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.

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.

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.

Oral Fluid and Drug Impairment: Pairing Toxicology with Drug Recognition Expert Observations

2019 ◽  
Vol 43 (8) ◽  
pp. 637-643
Author(s):  
Michael T Truver ◽  
Kaitlyn B Palmquist ◽  
Madeleine J Swortwood
Keyword(s):  
Law Enforcement ◽  
Oral Fluid ◽  
Drugs Of Abuse ◽  
The Body ◽  
Driving Under The Influence ◽  
Attractive Alternative ◽  
Liquid Chromatograph ◽  
Non Invasive ◽  
Institutional Review ◽  
Drug Impairment

Abstract According to the Governors Highway Safety Association, drugs are detected more frequently in fatally injured drivers than alcohol. Due to the variety of drugs (prescribed and/or illicit) and their various physiological effects on the body, it is difficult for law enforcement to detect/prosecute drug impairment. While blood and urine are typical biological specimens used to test for drugs, oral fluid is an attractive alternative matrix. Drugs are incorporated into oral fluid by oral contamination (chewing or smoking) or from the bloodstream. Oral fluid is non-invasive and easy to collect without the need for a trained professional to obtain the sample, unlike urine or blood. This study analyzes paired oral fluid and urine with drug recognition expert (DRE) observations. Authentic oral fluid samples (n = 20) were collected via Quantisal™ devices from arrestees under an institutional review board-approved protocol. Urine samples (n = 18) were collected with EZ-SCREEN® cups that presumptively screened for Δ9-tetrahydrocannabinol (cannabinoids), opiates, methamphetamine, cocaine, methadone, phencyclidine, amphetamine, benzodiazepines and oxycodone. Impairment observations (n = 18) were recorded from officers undergoing DRE certification. Oral fluid samples were screened using an Agilent Technologies 1290 Infinity liquid chromatograph (LC) coupled to an Agilent Technologies 6530 Accurate Mass Time-of-Flight mass spectrometer (MS). Personal compound and database libraries were produced in-house containing 64 drugs of abuse. An Agilent 1290 Infinity LC system equipped with an Agilent 6470 Triple Quadrupole MS was used for quantification of buprenorphine, heroin markers (6-acetylmorphine, morphine) and synthetic opioids. Subjects were 23–54 years old; 11 (55%) were male and 9 (45%) were female. Evaluator opinion of drug class was confirmed in oral fluid 90% of time and in urine 85% of the time in reference to scope of testing by the LC–MS methods employed (excludes cannabis and central nervous system depressants). Data indicate that oral fluid may be a viable source for confirming driving under the influence of drugs.

scholarly journals Simultaneous Screening and Quantification of 29 Drugs of Abuse in Oral Fluid by Solid-Phase Extraction and Ultraperformance LC-MS/MS

2009 ◽  
Vol 55 (11) ◽  
pp. 2004-2018 ◽  
Author(s):  
Nora Badawi ◽  
Kirsten Wiese Simonsen ◽  
Anni Steentoft ◽  
Inger Marie Bernhoft ◽  
Kristian Linnet
Keyword(s):  
Solid Phase Extraction ◽  
Oral Fluid ◽  
Drugs Of Abuse ◽  
Matrix Effects ◽  
Solid Phase ◽  
Multiple Reaction Monitoring ◽  
Ammonium Hydroxide ◽  
Driving Under The Influence ◽  
Phase Extraction ◽  
Limit Of Quantification

Abstract Background: The European DRUID (Driving under the Influence of Drugs, Alcohol And Medicines) project calls for analysis of oral fluid (OF) samples, collected randomly and anonymously at the roadside from drivers in Denmark throughout 2008–2009. To analyze these samples we developed an ultra performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) method for detection of 29 drugs and illicit compounds in OF. The drugs detected were opioids, amphetamines, cocaine, benzodiazepines, and Δ-9-tetrahydrocannabinol. Method: Solid-phase extraction was performed with a Gilson ASPEC XL4 system equipped with Bond Elut Certify sample cartridges. OF samples (200 mg) diluted with 5 mL of ammonium acetate/methanol (vol/vol 90:10) buffer were applied to the columns and eluted with 3 mL of acetonitrile with aqueous ammonium hydroxide. Target drugs were quantified by use of a Waters ACQUITY UPLC system coupled to a Waters Quattro Premier XE triple quadrupole (positive electrospray ionization mode, multiple reaction monitoring mode). Results: Extraction recoveries were 36%–114% for all analytes, including Δ-9-tetrahydrocannabinol and benzoylecgonine. The lower limit of quantification was 0.5 μg/kg for all analytes. Total imprecision (CV) was 5.9%–19.4%. With the use of deuterated internal standards for most compounds, the performance of the method was not influenced by matrix effects. A preliminary account of OF samples collected at the roadside showed the presence of amphetamine, cocaine, codeine, Δ-9-tetrahydrocannabinol, tramadol, and zopiclone. Conclusions: The UPLC-MS/MS method makes it possible to detect all 29 analytes in 1 chromatographic run (15 min), including Δ-9-tetrahydrocannabinol and benzoylecgonine, which previously have been difficult to incorporate into multicomponent methods.

Evaluation of three rapid oral fluid test devices on the screening of multiple drugs of abuse including ketamine

2018 ◽  
Vol 286 ◽  
pp. 113-120 ◽  
Author(s):  
Magdalene H.Y. Tang ◽  
C.K. Ching ◽  
Simon Poon ◽  
Suzanne S.S. Chan ◽  
W.Y. Ng ◽  
...  
Keyword(s):  
Oral Fluid ◽  
Drugs Of Abuse ◽  
Multiple Drugs ◽  
Fluid Test

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.

ORALVEQ: External quality assessment scheme of drugs of abuse in oral fluid

2008 ◽  
Vol 182 (1-3) ◽  
pp. 35-40 ◽  
Author(s):  
M. Ventura ◽  
R. Ventura ◽  
S. Pichini ◽  
S. Leal ◽  
P. Zuccaro ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Oral Fluid ◽  
Drugs Of Abuse ◽  
External Quality Assessment ◽  
External Quality ◽  
External Quality Assessment Scheme

Screening of 104 New Psychoactive Substances (NPS) and Other Drugs of Abuse in Oral Fluid by LC–MS-MS

2020 ◽  
Vol 44 (7) ◽  
pp. 697-707
Author(s):  
Kelly Francisco da Cunha ◽  
Karina Diniz Oliveira ◽  
Marilyn A Huestis ◽  
Jose Luiz Costa
Keyword(s):  
Oral Fluid ◽  
Drugs Of Abuse ◽  
Matrix Effects ◽  
Synthetic Cannabinoids ◽  
Screening Method ◽  
Simultaneous Detection ◽  
New Psychoactive Substances ◽  
Major Public Health Problem ◽  
Psychoactive Substances ◽  
Wide Range

Abstract New psychoactive substances (NPS) are a major public health problem, primarily due to the increased number of acute poisoning cases. Detection of these substances is a challenge. The aim of this research was to develop and validate a sensitive screening method for 104 drugs of abuse, including synthetic cannabinoids, synthetic cathinones, fentanyl analogues, phenethylamines and other abused psychoactive compounds (i.e., THC, MDMA, LSD and their metabolites) in oral fluid by liquid chromatography–tandem mass spectrometry (LC–MS-MS). The Quantisal™ oral fluid device was used to collect oral fluid samples. The oral fluid–elution buffer mixture (500-μL sample) was extracted with t-butyl methyl ether, and chromatographic separation was performed on a Raptor™ biphenyl column (100 × 2.1 mm ID, 2.7 μm), with a total run time of 13.5 min. Limits of detection were established at three concentrations (0.05, 0.1 or 1 ng/mL) for most analytes, except for acetyl norfentanyl and mescaline (5 ng/mL). Matrix effects were generally <20% and overall extraction recoveries >60%. The highest matrix effect was observed within the synthetic cannabinoid group (PB22, −55.5%). Lower recoveries were observed for 2C-T (47.2%) and JWH-175 (58.7%). Recoveries from the Quantisal™ device were also evaluated for all analytes (56.7–127%), with lower recoveries noted for 25I-NBOMe, valerylfentanyl and mCPP (56.7, 63.0 and 69.9%, respectively). Drug stability in oral fluid was evaluated at 15, 60 and 90 days and at 25, 4 and −20°C. As expected, greater stability was observed when samples were stored at −20°C, but even when frozen, some NPS (e.g., synthetic cannabinoids) showed more than 20% degradation. The method was successfully applied to the analysis of seven authentic oral fluid samples positive for 17 different analytes. The method achieved good sensitivity and simultaneous detection of a wide range of NPS.

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