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Pure Appl. Chem., 2000, Vol. 72, No. 6, pp. 1057-1066

Sectional hair testing. Judicial and clinical applications

Aristidis M. Tsatsakis* and Manolis Tzatzarakis

Laboratory of Toxicology, Medical School, University of Crete, Voutes, Heraklion 71409, Crete, Greece

Abstract: Modern sophisticated analytical tools have enabled toxicologists to investigate hair specimens for the presence of drugs. Although great sensitivity and specificity in hair analysis have been already achieved, some concerns about bias due to hair color, lack of reference materials, and dose versus concentration relationship make the quantitative data sometimes debatable. The most commonly held opinion in this field nowadays indicates that hair analysis has sufficient scientific validity. Experts should always be aware and take into account limitations of hair analysis results and its evaluation. Unresolved scientific issues, however, should not obstruct the admissibility of strongly positive test results. Recent applications of hair testing include forensic investigations, epidemiological studies, gestational drug exposure, legal issues, clinical drug monitoring, and historical research. In this paper, the use of sectional hair tests to assess exposure to drugs of abuse (evaluation of toxicomania) and to assess compliance with carbamazepine, phenytoin and valproic acid therapy regime is presented. We conclude that hair drug versus time profiles give strong evidence that confirm chronic abuse, the diagnosis of drugs of abuse poisoning, and the state of addiction (toxicomania). Additionally, they may be used as a marker of the dosage history and the compliance of patients under long-term treatment with carbamazepine and phenytoin.