Prevalence of Amphetamine Abuse in the Kingdom of Saudi Arabia

The National Guard Health Affairs, Saudi Arabia implemented a forensic urine drug testing program in the hospital from October 2003. Urine specimens were screened for amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, opiates by CEDIA^® reagents of Microgenics Corporation and DRI^® reagents for alcohol, using Hitachi automatic analyzers. Confirmation tests were done by ThermoFinnigan GCMS for all the drugs mentioned above, except alcohol, which was done by Perkin Elmer Head Space GC. In total, 5083 urine specimens were analyzed. Of these, 1039 were found to be suspected positive and the rate of positive case for one or more drugs of abuse was 20.4%. Captagon (Fenethylline) is the most popular drug of abuse in the country. Fenethylline (FNT) metabolizes into amphetamine which can be detected by CEDIA technique and confirmed by GC-MS method. All the 554 specimens, screened positive for amphetamine, were subjected for confirmation by GC-MS method. Samples were derivatized with acetic anhydride and pyridine. Cerilliant^® Amphetamine-d11 and MDA-d5 were used as internal standards. Medichem^® Urine BTM and DPC^® quality controls were used. In GC-MS analysis under SIM mode, the ions monitored were 44, 86 and 118. Out of 554 suspected positives, 539 specimens were confirmed to be positive for amphetamine (97.2%). The study shows that among various types of drugs, amphetamine could be the leading drug of abuse in Saudi Arabia.