以指甲與頭髮藥物檢驗方法監測緩起訴附命治療者之用藥狀況

研究目的：本研究旨在探討指甲與頭髮檢體，並與尿液檢體比較，來監測二級毒品緩起訴附命治療者的用藥狀態。研究方法及資料：受試者為二級毒品緩起訴附命治療者，檢體為手指甲與頭髮，檢驗品項為四種傳統毒品及其代謝物，包括安非他命類、搖頭丸(MDMA)、海洛因與愷他命。檢驗儀器為三段四極柱液相層析串聯質譜儀。分析方法以SPSS 軟體進行卡方檢定。研究結果：研究總共收集了17位受試者，共取得20個手指甲檢體，7個頭髮檢體。在手指甲檢體中，安非他命陽性率為70.0%，海洛因陽性率為10.0%，搖頭丸與愷他命皆為陰性反應。手指甲檢體中，以6個月為時間切分點，看診6個月內的個案檢體安非他命陽性率為100%，看診已經超過6個月後的個案，安非他命陽性率為66.7%。頭髮檢體當中，安非他命陽性率為57.1%，海洛因陽性率為14.3%，搖頭丸與愷他命皆為陰性反應。比對同時期的尿液檢驗皆為陰性反應。結論與建議：本研究建立了四種傳統毒品指甲與頭髮的檢驗方法，並發現比尿液更能監測緩起訴者的用藥狀況。唯有確認緩起訴者真實的用藥狀態，才能提供治療的介入。此研究結果可成為未來藥物檢驗政策之參考。

關鍵字

緩起訴；液相層析串聯質譜儀；指甲檢驗；頭髮檢驗

並列摘要

Objective:This study aims to investigate nail and hair specimens and compare them with urine specimens to monitor the drug use status of patients with deferred prosecution. Methods and materials: The participants were category two drug users with deferred prosecution. The specimens were fingernails and hair. The method detected four conventional drugs and their metabolites, including amphetamines, ecstasy (MDMA), heroin and ketamine. The testing was performed by triple quadrupole liquid chromatography tandem mass spectrometer (LC-MS/MS). The analysis method was chi-squared with SPSS software. Results: A total of 17 participants were included in the study, and a total of 20 fingernail samples and seven hair samples were obtained. In fingernail samples, the positive rate of amphetamine was 70.0%, the positive rate of heroin was 10.0%, and both ecstasy and ketamine were negative. In fingernail testing, we divided them into two groups: samples obtained during the first six months since abstinence treatment started and samples taken after the first six months of treatment. The positive rate of amphetamines in samples within six months of the commencement of treatment was 100%, and the positive rate of amphetamines in samples more than six months after the treatment commencement was 66.7%. Among the hair samples, the positive rate of amphetamine was 57.1%, the positive rate of heroin was 14.3%, and both ecstasy and ketamine were negative. The urine testing samples in the same participants were all negative. Conclusions and recommendations: This study investigated the testing of nail and hair samples for four conventional drugs. It was found that nail and hair testing is more effective at detecting drugs of abuse in participants than urine testing. Only by confirming the true drug use status of the patients with deferred prosecution can more effective intervention treatment be provided. The results of this study can serve as a reference for future drug testing policies.