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Suraev A, McCartney D, Kevin R, Gordon R, Grunstein RR, Hoyos CM, McGregor IS. Detection of Δ 9 -tetrahydrocannabinol (THC) in oral fluid using two point-of-collection testing devices following oral administration of a THC and cannabidiol containing oil. Drug Test Anal 2024. [PMID: 38414100 DOI: 10.1002/dta.3658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 01/17/2024] [Accepted: 01/30/2024] [Indexed: 02/29/2024]
Abstract
Point-of-collection testing (POCT) devices are widely used in roadside and workplace drug testing to identify recent cannabis use by measuring the presence of Δ9 -tetrahydrocannabinol (THC) in oral fluid (OF). However, the performance of POCT devices with oral medicinal cannabis products remains poorly described. In a randomised, double-blinded, crossover trial, adults with insomnia disorder (n = 20) received a single (2 mL) oral dose of oil containing 10 mg THC + 200 mg cannabidiol, or placebo, prior to sleep. Participants were tested with the Securetec DrugWipe® 5S (10 ng/mL THC cut-off) and Dräger DrugTest® 5000 (25 ng/mL THC cut-off) POCT devices at baseline (pre-treatment) and then at 0.5, 10, and 18 h post-treatment. An OF sample, taken at each time point, was also analysed using liquid chromatography-tandem mass spectrometry. Large individual variability in OF THC concentrations was observed 0.5 h post-treatment (range: 0-425 ng/mL; mean (SD) 48.7 (107.5) ng/mL). Both the Securetec DrugWipe® 5S and DrugTest® 5000 demonstrated poor sensitivity to THC at 0.5 h post-treatment (25% and 50%, respectively). At 10 and 18 h post-treatment, all participant OF THC concentrations were below screening cut-offs, and all test results were negative. These findings highlight the relatively poor sensitivity of both devices in detecting recent use of an oral medicinal cannabis product. They also suggest a low probability of obtaining a positive THC result the morning after ('one-off') use. Further research is required to establish the probability of obtaining a positive THC result with regular medicinal cannabis use.
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Affiliation(s)
- Anastasia Suraev
- Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, New South Wales, Australia
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Danielle McCartney
- Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Richard Kevin
- Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, New South Wales, Australia
- St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Rebecca Gordon
- Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, New South Wales, Australia
| | - Ronald R Grunstein
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Camilla M Hoyos
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Human Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Iain S McGregor
- Lambert Initiative for Cannabinoid Therapeutics, University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
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Clément P, Schlage WK, Hoeng J. Recent advances in the development of portable technologies and commercial products to detect Δ 9-tetrahydrocannabinol in biofluids: a systematic review. J Cannabis Res 2024; 6:9. [PMID: 38414071 PMCID: PMC10898188 DOI: 10.1186/s42238-024-00216-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/31/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The primary components driving the current commercial fascination with cannabis products are phytocannabinoids, a diverse group of over 100 lipophilic secondary metabolites derived from the cannabis plant. Although numerous phytocannabinoids exhibit pharmacological effects, the foremost attention has been directed towards Δ9-tetrahydrocannabinol (THC) and cannabidiol, the two most abundant phytocannabinoids, for their potential human applications. Despite their structural similarity, THC and cannabidiol diverge in terms of their psychotropic effects, with THC inducing notable psychological alterations. There is a clear need for accurate and rapid THC measurement methods that offer dependable, readily accessible, and cost-effective analytical information. This review presents a comprehensive view of the present state of alternative technologies that could potentially facilitate the creation of portable devices suitable for on-site usage or as personal monitors, enabling non-intrusive THC measurements. METHOD A literature survey from 2017 to 2023 on the development of portable technologies and commercial products to detect THC in biofluids was performed using electronic databases such as PubMed, Scopus, and Google Scholar. A systematic review of available literature was conducted using Preferred Reporting Items for Systematic. Reviews and Meta-analysis (PRISMA) guidelines. RESULTS Eighty-nine studies met the selection criteria. Fifty-seven peer-reviewed studies were related to the detection of THC by conventional separation techniques used in analytical laboratories that are still considered the gold standard. Studies using optical (n = 12) and electrochemical (n = 13) portable sensors and biosensors were also identified as well as commercially available devices (n = 7). DISCUSSION The landscape of THC detection technology is predominantly shaped by immunoassay tests, owing to their established reliability. However, these methods have distinct drawbacks, particularly for quantitative analysis. Electrochemical sensing technology holds great potential to overcome the challenges of quantification and present a multitude of advantages, encompassing the possibility of miniaturization and diverse modifications to amplify sensitivity and selectivity. Nevertheless, these sensors have considerable limitations, including non-specific interactions and the potential interference of compounds and substances existing in biofluids. CONCLUSION The foremost challenge in THC detection involves creating electrochemical sensors that are both stable and long-lasting while exhibiting exceptional selectivity, minimal non-specific interactions, and decreased susceptibility to matrix interferences. These aspects need to be resolved before these sensors can be successfully introduced to the market.
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Affiliation(s)
- Pierrick Clément
- Centre Suisse d'Electronique Et de Microtechnique SA (CSEM), Rue Jaquet-Droz 1, 2002, Neuchâtel, Switzerland.
| | - Walter K Schlage
- Biology Consultant, Max-Baermann-Strasse 21, 51429, Bergisch Gladbach, Germany
| | - Julia Hoeng
- Biology Consultant, Max-Baermann-Strasse 21, 51429, Bergisch Gladbach, Germany
- Vectura Fertin Pharma, C/O Jagotec AG, Messeplatz 10, 4058, Basel, Switzerland
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Willeman T, Micallef J, Alvarez JC, Revol B. [Use CBD or drive, do you have to choose?]. Therapie 2023; 78:749-751. [PMID: 36517303 DOI: 10.1016/j.therap.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/18/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Théo Willeman
- Laboratoire de pharmacologie, pharmacogénétique, toxicologie, CHU Grenoble Alpes, 38000 Grenoble, France; Clinique de médecine légale, CHU Grenoble Alpes, 38000 Grenoble, France
| | - Joëlle Micallef
- CEIP-addictovigilance Paca Corse, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, 13000 Marseille, France; Aix-Marseille université, institut de neurosciences des systèmes Inserm UMR1106, 13000 Marseille, France
| | - Jean-Claude Alvarez
- Département de pharmacologie-toxicologie, hôpital Raymond-Poincaré, Assistance publique-Hôpitaux de Paris, 92380 Garches, France; Université Paris-Saclay (UVSQ), MasSpecLab Inserm U1173, 78180 Montigny-le-Bretonneux, France
| | - Bruno Revol
- CEIP-addictovigilance, centre d'évaluation et d'information sur la pharmacodépendance - addictovigilance, CHU Grenoble Alpes, CS 10217, 38043 Grenoble cedex 9, France; Université Grenoble Alpes, laboratoire HP2 Inserm U1300, 38000 Grenoble, France.
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Alvarez JC, Pelissier AL, Mura P, Goullé JP. [Cannabidiol (CBD): Analytical and toxicological aspects]. Therapie 2023; 78:639-645. [PMID: 36868996 DOI: 10.1016/j.therap.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 01/31/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023]
Abstract
Cannabidiol (CBD) is a phytocannabinoid present in cannabis, obtained either by extraction from the plant or by synthesis. The latter has the advantage of being pure and contains few impurities, unlike CBD of plant origin. It is used by inhalation, ingestion or skin application. In France, the law stipulates that specialties containing CBD may contain up to 0.3% of tetrahydrocannabinol (THC), the psychoactive principle of cannabis. From an analytical point of view, it is therefore important to be able to quantify the two compounds as well as their metabolites in the various matrices that can be used clinically or forensically, in particular saliva and blood. The transformation of CBD into THC, which has long been suggested, appears to be an analytical artifact under certain conditions. CBD is not without toxicity, whether acute or chronic, as seems to attest to the serious adverse effects recorded by pharmacovigilance during the experiment currently being conducted in France by the Agence Nationale de Sécurité du Médicament et des Produits de Santé. Although CBD does not seem to modify driving abilities, driving a vehicle after consuming CBD containing up to 0.3% THC, and sometimes much more in products bought on the internet, can lead to a positive result in screening and confirmation tests by law enforcement agencies, whether salivary or blood tests, and therefore lead to a legal sanction.
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Affiliation(s)
- Jean-Claude Alvarez
- Laboratoire de pharmacologie/toxicologie, CHU Garches, université Paris-Saclay (Versailles-St Quentin-en-Yvelines), plateforme de spectrométrie de masse MasSpecLab, UFR médecine Simone Veil, Inserm U-1018, CESP, Équipe MOODS, 92380 Garches, France.
| | - Anne-Laure Pelissier
- Laboratoire de toxicologie, service de médecine légale, AP-HM, CHU Timone, Aix-Marseille université, 13005 Marseille, France
| | - Patrick Mura
- Académie nationale de Pharmacie, 75270 Paris, France
| | - Jean-Pierre Goullé
- Laboratoire de toxicologie, UNIROUEN, UR ABTE EA 4651, UFR de santé, université de Rouen, 76183 Rouen, France
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Lavender I, McCartney D, Marshall N, Suraev A, Irwin C, D'Rozario AL, Gordon CJ, Saini B, Grunstein RR, Yee B, McGregor I, Hoyos CM. Cannabinol (CBN; 30 and 300 mg) effects on sleep and next-day function in insomnia disorder ('CUPID' study): protocol for a randomised, double-blind, placebo-controlled, cross-over, three-arm, proof-of-concept trial. BMJ Open 2023; 13:e071148. [PMID: 37612115 PMCID: PMC10450062 DOI: 10.1136/bmjopen-2022-071148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 08/07/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVE Insomnia is the most prevalent sleep disorder, with few effective pharmacotherapies. Anecdotal reports and recent preclinical research suggest that cannabinol (CBN), a constituent of Cannabis sativa derived from delta-9-tetrahydrocannabinol, could be an effective treatment. Despite this, the isolated effects of CBN on sleep have yet to be systematically studied in humans. METHODS The present protocol paper describes a randomised, double-blind, placebo-controlled, single-dose, three-arm, cross-over, proof-of-concept study which investigates the effects of CBN on sleep and next-day function in 20 participants with clinician-diagnosed insomnia disorder and an Insomnia Severity Index Score ≥15. Participants receive a single fixed oral liquid dose of 30 mg CBN, 300 mg CBN and matched placebo, in random order on three treatment nights; each separated by a 2-week wash-out period. Participants undergo overnight sleep assessment using in-laboratory polysomnography and next-day neurobehavioural function tests. The primary outcome is wake after sleep onset minutes. Secondary outcomes include changes to traditional sleep staging, sleep-onset latency and absolute spectral power during non-rapid eye movement (NREM) sleep. Tertiary outcomes include changes to sleep spindles during NREM sleep, arousal indices, absolute spectral power during REM sleep and subjective sleep quality. Safety-related and exploratory outcomes include changes to next-day simulated driving performance, subjective mood and drug effects, postural sway, alertness and reaction time, overnight memory consolidation, pre and post-sleep subjective and objective sleepiness; and plasma, urinary, and salivary cannabinoid concentrations. The study will provide novel preliminary data on CBN efficacy and safety in insomnia disorder, which will inform larger clinical trials. ETHICS AND DISSEMINATION Human Research Ethics Committee approval has been granted by Bellberry (2021-08-907). Study findings will be disseminated in a peer-reviewed journal and at academic conferences. TRIAL REGISTRATION NUMBER NCT05344170.
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Affiliation(s)
- Isobel Lavender
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Danielle McCartney
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Nathaniel Marshall
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Anastasia Suraev
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Chris Irwin
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Angela L D'Rozario
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Christopher J Gordon
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
| | - Bandana Saini
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
| | - Ronald R Grunstein
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
- CPC-RPA clinic, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Brendon Yee
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
- CPC-RPA clinic, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Iain McGregor
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Camilla M Hoyos
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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Romeuf L, Fourmaux J, Hoizey G, Gaillard Y, Chatenay C, Bottinelli C. Étude de la stabilité du Δ-9-tetrahydrocannabinol et du cannabidiol dans le fluide oral sur écouvillon FLOQSwabs®. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2023. [DOI: 10.1016/j.toxac.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
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McCartney D, Suraev AS, Doohan PT, Irwin C, Kevin RC, Grunstein RR, Hoyos CM, McGregor IS. Effects of cannabidiol on simulated driving and cognitive performance: A dose-ranging randomised controlled trial. J Psychopharmacol 2022; 36:1338-1349. [PMID: 35637624 PMCID: PMC9716488 DOI: 10.1177/02698811221095356] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Cannabidiol (CBD), a major cannabinoid of Cannabis sativa, is widely consumed in prescription and non-prescription products. While CBD is generally considered 'non-intoxicating', its effects on safety-sensitive tasks are still under scrutiny. AIM We investigated the effects of CBD on driving performance. METHODS Healthy adults (n = 17) completed four treatment sessions involving the oral administration of a placebo, or 15, 300 or 1500 mg CBD in a randomised, double-blind, crossover design. Simulated driving performance was assessed between ~45-75 and ~210-240 min post-treatment (Drives 1 and 2) using a two-part scenario with 'standard' and 'car following' (CF) components. The primary outcome was standard deviation of lateral position (SDLP), a well-established measure of vehicular control. Cognitive function, subjective experiences and plasma CBD concentrations were also measured. Non-inferiority analyses tested the hypothesis that CBD would not increase SDLP by more than a margin equivalent to a 0.05% blood alcohol concentration (Cohen's dz = 0.50). RESULTS Non-inferiority was established during the standard component of Drive 1 and CF component of Drive 2 on all CBD treatments and during the standard component of Drive 2 on the 15 and 1500 mg treatments (95% CIs < 0.5). The remaining comparisons to placebo were inconclusive (the 95% CIs included 0 and 0.50). No dose of CBD impaired cognition or induced feelings of intoxication (ps > 0.05). CBD was unexpectedly found to persist in plasma for prolonged periods of time (e.g. >4 weeks at 1500 mg). CONCLUSION Acute, oral CBD treatment does not appear to induce feelings of intoxication and is unlikely to impair cognitive function or driving performance (Registration: ACTRN12619001552178).
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Affiliation(s)
- Danielle McCartney
- Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia,Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia,School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia,Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, NSW, Australia,Danielle McCartney, Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia.
| | - Anastasia S Suraev
- Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia,Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia,School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia,Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, NSW, Australia
| | - Peter T Doohan
- Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia,Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia,School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Christopher Irwin
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia,Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Richard C Kevin
- Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia,Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia,School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Ronald R Grunstein
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, NSW, Australia,RPA-Charles Perkins Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia,Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Camilla M Hoyos
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia,School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia,Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, NSW, Australia
| | - Iain S McGregor
- Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, NSW, Australia,Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia,School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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Savage T, Sanders T, Pieters R, Miles A, Barkholtz H. Suitability of SoToxa® Oral Fluid Screening Over Time: Re-examination of Drugged Driving in Wisconsin. J Anal Toxicol 2022; 46:825-834. [PMID: 35767245 DOI: 10.1093/jat/bkac047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/11/2022] [Accepted: 06/28/2022] [Indexed: 11/15/2022] Open
Abstract
Drug impaired driver detection is a critical element of traffic safety. However, shifting drug use patterns over time and geography may limit long-term reliability of assay-based screening tools. In this work, we compare qualitative results from the Abbott SoToxa® oral fluid (OF) screening device to Quantisal™ OF and whole blood. Our objective was to examine these three qualitative toxicological approaches, scope applicability of OF collection at the roadside, and compare to a previous analysis of SoToxa® in Wisconsin. OF specimens were screened with the SoToxa® for six drugs or drug classes including amphetamine, benzodiazepines, cocaine, methamphetamine, opioids, and tetrahydrocannabinol (THC). OF and blood specimens were collected from 106 participants. Quantisal™ OF and blood specimens were screened for drugs on ultra-performance liquid chromatography coupled to quadrupole time-of-flight high-resolution mass spectrometry (UPLC-QToF-HRMS) using a data independent acquisition mode. UPLC-QToF-HRMS data was compared to comprehensive spectral libraries and drugs were qualitatively identified. Drug Recognition Expert evaluations were performed, and face sheets submitted for 21 participants in this work. In general, the SoToxa® results were consistent with the combined qualitative results observed in Quantisal™ OF specimens and whole blood specimens. Limitations were uncovered for benzodiazepines, opioids, and THC. The SoToxa® benzodiazepine assay has high cutoff concentrations for diazepam and clonazepam, limiting its sensitivity and positive predictive value when considering these drugs. SoToxa® opioid screening did not detect fentanyl, which is increasingly prevalent among drug users. Finally, ∆9-THC and its major metabolite 11-nor-9-carboxy-∆9-THC are lipophilic, limiting partitioning into oral fluid. Despite these limitations, the SoToxa® instrument may be useful in assisting law enforcement with identifying individuals driving under the influence of drugs and establishing probable cause at roadside for making impaired driving arrests. Furthermore, Quantisal™ OF may be useful as screening specimens due to their ease of collection and results consistent with whole blood.
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Affiliation(s)
- Theodore Savage
- University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, Forensic Toxicology Section, 2601 Agriculture Drive, Madison, WI 53718, USA
| | - Therese Sanders
- Wisconsin Department of Transportation, Bureau of Transportation Safety and Technical Services, Chemical Testing Section, 3502 Kinsman Boulevard, Madison, WI 53704, USA
| | - Ryan Pieters
- University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, Forensic Toxicology Section, 2601 Agriculture Drive, Madison, WI 53718, USA
| | - Amy Miles
- University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, Forensic Toxicology Section, 2601 Agriculture Drive, Madison, WI 53718, USA
| | - Heather Barkholtz
- University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, Forensic Toxicology Section, 2601 Agriculture Drive, Madison, WI 53718, USA.,Pharmaceutical Sciences Division, University of Wisconsin-Madison, School of Pharmacy, 777 Highland Avenue, Madison, WI 53705, USA
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9
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McCartney D, Arkell TR, Irwin C, Kevin RC, McGregor IS. Are blood and oral fluid Δ 9-tetrahydrocannabinol (THC) and metabolite concentrations related to impairment? A meta-regression analysis. Neurosci Biobehav Rev 2021; 134:104433. [PMID: 34767878 DOI: 10.1016/j.neubiorev.2021.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/29/2021] [Accepted: 11/05/2021] [Indexed: 12/17/2022]
Abstract
Blood and oral fluid Δ9-tetrahydrocannabinol (THC) concentrations are often used to identify cannabis-impaired drivers. We used meta-analytic techniques to characterise the relationships between biomarkers of cannabis use, subjective intoxication, and impairment of driving and driving-related cognitive skills. Twenty-eight publications and 822 driving-related outcomes were reviewed. Each outcome was measured in concert with one or more biomarkers of cannabis/THC use and/or subjective intoxication. Higher blood THC and 11-OH-THC concentrations, oral fluid THC concentrations and subjective ratings of intoxication were associated with greater impairment in 'other' (mostly occasional) cannabis users (p's<0.05). Blood 11-COOH-THC concentrations were associated with impairment after inhaling, but not orally ingesting, cannabis/THC. However t these 'biomarker-performance' relationships (R) were only very weak (blood THCpost-ingestion: -0.08; blood THCpost-inhalation: -0.10; blood 11-OH-THCpost-ingestion: -0.13), weak (blood 11-OH-THCpost-inhalation: -0.24; oral fluid THCpost-inhalation: -0.36; subjective intoxication: -0.29) or moderate (blood 11-COOH-THCpost-inhalation: -0.43) in strength. No significant biomarker-performance relationships were observed in 'regular' (weekly or more often) cannabis users (p's>0.10), although the analyses were less robust. Blood and oral fluid THC concentrations are relatively poor indicators of cannabis/THC-induced impairment.
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Affiliation(s)
- Danielle McCartney
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia.
| | - Thomas R Arkell
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Christopher Irwin
- Menzies Health Institute Queensland and School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Richard C Kevin
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia
| | - Iain S McGregor
- The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia; The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia
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