scholarly journals Comparison of Urine to Oral Fluid and the Recommendation for Routine Drug Analysis for Driving Under the Influence Cases

2015 ◽  
Vol 39 (4) ◽  
pp. 330-331 ◽  
Author(s):  
N. B. Tiscione
Keyword(s):  
Oral Fluid ◽  
Drug Analysis ◽  
Driving Under The Influence

Biomarkers of Recent Cannabis Use in Blood, Oral Fluid and Breath

2021 ◽  
Author(s):  
J A Hubbard ◽  
M A Hoffman ◽  
S E Ellis ◽  
P M Sobolesky ◽  
B E Smith ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Oral Fluid ◽  
Behavioral Assessment ◽  
Driving Under The Influence ◽  
Time Points ◽  
Behavioral Observations ◽  
Ad Libitum ◽  
Per Se ◽  
Alternative Routes ◽  
Limited Usefulness

Abstract Proving driving under the influence of cannabis (DUIC) is difficult. Establishing a biomarker of recent use to supplement behavioral observations may be a useful alternative strategy. We determined whether cannabinoid concentrations in blood, oral fluid (OF), or breath could identify use within 3h, likely the period of greatest impairment. In a randomized trial, 191 frequent (≥4/week) and occasional (<4/week) cannabis users smoked one cannabis (placebo [0.02%], 5.9% or 13.4% THC) cigarette ad libitum. Blood, OF and breath samples were collected prior to and up to 6h after smoking. Samples were analyzed for 10 cannabinoids in OF, 8 in blood, and THC in breath. Frequent users had more residual THC in blood and were categorized as “recently used” prior to smoking; this did not occur in OF. Per se limits ranging from undetectable to 5 ng/mL THC in blood offered limited usefulness as biomarkers of recent use. Cannabinol (CBN, cutoff=1 ng/mL) in blood offered 100% specificity but only 31.4% sensitivity, resulting in 100% PPV and 94.0% NPV at 4.3% prevalence; but CBN may vary by cannabis chemovar. A 10 ng/mL THC cutoff in OF exhibited the overall highest performance to detect use within 3h (99.7% specificity, 82.4% sensitivity, 92.5% PPV, 99.2% NPV) but was still detectable in 23.2% of participants ~4.4h post smoking limiting specificity at later time points. OF THC may be a helpful indicator of recent cannabis intake, but this does not equate to impairment. Behavioral assessment of impairment is still required to determine DUIC. This study only involved cannabis inhalation and additional research evaluating alternative routes of ingestion (i.e., oral) is needed.

Oral fluid drug analysis in the age of new psychoactive substances

Bioanalysis ◽  
2016 ◽  
Vol 8 (7) ◽  
pp. 691-710 ◽  
Author(s):  
Elisabeth Leere Øiestad ◽  
Åse Marit Leere Øiestad ◽  
Astrid Gjelstad ◽  
Ritva Karinen
Keyword(s):  
Oral Fluid ◽  
Drug Analysis ◽  
New Psychoactive Substances ◽  
Psychoactive Substances

scholarly journals Relationship Between Oral Fluid and Blood Concentrations of Drugs of Abuse in Drivers Suspected of Driving Under the Influence of Drugs

2009 ◽  
Vol 31 (4) ◽  
pp. 511-519 ◽  
Author(s):  
Sarah M R Wille ◽  
Elke Raes ◽  
Pirjo Lillsunde ◽  
Teemu Gunnar ◽  
Marleen Laloup ◽  
...  
Keyword(s):  
Oral Fluid ◽  
Drugs Of Abuse ◽  
Driving Under The Influence ◽  
Blood Concentrations

scholarly journals Oral Fluid Testing for Drugs of Abuse

2009 ◽  
Vol 55 (11) ◽  
pp. 1910-1931 ◽  
Author(s):  
Wendy M Bosker ◽  
Marilyn A Huestis
Keyword(s):  
Mental Health ◽  
Substance Abuse ◽  
Criminal Justice ◽  
Mental Health Services ◽  
Health Services ◽  
Oral Fluid ◽  
Drugs Of Abuse ◽  
Driving Under The Influence ◽  
Device Performance ◽  
Health Services Administration

Abstract Background: Oral fluid (OF) is an exciting alternative matrix for monitoring drugs of abuse in workplace, clinical toxicology, criminal justice, and driving under the influence of drugs (DUID) programs. During the last 5 years, scientific and technological advances in OF collection, point-of-collection testing devices, and screening and confirmation methods were achieved. Guidelines were proposed for workplace OF testing by the Substance Abuse and Mental Health Services Administration, DUID testing by the European Union’s Driving under the Influence of Drugs, Alcohol and Medicines (DRUID) program, and standardization of DUID research. Although OF testing is now commonplace in many monitoring programs, the greatest current limitation is the scarcity of controlled drug administration studies available to guide interpretation. Content: This review outlines OF testing advantages and limitations, and the progress in OF that has occurred during the last 5 years in collection, screening, confirmation, and interpretation of cannabinoids, opioids, amphetamines, cocaine, and benzodiazepines. We examine controlled drug administration studies, immunoassay and chromatographic methods, collection devices, point-of-collection testing device performance, and recent applications of OF testing. Summary: Substance Abuse and Mental Health Services Administration approval of OF testing was delayed because questions about drug OF disposition were not yet resolved, and collection device performance and testing assays required improvement. Here, we document the many advances achieved in the use of OF. Additional research is needed to identify new biomarkers, determine drug detection windows, characterize OF adulteration techniques, and evaluate analyte stability. Nevertheless, there is no doubt that OF offers multiple advantages as an alternative matrix for drug monitoring and has an important role in DUID, treatment, workplace, and criminal justice programs.

Blood and Oral Fluid Cannabinoid Profiles of Frequent and Occasional Cannabis Smokers

2021 ◽  
Author(s):  
Melissa A Hoffman ◽  
Jacqueline A Hubbard ◽  
Philip M Sobolesky ◽  
Breland E Smith ◽  
Raymond T Suhandynata ◽  
...  
Keyword(s):  
Oral Fluid ◽  
Safety Concern ◽  
Biological Fluid ◽  
Driving Under The Influence ◽  
Sample Collection ◽  
Detection Rates ◽  
Specimen Collection ◽  
Final Sample ◽  
Cannabis Consumption ◽  
Per Se

Abstract Increased prevalence of cannabis consumption and impaired driving are a growing public safety concern. Some states adopted per se driving laws, making it illegal to drive with more than a specified ∆9-tetrahydrocannabinol (THC) blood concentration of THC in a biological fluid (typically blood). Blood THC concentrations decrease significantly (~90%) with delays in specimen collection, suggesting use of alternative matrices, such as oral fluid (OF). We characterized 10 cannabinoids’ concentrations, including THC metabolites, in blood and OF from 191 frequent and occasional users by LC–MS-MS for up to 6 h after ad libitum smoking. Subjects self-titrated when smoking placebo, 5.9 or 13.4% THC cannabis. Higher maximum blood THC concentrations (Cmax) were observed in individuals who received the 5.9% THC versus the 13.4% THC plant material. In blood, the Cmax of multiple analytes, including THC and its metabolites, were increased in frequent compared to occasional users, whereas there were no significant differences in OF Cmax. Blood THC remained detectable (≥5 ng/mL) at the final sample collection for 14% of individuals who smoked either the 5.9% or 13.4% THC cigarette, whereas 54% had detectable THC in OF when applying the same cutoff. Occasional and frequent cannabis users’ profiles were compared, THC was detectable for significantly longer in blood and OF from frequent users. Detection rates between frequent and occasional users at multiple per se cutoffs showed larger differences in blood versus OF. Understanding cannabinoid profiles of frequent and occasional users and the subsequent impact on detectability with current drug per se driving limits is important to support forensic interpretations and the development of scientifically supported driving under the influence of cannabis laws.

scholarly journals Validation of an Enzyme Immunoassay for Detection and Semiquantification of Cannabinoids in Oral Fluid

2010 ◽  
Vol 56 (6) ◽  
pp. 1007-1014 ◽  
Author(s):  
David M Schwope ◽  
Garry Milman ◽  
Marilyn A Huestis
Keyword(s):  
Oral Fluid ◽  
Drugs Of Abuse ◽  
Limit Of Detection ◽  
Cross Reactivity ◽  
Driving Under The Influence ◽  
Diagnostic Efficiency ◽  
Diagnostic Specificity ◽  
Collection Device ◽  
Assay Performance ◽  
Direct Elisa

Abstract Background: Oral fluid (OF) is gaining prominence as an alternative matrix for monitoring drugs of abuse in the workplace, criminal justice, and driving under the influence of drugs programs. It is important to characterize assay performance and limitations of screening techniques for Δ9-tetrahydrocannabinol (THC) in OF. Methods: We collected OF specimens by use of the Quantisal™ OF collection device from 13 daily cannabis users after controlled oral cannabinoid administration. All specimens were tested with the Immunalysis Sweat/OF THC Direct ELISA and confirmed by 2-dimensional GC-MS. Results: The limit of detection was <1 μg/L THC equivalent, and the assay demonstrated linearity from 1 to 50 μg/L, with semiquantification to 200 μg/L. Intraplate imprecision (n = 7) ranged from 2.9% to 7.7% CV, and interplate imprecision (n = 20) was 3.0%–9.1%. Cross-reactivities at 4 μg/L were as follows: 11-hydroxy-THC, 198%; Δ8-tetrahydrocannabinol (Δ8-THC), 128%; 11-nor-9-carboxy-THC (THCCOOH), 121%; THC (target), 98%; cannabinol, 87%; THCCOOH-glucuronide, 11%; THC-glucuronide, 10%; and cannabidiol, 2.4%. Of 499 tested OF specimens, 52 confirmed positive (THC 2.0–290 μg/L), with 100% diagnostic sensitivity at the proposed Substance Abuse and Mental Health Services Administration screening cutoff of 4 μg/L cannabinoids and GC-MS cutoff of 2 μg/L THC. Forty-seven specimens screened positive but were not confirmed by 2D-GC-MS, yielding 89.5% diagnostic specificity and 90.6% diagnostic efficiency. Thirty-one of 47 unconfirmed immunoassay positive specimens were from 1 individual and contained >400 ng/L THCCOOH, potentially contributing to cross-reactivity. Conclusions: The Immunalysis Sweat/OF THC Direct ELISA is an effective screening procedure for detecting cannabinoids in OF.

Driving under the influence of cocaine: Quantitative determination of basic drugs in oral fluid obtained during roadside controls and a controlled study with cocaine users

2018 ◽  
Vol 10 (8) ◽  
pp. 1285-1296 ◽  
Author(s):  
Vincent Di Fazio ◽  
Sarah M.R. Wille ◽  
Stefan W. Toennes ◽  
Janelle H.P. van Wel ◽  
Johannes G. Ramaekers ◽  
...  
Keyword(s):  
Quantitative Determination ◽  
Oral Fluid ◽  
Driving Under The Influence ◽  
Controlled Study ◽  
Basic Drugs ◽  
Cocaine Users

Oral Fluid Drug Testing: Analytical Approaches, Issues and Interpretation of Results

2019 ◽  
Vol 43 (6) ◽  
pp. 415-443 ◽  
Author(s):  
Nathalie A Desrosiers ◽  
Marilyn A Huestis
Keyword(s):  
Analytical Methods ◽  
Drug Testing ◽  
Oral Fluid ◽  
Driving Under The Influence ◽  
Multiple Drug ◽  
Blood Concentrations ◽  
The Past ◽  
Drug Classes ◽  
Drug Concentrations ◽  
Analytical Approaches

AbstractWith advances in analytical technology and new research informing result interpretation, oral fluid (OF) testing has gained acceptance over the past decades as an alternative biological matrix for detecting drugs in forensic and clinical settings. OF testing offers simple, rapid, non-invasive, observed specimen collection. This article offers a review of the scientific literature covering analytical methods and interpretation published over the past two decades for amphetamines, cannabis, cocaine, opioids, and benzodiazepines. Several analytical methods have been published for individual drug classes and, increasingly, for multiple drug classes. The method of OF collection can have a significant impact on the resultant drug concentration. Drug concentrations for amphetamines, cannabis, cocaine, opioids, and benzodiazepines are reviewed in the context of the dosing condition and the collection method. Time of last detection is evaluated against several agencies' cutoffs, including the proposed Substance Abuse and Mental Health Services Administration, European Workplace Drug Testing Society and Driving Under the Influence of Drugs, Alcohol and Medicines cutoffs. A significant correlation was frequently observed between matrices (i.e., between OF and plasma or blood concentrations); however, high intra-subject and inter-subject variability precludes prediction of blood concentrations from OF concentrations. This article will assist individuals in understanding the relative merits and limitations of various methods of OF collection, analysis and interpretation.

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