الفهرس 
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Abstract
Drug abuse is considered a major contributor to both medical morbidity and mortality all over the world. It also represents an important health problem that has a great impact on the person’s life both socially and economically. Therefore, detection of substances of abuse in biological samples is of great value. However, because of many problems concerning sampling difficulties as well as the risk of adulteration or alternation, the use of alternative biological specimens such as fingerprints in drug testing presents some advantages and initiates more attention.
Each finger skin ridge is populated by a row of pores through which sweat from eccrine glands is excreted and deposited on the surface of skin.
Several analytical approaches have been developed for the detection of drugs of abuse in pharmaceutical and common biological samples but few methodologies have been created to identify drugs of abuse from fingerprints.
Medico legally LC–MS plays a major role in detection of drugs of abuse, drug-facilitated sexual assault and detection of drugs of forensic importance in postmortem cases.
The current study aimed at assessing the possibility of detection of some drugs of abuse (tramadol, clonazepam and phenobarbital) from fingerprints using liquid chromatography¬-mass spectrometry in drug abusers as well as in drug handlers. The aim was extended in order to assess the possibility of detection of the above-mentioned drugs of abuse in fingerprints of drug handlers till three days of handling the drugs as well as to assess the effect of duration of abuse on the concentration of drugs detected in fingerprints.
The present study was conducted on randomly selected adult individuals who were either drug abusers seeking treatment at private clinics or centers of drug dependence in Alexandria, Egypt or normal volunteers who were asked to handle the different studied drugs (drug handlers). The study was carried out between the 1st of May and the 30th of November 2016.
An informed consent was obtained from all individuals before participation in the present study.
Participants were classified into 3 groups; control group that consisted of 50 normal individuals (non-drug abusers), drug abuser group that consisted of 30 individuals who abused tramadol, clonazepam or phenobarbital (10 individuals for each drug) and drug handler group that consisted of 50 individuals who were touching either the powder of drugs of abuse: tramadol, clonazepam or phenobarbital (10 individuals for each drug) or the powder of the control substances which were of similar appearance (white powder) and that might be used in the adulteration of drugs of abuse: acetyl salicylic acid, acetaminophen and talc powder (10 individuals for each drug). Samples were taken from the handler individuals for three consecutive days for the same individual.
Fingerprint samples from volunteers who were handling talc powder couldn’t be analyzed successfully because of its large particle size that couldn’t pass through the Column of the LC-MS.
The diagnosis of drug abusers was based on the current Diagnostic and Statistical Manual of Mental disorders (DSM-V) and urine screening tests using immunoassay technique.
Preliminary drug screening tests of urine samples were also done for drug handlers and the control groups to indicate the presence or absence of the studied drugs of abuse. Fingerprints of all participants (drug abusers, handlers and control individuals) were then taken on a filter paper previously soaked with methanol to be analyzed by LC-MS using SCIEX Triple Quad or QTRAP 5500 System.
The concentration of drugs in each sample was calculated using the regression equations between concentration in ng/ml and peak area of each reference standard.
The present study revealed that:
The age of the control group ranged from 18- 35 years, all of them were from urban areas, most of them (60%) were educated and half of them (50%) were manual and skilled workers.
As regards drug abusers, their age ranged from 18- 35 years and the majority (60%) came from urban areas. They were either university graduates or illiterate (40% each) while the rest (20%) had secondary school education. Concerning the occupation, 40% were manual and skilled workers whereas the rest were employees, students and unemployed persons (20% each). It is also worth mentioning that nearly two thirds of drug abusers (60%) had positive family history for substance abuse.
In the abuser group, all fingerprint samples showed positive results with LC-MS for the tested drugs. There was a significant difference between the mean concentration of tramadol and clonazepam and also between mean concentration of tramadol and phenobarbital, while there was no significant difference between mean concentration of clonazepam and phenobarbital.
The mean concentrations of the drugs in the abusers’ samples were highest when the duration of abuse was more than two years, while they were the lowest when the duration of the abuse was less than one year, which was significantly different in case of clonazepam and phenobarbital and insignificant in case of tramadol.
There was a significant difference between all age groups abusing tramadol, clonazepam and phenobarbital. The mean concentrations of those drugs in the abusers were the highest among the age group between18-25 years while they were the lowest among the age group between >30-35 years.
A significant increase in the mean concentrations of tramadol, clonazepam and phenobarbital was noticed in urban areas when compared to rural areas.
A significant difference between the mean concentration of drugs of abuse and type of education received was also detected in the abuser group. The mean concentration of tramadol, phenobarbital among the highly educated abusers was significantly higher than the illiterate and the secondary school abusers who showed the least mean concentration for these drugs, while there was no significant difference among clonazepam abusers.
It is also worth mentioning that the mean concentrations of tramadol, clonazepam and phenobarbital were higher among workers than in students whose mean concentrations were also higher than in employees. The unemployed group showed the least mean concentration of the above-mentioned drugs. There was a significant difference between them.
The current study revealed also that the mean concentrations of tramadol, clonazepam and phenobarbital were significantly higher in abusers with positive family history than in abusers with negative family history.
Regarding the handlers group, the age of the selected subjects ranged from 20- 35 years, half of them were males and the other half were females, all of them were university graduates and all of them came from urban areas.
The present study showed that tramadol, clonazepam and phenobarbital were successfully detected from fingerprints of drug handlers using LC-MS. Moreover, this highly sensitive technique was able to detect those drugs in fingerprints till 3 days of handling the drugs.
The current work showed also that the mean concentration of the chosen drugs of abuse among the handlers group decreased when the days of samples intake increased.
The mean concentrations of drugs among the drug handlers touching either the drugs of abuse: tramadol, clonazepam, phenobarbital or the control substances: acetylsalicylic acid and acetaminophen were slightly higher in males than in females yet no significant difference was elicited.
All samples from drug abusers and handlers showed positive results with LC-MS, while all samples from the control individuals showed negative results.