{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:17:42Z","timestamp":1790360262240,"version":"4.1.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T00:00:00Z","timestamp":1693180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Urine has been the preferred matrix for monitoring heroin and methadone adherence due to its large detection window. Drawbacks such as privacy concerns and adulteration however require other matrices. The study aims to determine if oral fluid and exhaled breath are suitable alternatives for heroin and methadone monitoring and to assess the detection time in exhaled breath. Forty-three participants, all on methadone and heroin-assisted treatment, were studied. Participants were monitored after the first and right before the second dosage of heroin. At both time points, oral fluid and exhaled breath samples were collected with urine at the second time point. All samples were screened for opiates, methadone and other drugs using immunoassay and LC\u2013MS-MS. At the second time point, 98% of oral fluid samples and all exhaled breath samples tested positive for 6-monoacetylmorphine (6-MAM). Regarding morphine detection, the findings were reversed (100% in oral fluid, 98% in exhaled breath). Methadone-related results were 100% positive across all matrices, as expected. Notable is the detection of the heroin marker acetylcodeine in oral fluid and exhaled breath samples, which resulted in relatively low negative predictive value (average 54.6%). Oral fluid and exhaled breath are suitable alternatives for heroin and methadone maintenance monitoring. Clinicians should consider ease of collection, adulteration risk, costs, turn-around time and the substance of interest while choosing a matrix. In addition, even in cases when medicinal heroin is used, medical professionals should be aware of the presence of acetylcodeine in these alternate matrices.<\/jats:p>","DOI":"10.1093\/jat\/bkad060","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T19:26:51Z","timestamp":1693250811000},"page":"842-849","source":"Crossref","is-referenced-by-count":7,"title":["Towards adherence monitoring using breath or oral fluid as a matrix in a methadone maintenance treatment program for patients with a chronic heroin use disorder: Issues and interpretation of the results"],"prefix":"10.1093","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5158-8794","authenticated-orcid":false,"given":"Lutea A A","family":"de Jong","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, Expert center Gelre-iLab , Gelre Hospitals, P.O. Box 9014, Apeldoorn 7300 DS, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Kloost","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Expert center Gelre-iLab , Gelre Hospitals, P.O. Box 9014, Apeldoorn 7300 DS, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik J H","family":"Olyslager","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Expert center Gelre-iLab , Gelre Hospitals, P.O. Box 9014, Apeldoorn 7300 DS, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"B\u00f6ttcher","sequence":"additional","affiliation":[{"name":"Department of Toxicology, MVZ Medizinische Labore Dessau Kassel GmbH , Bauh\u00fcttenstr. 6, Dessau-Ro\u00dflau 06847, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan A","family":"Wieferink","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Expert center Gelre-iLab , Gelre Hospitals, P.O. Box 9014, Apeldoorn 7300 DS, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Vossenberg","sequence":"additional","affiliation":[{"name":"Tactus Addiction Treatment Center , P.O. Box 154, Deventer 7400 AD, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Belgers","sequence":"additional","affiliation":[{"name":"IrisZorg, Institute for Addiction Care and Sheltered Housing , Mr. B.M. Teldersstraat 7, Arnhem 6842 CT, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harmen","family":"Beurmanjer","sequence":"additional","affiliation":[{"name":"Novadic-Kentron Addictioncare , Hogedwarsstraat 3, Vught AE 5261, The Netherlands"},{"name":"Behavioural Science Institute, Radboud University Nijmegen , P.O. Box 9104, Nijmegen 6500 HE, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hein A","family":"de Haan","sequence":"additional","affiliation":[{"name":"Tactus Addiction Treatment Center , P.O. 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