量被高估。结论 规范医院药品的处置和污水的处理、优化毒品滥用量计算模型有着非常重要的作用,可将医院作为毒品监测的重点区域,建立长期监测网络,优化毒情评估模型,为准确评估毒情和精准打击毒品犯罪提供参考。

Objective There is a new technology to assess the illicit drug abuse in specific regions,based on the content of drugs and their metabolites as well as population markers in sewage.However,morphine,codeine and ephedrine used in hospital may be discharged into the sewage treatment plant through the sewage pipe network.It may make the levels of drug abuse overestimated.In order to avoid misjudgment about drug abuse,the illicit drugs in hospital sewage were monitored and the results were analyzed.Methods An online solid phase extraction high-performance liquid chromatography-tandem mass spectrometry method was established for the determination of 13 drugs and their metabolites as well as the population marker cotinine in 171 sewage samples from 87 hospitals,and the concentration of each ingredient was obtained.Furthermore,the correlation of drug concentration,removal rate before and after sewage treatment were analyzed.Results Among the monitored drugs and their metabolites,the detection frequency and concentration of morphine are the highest,much higher than the average level of sewage treatment plants in China.Moreover,the concentrations of morphine and cotinine were positively correlated,as did morphine and codeine.Most of the drugs in hospital sewage had high removal rates,but insufficient treatment of hospital sewage still existed,which may lead to an overestimation of the abuse of morphine and other illicit drug.Conclusion It is very important to standardize the disposal of drugs and the treatment of sewage in hospitals,and to optimize the calculation model of drug abuse.Hospitals can be regarded as key areas for drug monitoring,and a long-term monitoring network can also be established.By optimizing the evaluation model ofillicit drug,it will provide a reference for accurate evaluation of illicit drug and precise crackdown on drug crimes.