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Kacinko SL, Isenschmid DS, Logan BK. Are Postmortem Cannabinoid Concentrations Forensically Reliable? Am J Forensic Med Pathol 2024; 45:92-93. [PMID: 37801547 DOI: 10.1097/paf.0000000000000887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
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2
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Charles AL, Charloux A, Vogel T, Raul JS, Kindo M, Wolff V, Geny B. Cumulative Deleterious Effects of Tetrahydrocannabinoid (THC) and Ethanol on Mitochondrial Respiration and Reactive Oxygen Species Production Are Enhanced in Old Isolated Cardiac Mitochondria. Int J Mol Sci 2024; 25:1835. [PMID: 38339113 PMCID: PMC10855679 DOI: 10.3390/ijms25031835] [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: 12/15/2023] [Revised: 01/24/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Delta 9 tetrahydrocannabinol (THC), the main component of cannabis, has adverse effects on the cardiovascular system, but whether concomitant ethanol (EtOH) and aging modulate its toxicity is unknown. We investigated dose responses of THC and its vehicle, EtOH, on mitochondrial respiration and reactive oxygen production in both young and old rat cardiac mitochondria (12 and 90 weeks). THC dose-dependently impaired mitochondrial respiration in both groups, and such impairment was enhanced in aged rats (-97.5 ± 1.4% vs. -75.6 ± 4.0% at 2 × 10-5 M, and IC50: 0.7 ± 0.05 vs. 1.3 ± 0.1 × 10-5 M, p < 0.01, for old and young rats, respectively). The EtOH-induced decrease in mitochondrial respiration was greater in old rats (-50.1 ± 2.4% vs. -19.8 ± 4.4% at 0.9 × 10-5 M, p < 0.0001). Further, mitochondrial hydrogen peroxide (H2O2) production was enhanced in old rats after THC injection (+46.6 ± 5.3 vs. + 17.9 ± 7.8%, p < 0.01, at 2 × 10-5 M). In conclusion, the deleterious cardiac effects of THC were enhanced with concomitant EtOH, particularly in old cardiac mitochondria, showing greater mitochondrial respiration impairment and ROS production. These data improve our knowledge of the mechanisms potentially involved in cannabis toxicity, and likely support additional caution when THC is used by elderly people who consume alcohol.
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Affiliation(s)
- Anne-Laure Charles
- Biomedicine Research Center of Strasbourg (CRBS), UR 3072, “Mitochondria, Oxidative Stress and Muscle Plasticity”, University of Strasbourg, 67000 Strasbourg, France; (A.-L.C.); (A.C.); (T.V.); (M.K.); (V.W.)
- Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France;
| | - Anne Charloux
- Biomedicine Research Center of Strasbourg (CRBS), UR 3072, “Mitochondria, Oxidative Stress and Muscle Plasticity”, University of Strasbourg, 67000 Strasbourg, France; (A.-L.C.); (A.C.); (T.V.); (M.K.); (V.W.)
- Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France;
- Department of Physiology and Functional Explorations, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Thomas Vogel
- Biomedicine Research Center of Strasbourg (CRBS), UR 3072, “Mitochondria, Oxidative Stress and Muscle Plasticity”, University of Strasbourg, 67000 Strasbourg, France; (A.-L.C.); (A.C.); (T.V.); (M.K.); (V.W.)
- Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France;
- Geriatrics Department, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Jean-Sébastien Raul
- Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France;
- Toxicology Laboratory, Institute of Legal Medicine, Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France
| | - Michel Kindo
- Biomedicine Research Center of Strasbourg (CRBS), UR 3072, “Mitochondria, Oxidative Stress and Muscle Plasticity”, University of Strasbourg, 67000 Strasbourg, France; (A.-L.C.); (A.C.); (T.V.); (M.K.); (V.W.)
- Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France;
- Cardiovascular Surgery Department, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Valérie Wolff
- Biomedicine Research Center of Strasbourg (CRBS), UR 3072, “Mitochondria, Oxidative Stress and Muscle Plasticity”, University of Strasbourg, 67000 Strasbourg, France; (A.-L.C.); (A.C.); (T.V.); (M.K.); (V.W.)
- Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France;
- Neuro-Vascular Department, University Hospital of Strasbourg, 67098 Strasbourg, France
| | - Bernard Geny
- Biomedicine Research Center of Strasbourg (CRBS), UR 3072, “Mitochondria, Oxidative Stress and Muscle Plasticity”, University of Strasbourg, 67000 Strasbourg, France; (A.-L.C.); (A.C.); (T.V.); (M.K.); (V.W.)
- Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France;
- Department of Physiology and Functional Explorations, University Hospital of Strasbourg, 67091 Strasbourg, France
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3
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Cliburn KD, Kemp PM, Huestis MA, Wagner JR, Payton M, Liu L, Liang Y, Maxwell LK. Time- and temperature-dependent postmortem ∆9-tetrahydrocannabinol concentration changes in rabbits following controlled inhaled cannabis administration. J Anal Toxicol 2023; 47:850-857. [PMID: 37758448 DOI: 10.1093/jat/bkad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/14/2023] [Accepted: 09/27/2023] [Indexed: 10/03/2023] Open
Abstract
ostmortem redistribution (PMR), a well-known phenomenon in forensic toxicology, can result in substantial changes in drug concentrations after death, depending on the chemical characteristics of the drug, blood collection site, storage conditions of the body and postmortem interval (PMI). Limited PMR data are available for ∆9-tetrahydrocannabinol (THC), the primary psychoactive component in Cannabis sativa. PMR was evaluated after controlled cannabis inhalation via a smoking machine and exposure chamber in New Zealand white rabbits. Necropsies were performed on five control rabbits immediately after euthanasia, whereas 27 others were stored at room temperature (21°C) or refrigerated conditions (4°C) until necropsy at 2, 6, 16, 24 or 36 h after death. THC and its Phase I and glucuronidated Phase II metabolites were quantified in blood, vitreous humor, urine, bile and tissues by liquid chromatography-tandem mass spectrometry (LC-MS-MS). Under refrigerated temperature, heart blood THC concentrations significantly increased at PMI 2 h in rabbits, whereas peripheral blood THC concentrations showed a significant increase at PMI 16 h. Central:peripheral blood and liver:peripheral blood ratios for THC ranged from 0.13 to 4.1 and 0.28 to 8.9, respectively. Lung revealed the highest THC concentrations, while brain and liver exhibited the most stable THC concentrations over time. This report contributes much needed data to our understanding of postmortem THC behavior and can aid toxicologists in the interpretation of THC concentrations in medicolegal death investigations.
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Affiliation(s)
- Kacey D Cliburn
- College of Veterinary Medicine, Department of Physiological Sciences, Oklahoma State University, 205 McElroy Hall, Stillwater, OK 74078, United States
- Office of the Chief Medical Examiner, Toxicology Laboratory, 921 NE 23rd St, Oklahoma City, OK 73105, United States
| | - Philip M Kemp
- Randall University, Biology Department, 3701 S I-35 Service Rd, Moore, OK 73160, United States
- School of Forensic Sciences, Oklahoma State University Center for Health Sciences, 1111 W. 17th St, Tulsa, OK 74107, United States
| | - Marilyn A Huestis
- School of Forensic Sciences, Oklahoma State University Center for Health Sciences, 1111 W. 17th St, Tulsa, OK 74107, United States
- Institute for Emerging Health Professions, Thomas Jefferson University, 683 Shore Road, Severna, MD 21146, United States
| | - Jarrad R Wagner
- School of Forensic Sciences, Oklahoma State University Center for Health Sciences, 1111 W. 17th St, Tulsa, OK 74107, United States
| | - Mark Payton
- Department of Biomedical Sciences, Rocky Vista University, 8401 S Chambers Rd, Parker, CO 80134, United States
| | - Lin Liu
- College of Veterinary Medicine, Department of Physiological Sciences, Oklahoma State University, 205 McElroy Hall, Stillwater, OK 74078, United States
| | - Yurong Liang
- College of Veterinary Medicine, Department of Physiological Sciences, Oklahoma State University, 205 McElroy Hall, Stillwater, OK 74078, United States
| | - Lara K Maxwell
- College of Veterinary Medicine, Department of Physiological Sciences, Oklahoma State University, 205 McElroy Hall, Stillwater, OK 74078, United States
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4
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Tascon I, Côté C, Garneau B, Desharnais B, Gosselin V, Mireault P. Postmortem redistribution of cannabinoids: Statistical analysis of a novel dataset and meta-analysis. Forensic Sci Int 2023; 353:111873. [PMID: 37944415 DOI: 10.1016/j.forsciint.2023.111873] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/10/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
The assessment of human postmortem concentrations of Δ9-THC (THC) and its metabolites, 11-nor-9-carboxy-THC (THCCOOH) and 11-hydroxy-THC (11-OH-THC), is routinely performed in forensic toxicology laboratories. However, the literature on cannabinoids postmortem redistribution (PMR) is scarce and highlights their complex postmortem changes. This study aims to investigate the postmortem behavior of THC and its metabolites in order to provide practitioners with potential indicators of PMR. To do so, antemortem and postmortem cases positive for cannabinoids were compiled in a database. Its analysis shows significantly higher THC concentrations in postmortem blood than in antemortem blood. Antemortem and postmortem blood also present significantly different profiles for their THC to THCCOOH ratios. Whereas antemortem blood generally shows THCCOOH concentrations higher or equal to THC, several postmortem cases show the opposite, with THC concentrations higher than THCCOOH. While occurrence of postmortem redistribution (PMR) is difficult to measure directly, an evaluation was performed using the central to peripheral (C/P) blood concentrations ratio as a proxy. With a C/P significantly lower than 1.0 for THC and significantly higher than 1.0 for THCCOOH, the PMR hypothesis is supported for both compounds, with redistribution towards peripheral blood for THC and towards central blood for THCCOOH. On the other hand, 11-OH-THC does not show a C/P significantly different than 1.0, suggesting the absence of PMR. Influence of body mass index, conservation state and postmortem interval on C/P was statistically analyzed and no significant impact was observed. To compare and contrast C/P observed in the database with those published in the literature, a meta-analysis was performed using a median of median (MM) model. THC PMR towards peripheral blood is supported by a global estimate of 0.81 (CI95%: 0.51 to 1.2). Redistribution towards femoral blood appears to be stronger than towards iliac blood; indeed, the median estimate of C/P decreases to 0.64 (CI95%: 0.40 to 1.1) when studies with iliac blood were removed from the meta-analysis. THCCOOH PMR towards central blood is supported by a C/P median estimate of 1.3 (CI95%: 0.97 to 1.6). THC PMR can be suspected when these indicators are observed (i) high THC blood concentration (>50 ng/mL), (ii) THC C/P lower than 1.0 (iii) blood THC/THCCOOH concentration ratios greater than 1.0 and (iv) non-detectability of THCCOOH in urine. In postmortem samples, many factors may contribute to the overestimation of THC concentration, therefore a careful interpretation is required, relying on both central and peripheral blood samples.
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Affiliation(s)
- Ines Tascon
- Université de Lausanne, École des sciences criminelles, Bâtiment Batochime, CH-1015 Lausanne, Switzerland; Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec H2K 3S7, Canada
| | - Cynthia Côté
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec H2K 3S7, Canada.
| | - Béatrice Garneau
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec H2K 3S7, Canada
| | - Brigitte Desharnais
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec H2K 3S7, Canada
| | - Véronique Gosselin
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec H2K 3S7, Canada
| | - Pascal Mireault
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec H2K 3S7, Canada
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5
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Brubacher JR, Chan H, Erdelyi S, Yuan Y, Daoust R, Vaillancourt C, Rowe B, Lee J, Mercier E, Atkinson P, Davis P, Clarke D, Taylor J, Macpherson A, Emond M, Al-Hakim D, Horwood C, Wishart I, Magee K, Rao J, Eppler J. High-'n'-dry? A comparison of cannabis and alcohol use in drivers presenting to hospital after a vehicular collision. Addiction 2023; 118:1507-1516. [PMID: 36898848 DOI: 10.1111/add.16186] [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: 10/09/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023]
Abstract
DESIGN This was a prospective observational study. BACKGROUND AND AIMS The characteristics of cannabis-involved motor vehicle collisions are poorly understood. This study of injured drivers identifies demographic and collision characteristics associated with high tetrahydrocannabinol (THC) concentrations. SETTING The study was conducted in 15 Canadian trauma centres between January 2018 and December 2021. CASES The cases (n = 6956) comprised injured drivers who required blood testing as part of routine trauma care. MEASUREMENTS We quantified whole blood THC and blood alcohol concentration (BAC) and recorded driver sex, age and postal code, time of crash, crash type and injury severity. We defined three driver groups: high THC (THC ≥ 5 ng/ml and BAC = 0), high alcohol (BAC ≥ 0.08% and THC = 0) and THC/BAC-negative (THC = 0 = BAC). We used logistic regression techniques to identify factors associated with group membership. FINDINGS Most injured drivers (70.2%) were THC/BAC-negative; 1274 (18.3%) had THC > 0, including 186 (2.7%) in the high THC group; 1161 (16.7%) had BAC > 0, including 606 (8.7%) in the high BAC group. Males and drivers aged less than 45 years had higher adjusted odds of being in the high THC group (versus the THC/BAC-negative group). Importantly, 4.6% of drivers aged less than 19 years had THC ≥ 5 ng/ml, and drivers aged less than 19 years had higher unadjusted odds of being in the high THC group than drivers aged 45-54 years. Males, drivers aged 19-44 years, rural drivers, seriously injured drivers and drivers injured in single-vehicle, night-time or weekend collisions had higher adjusted odds ratios (aORs) for being in the high alcohol group (versus THC/BAC-negative). Drivers aged less than 35 or more than 65 years and drivers involved in multi-vehicle, daytime or weekday collisions had higher adjusted odds for being in the high THC group (versus the high BAC group). CONCLUSIONS In Canada, risk factors for cannabis-related motor vehicle collisions appear to differ from those for alcohol-related motor vehicle collisions. The collision factors associated with alcohol (single-vehicle, night-time, weekend, rural, serious injury) are not associated with cannabis-related collisions. Demographic factors (young drivers, male drivers) are associated with both alcohol and cannabis-related collisions, but are more strongly associated with cannabis-related collisions.
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Affiliation(s)
- J R Brubacher
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - H Chan
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - S Erdelyi
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - Y Yuan
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - R Daoust
- Department of Emergency Medicine, University of Montréal, Montréal, QC, Canada
| | - C Vaillancourt
- Department of Emergency Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - B Rowe
- Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada
| | - J Lee
- Department of Emergency Medicine, University of Toronto, Toronto, ON, Canada
| | - E Mercier
- Department of Emergency Medicine, Université Laval, Québec City, QC, Canada
| | - P Atkinson
- Department of Emergency Medicine, Dalhousie Medicine New Brunswick, St John, NB, Canada
| | - P Davis
- Department of Emergency Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - D Clarke
- Department of Surgery (Neurosurgery), Dalhousie University, Halifax, NS, Canada
| | - J Taylor
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - A Macpherson
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - M Emond
- Department of Emergency Medicine, Université Laval, Québec City, QC, Canada
| | - D Al-Hakim
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
| | - C Horwood
- Department of Emergency Medicine, Memorial University, St John, NB, Canada
| | - I Wishart
- Department of Emergency Medicine, University of Calgary, Calgary, AB, Canada
| | - K Magee
- Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada
| | - J Rao
- Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada
| | - J Eppler
- Department of Emergency Medicine, University of British Columbia, Columbia, BC, Canada
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6
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Santunione AL, Palazzoli F, Verri P, Vandelli D, Chiapelli F, Silingardi E. Cannabinoid Stability in Postmortem Brain Samples Stored at Different Temperatures. J Anal Toxicol 2023; 47:121-128. [PMID: 35735137 DOI: 10.1093/jat/bkac041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Drug stability is an important concern of forensic toxicological testing, particularly postmortem (PM) samples that may be stored for an extensive period of time before analysis. In PM toxicology, the complex assessment of analyte stability in biological matrices can profoundly impact the interpretation of toxicological results and the outcome of forensic casework. The aim of this work is to assess the stability of ∆9-tetrahydrocannabinol (THC), cannabidiol, 11-hydroxy-THC (11-OH-THC), 11-nor-9-carboxy-∆9-THC (THCCOOH) and 11-nor-∆9-THC-9-carboxylic acid glucuronide (THCCOOH-glucuronide) in brain stored at three different temperatures (4°C, -20°C and -70°C) up to over 12 months (390 days) in order to establish the best storage condition for preventing potential drug degradation during the storage period. Brain is suitable and useful for xenobiotic concentrations and is a valuable specimen in the interpretation of PM toxicological results. In our study, pooled brain specimens were spiked at low and high concentrations to evaluate the change in concentration over time. Stable compounds were quantified within ±20% of the target concentration (the mean concentration resulting from the initial analysis). According to stability criteria, our preliminary findings revealed that all the cannabinoids studied are stable in frozen brain samples (-20°C and -70°C) for over 12 months: all the analytes' concentrations remained unaffected during storage over time, with the analytical variation staying within ±20%. On the contrary, under refrigeration conditions (4°C), 11-OH-THC, THCCOOH and THCCOOH-glucuronide were instable. Authentic brain samples, collected from eight cases during the autopsy, were analyzed, and the stability was evaluated. This study provided new data on cannabinoid stability in brain. The stability of the brain samples, both in spiked samples and in authentic caseworks, highlights the importance of the brain as a valid testing matrix when retesting is required after a long period of time or when laboratories are faced with backlog.
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Affiliation(s)
- Anna L Santunione
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, via del Pozzo 71, 41124 Modena, Italy
| | - Federica Palazzoli
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, via del Pozzo 71, 41124 Modena, Italy
| | - Patrizia Verri
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, via del Pozzo 71, 41124 Modena, Italy
| | - Daniele Vandelli
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, via del Pozzo 71, 41124 Modena, Italy
| | - Francesca Chiapelli
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, via del Pozzo 71, 41124 Modena, Italy
| | - Enrico Silingardi
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, via del Pozzo 71, 41124 Modena, Italy
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Rock KL, Englund A, Morley S, Rice K, Copeland CS. Can cannabis kill? Characteristics of deaths following cannabis use in England (1998-2020). J Psychopharmacol 2022; 36:1362-1370. [PMID: 35946604 PMCID: PMC9716494 DOI: 10.1177/02698811221115760] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Cannabis is the most widely used illegal drug but is rarely considered a causal factor in death. AIMS This study aimed to understand trends in deaths in England where cannabinoids were detected at post-mortem, and to evaluate the clinical utility of post-mortem cannabinoid concentrations in coronial investigations. METHODS Deaths with cannabinoid detections reported to the National Programme on Substance Abuse Deaths (NPSAD) were extracted and analysed. RESULTS From 1998 to 2011, on average 7% of all cases reported to NPSAD had a cannabinoid detected (n = 110 deaths per year), rising to 18% in 2020 (n = 350). Death following cannabis use alone was rare (4% of cases, n = 136/3455). Traumatic injury was the prevalent underlying cause in these cases (62%, n = 84/136), with cannabis toxicity cited in a single case. Polydrug use was evident in most cases (96%, n = 3319/3455), with acute drug toxicity the prevalent underlying cause (74%, n = 2458/3319). Cardiac complications were the most cited physiological underlying cause of death (4%, n = 144/3455). The median average Δ9-tetrahydrocannabinol post-mortem blood concentrations were several magnitudes lower than previously reported median blood concentrations in living users (cannabis alone: 4.3 µg/L; cannabis in combination with other drugs: 3.5 µg/L). CONCLUSIONS Risk of death due to cannabis toxicity is negligible. However, cannabis can prove fatal in circumstances with risk of traumatic physical injury, or in individuals with cardiac pathophysiologies. These indirect harms need careful consideration and further study to better elucidate the role cannabis plays in drug-related mortality. Furthermore, the relevance of cannabinoid quantifications in determining cause of death in coronial investigations is limited.
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Affiliation(s)
- Kirsten L Rock
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Sciences, King’s College London, London, UK
| | - Amir Englund
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, South London and Maudsley NHS Foundation Trust, London, UK
| | - Stephen Morley
- Toxicology Unit, Leicester Royal Infirmary, Leicester, UK
| | - Kathleen Rice
- Toxicology Unit, Leicester Royal Infirmary, Leicester, UK
| | - Caroline S Copeland
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Sciences, King’s College London, London, UK,National Programme on Substance Abuse Deaths, London, UK,Caroline Copeland, Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Sciences, King’s College London, London, UK.
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8
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Child RB, Tallon MJ. Cannabidiol (CBD) Dosing: Plasma Pharmacokinetics and Effects on Accumulation in Skeletal Muscle, Liver and Adipose Tissue. Nutrients 2022; 14:nu14102101. [PMID: 35631242 PMCID: PMC9146469 DOI: 10.3390/nu14102101] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 01/27/2023] Open
Abstract
Oral cannabidiol (CBD) consumption is widespread in North America and Europe, as it has analgesic, neuroprotective and antitumor effects. Although oral CBD consumption in humans affords beneficial effects in epileptic and inflammatory states, its pharmacokinetics and subsequent uptake into tissue are largely unknown. This study investigated plasma pharmacokinetics and accumulation of CBD in gastrocnemius muscle, liver and adipose tissue in adult rats following oral gavage. CBD was fed relative to body mass at 0 (control), 30, 115, or 230 mg/Kg/day for 28 days; with 6 males and 6 females per dosing group. Pharmacokinetics were assessed on day 1 and day 28 in the group receiving CBD at 115 mg/Kg/day. The rise in tissue CBD was closely related to specific pharmacokinetic parameters, and adipose tissue levels were ~10 to ~100 fold greater than liver or muscle. Tissue CBD levels were moderately correlated between adipose and muscle, and adipose and liver, but were highly correlated for liver and muscle. CBD feeding resulted in several gender-specific effects, including changes in pharmacokinetics, relationships between pharmacokinetic parameters and tissue CBD and differences in tissue CBD levels. CBD accumulation in mammalian tissues has the potential to influence receptor binding and metabolism; therefore, the present findings may have relevance for developing oral dosing regimens.
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Affiliation(s)
- Robert B. Child
- School of Chemical Engineering, University of Birmingham, Birmingham B15 2TT, UK
- Legal Products Group Ltd., 26 St Thomas Pl, Ely, Cambridgeshire CB7 4EX, UK;
- Correspondence:
| | - Mark J. Tallon
- Legal Products Group Ltd., 26 St Thomas Pl, Ely, Cambridgeshire CB7 4EX, UK;
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9
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Neiswenter SA, Tupu M, Cross C, Fudenberg J, Harding BE. Postmortem
THC
in decedents following legalization of recreational cannabis in Clark County, Nevada. J Forensic Sci 2022; 67:1632-1639. [DOI: 10.1111/1556-4029.15047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/08/2022] [Accepted: 04/12/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Momilani Tupu
- School of Life Sciences University of Nevada Las Vegas Nevada USA
| | - Chad Cross
- Department of Environmental and Occupational Health School of Public Health University of Nevada Las Vegas Nevada USA
| | - John Fudenberg
- Office of the Coroner/Medical Examiner Las Vegas Nevada USA
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10
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Brubacher JR, Chan H, Erdelyi S, Staples JA, Asbridge M, Mann RE. Cannabis Legalization and Detection of Tetrahydrocannabinol in Injured Drivers. N Engl J Med 2022; 386:148-156. [PMID: 35020985 DOI: 10.1056/nejmsa2109371] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The effect of cannabis legalization in Canada (in October 2018) on the prevalence of injured drivers testing positive for tetrahydrocannabinol (THC) is unclear. METHODS We studied drivers treated after a motor vehicle collision in four British Columbia trauma centers, with data from January 2013 through March 2020. We included moderately injured drivers (those whose condition warranted blood tests as part of clinical assessment) for whom excess blood remained after clinical testing was complete. Blood was analyzed at the provincial toxicology center. The primary outcomes were a THC level greater than 0, a THC level of at least 2 ng per milliliter (Canadian legal limit), and a THC level of at least 5 ng per milliliter. The secondary outcomes were a THC level of at least 2.5 ng per milliliter plus a blood alcohol level of at least 0.05%; a blood alcohol level greater than 0; and a blood alcohol level of at least 0.08%. We calculated the prevalence of all outcomes before and after legalization. We obtained adjusted prevalence ratios using log-binomial regression to model the association between substance prevalence and legalization after adjustment for relevant covariates. RESULTS During the study period, 4339 drivers (3550 before legalization and 789 after legalization) met the inclusion criteria. Before legalization, a THC level greater than 0 was detected in 9.2% of drivers, a THC level of at least 2 ng per milliliter in 3.8%, and a THC level of at least 5 ng per milliliter in 1.1%. After legalization, the values were 17.9%, 8.6%, and 3.5%, respectively. After legalization, there was an increased prevalence of drivers with a THC level greater than 0 (adjusted prevalence ratio, 1.33; 95% confidence interval [CI], 1.05 to 1.68), a THC level of at least 2 ng per milliliter (adjusted prevalence ratio, 2.29; 95% CI, 1.52 to 3.45), and a THC level of at least 5 ng per milliliter (adjusted prevalence ratio, 2.05; 95% CI, 1.00 to 4.18). The largest increases in a THC level of at least 2 ng per milliliter were among drivers 50 years of age or older (adjusted prevalence ratio, 5.18; 95% CI, 2.49 to 10.78) and among male drivers (adjusted prevalence ratio, 2.44; 95% CI, 1.60 to 3.74). There were no significant changes in the prevalence of drivers testing positive for alcohol. CONCLUSIONS After cannabis legalization, the prevalence of moderately injured drivers with a THC level of at least 2 ng per milliliter in participating British Columbia trauma centers more than doubled. The increase was largest among older drivers and male drivers. (Funded by the Canadian Institutes of Health Research.).
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Affiliation(s)
- Jeffrey R Brubacher
- From the University of British Columbia, Vancouver (J.R.B., H.C., S.E., J.A.S.), Dalhousie University, Halifax, NS (M.A.), and the Centre for Addiction and Mental Health (R.E.M.) and the University of Toronto (R.E.M.), Toronto - all in Canada
| | - Herbert Chan
- From the University of British Columbia, Vancouver (J.R.B., H.C., S.E., J.A.S.), Dalhousie University, Halifax, NS (M.A.), and the Centre for Addiction and Mental Health (R.E.M.) and the University of Toronto (R.E.M.), Toronto - all in Canada
| | - Shannon Erdelyi
- From the University of British Columbia, Vancouver (J.R.B., H.C., S.E., J.A.S.), Dalhousie University, Halifax, NS (M.A.), and the Centre for Addiction and Mental Health (R.E.M.) and the University of Toronto (R.E.M.), Toronto - all in Canada
| | - John A Staples
- From the University of British Columbia, Vancouver (J.R.B., H.C., S.E., J.A.S.), Dalhousie University, Halifax, NS (M.A.), and the Centre for Addiction and Mental Health (R.E.M.) and the University of Toronto (R.E.M.), Toronto - all in Canada
| | - Mark Asbridge
- From the University of British Columbia, Vancouver (J.R.B., H.C., S.E., J.A.S.), Dalhousie University, Halifax, NS (M.A.), and the Centre for Addiction and Mental Health (R.E.M.) and the University of Toronto (R.E.M.), Toronto - all in Canada
| | - Robert E Mann
- From the University of British Columbia, Vancouver (J.R.B., H.C., S.E., J.A.S.), Dalhousie University, Halifax, NS (M.A.), and the Centre for Addiction and Mental Health (R.E.M.) and the University of Toronto (R.E.M.), Toronto - all in Canada
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11
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Cliburn KD, Huestis MA, Wagner JR, Kemp PM. Cannabinoid distribution in fatally-injured pilots' postmortem fluids and tissues. Forensic Sci Int 2021; 329:111075. [PMID: 34749280 DOI: 10.1016/j.forsciint.2021.111075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 11/19/2022]
Abstract
The primary psychoactive component of cannabis, Δ9-tetrahydrocannabinol (THC) impairs cognitive function and psychomotor performance, particularly for complex tasks like piloting an aircraft. The Federal Aviation Administration's (FAA) Forensic Sciences Section at the Civil Aerospace Medical Institute (Oklahoma City, OK) performs toxicological analyses on pilots fatally injured in general aviation incidents, permitting cannabinoids measurement in a broad array of postmortem biological specimens. Cannabinoid concentrations in postmortem fluids and tissues from 10 pilots involved in airplane crashes are presented. Median (range) THC blood concentration was 1.6 (1.0-13.7) ng/mL. Phase I metabolites, 11-hydroxy-THC (11-OH-THC) and 11-nor-9-carboxy-THC (THCCOOH) and phase II glucuronide metabolite, THCCOOH-glucuronide, had median (range) blood concentrations of 1.4 (0.5-1.8), 9.9 (2.2-72.6) and 36.6 (7.1-160) ng/mL, respectively. Urine analyses revealed positive results for THCCOOH, THC-glucuronide, THCCOOH-glucuronide and 11-nor-9-carboxy-Δ9-tetrahydrocannabivarin (THCVCOOH). THC was readily distributed to lung, brain, kidney, spleen and heart. The psychoactive metabolite, 11-OH-THC, was identified in liver and brain with median (range) concentrations 7.1 (3.5-10.5) and 2.4 (2.0-6.0) ng/g, respectively. Substantial THCCOOH and THCCOOH-glucuronide concentrations were observed in liver, lung, brain, kidney, spleen and heart. These cannabinoid concentrations from multiple types of postmortem specimens add to the limited postmortem cannabinoid research data and suggest useful biological matrices for investigating cannabinoid-related deaths.
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Affiliation(s)
- Kacey D Cliburn
- Civil Aerospace Medical Institute, Federal Aviation Administration, 6500 S MacArthur Blvd, Oklahoma City, OK 73169, USA.
| | - Marilyn A Huestis
- Huestis and Smith Toxicology, LLC, 683 Shore Road, Severna Park, MD 21146, USA; School of Forensic Sciences, Oklahoma State University Center for Health Sciences, 1111 W. 17th St, Tulsa, OK 74107, USA
| | - Jarrad R Wagner
- School of Forensic Sciences, Oklahoma State University Center for Health Sciences, 1111 W. 17th St, Tulsa, OK 74107, USA
| | - Philip M Kemp
- Civil Aerospace Medical Institute, Federal Aviation Administration, 6500 S MacArthur Blvd, Oklahoma City, OK 73169, USA; School of Forensic Sciences, Oklahoma State University Center for Health Sciences, 1111 W. 17th St, Tulsa, OK 74107, USA
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12
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Palazzoli F, Santunione AL, Marchesi F, Verri P, Vandelli D, Licata M, Silingardi E. Cannabinoids Determination in Brain: A Supplemental Helpful in Postmortem Evaluation. J Anal Toxicol 2021; 45:918-926. [PMID: 33031554 DOI: 10.1093/jat/bkaa155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/08/2020] [Accepted: 10/06/2020] [Indexed: 11/13/2022] Open
Abstract
The scientific interest in cannabis has been documented by a wide literature, but postmortem studies and interpretations of autopsy findings are lacking or limited to few cases, few matrices analyzed or a small number of analytes. The present study describes the development and full in-house validation of a sensitive and simple method based on an optimized rapid clean-up procedure combined with a robust and highly sensitive liquid chromatography coupled with tandem mass spectrometry (LC-MS-MS) technique, designed to simultaneous determination of Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-THC), 11-nor-Δ9-tetrahydrocannabinol-carboxylic acid (THC-COOH) and 11-nor-Δ9-tetrahydrocannabinol-carboxylic acid glucuronated (THC-COOH gluc.) in postmortem samples: central blood (CB), femoral blood (FB) and brain tissue (BR). The developed method was validated and applied to 24 postmortem cases involving cannabinoids. In this study, we presented a full optimization and validation of target analyses for each matrix. The procedure had proven to be reliable and accurate. This study adds new data, particularly about the cannabinoids concentrations in BR samples. Combined pattern (CB, FB, BR) can be used in the interpretation of postmortem cases, proving and strengthening the assessments made on blood data. BR matrix is a helpful supplement in the investigation of the role of cannabinoids as crucial or contributory factor in leading to death.
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Affiliation(s)
- F Palazzoli
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - A L Santunione
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - F Marchesi
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - P Verri
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - D Vandelli
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - M Licata
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - E Silingardi
- Department of Biomedical, Metabolic and Neural Sciences, Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy
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13
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14
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Chu M, Rago MD, Mantinieks D, Glowacki L, Woodford NW, Gerostamoulos D, Drummer OH. Time-Dependent Changes in THC Concentrations in Deceased Persons. J Anal Toxicol 2021; 45:1-7. [PMID: 32435813 DOI: 10.1093/jat/bkaa052] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/02/2020] [Accepted: 04/13/2020] [Indexed: 11/13/2022] Open
Abstract
Changes in the concentrations of Δ9-tetrahydrocannabinol (THC) in the postmortem period were investigated in a series of cases by comparing concentrations in blood taken on receipt of the body in the mortuary (admission specimen, AD) with the concentrations obtained in blood taken at autopsy some time later and also from blood specimens taken antemortem. Overall, the median THC concentration in AD blood was 13.7 ng/mL (n = 239, range LOQ-220), while the median concentration at autopsy was 13.8 ng/mL (n = 106, range LOQ-810) and 1.9 ng/mL (n = 147, range LOQ-48) antemortem. Fourteen cases had all three specimens taken from the same decedent. The corresponding AM, AD and PM median concentrations were 4.0 (range LOQ-48), 15.5 (range 4.0-176) and 4.4 ng/mL (LOQ-56), respectively. The median elapsed times from AM to AD and AD to PM were 33 and 97.5 h, respectively. In contrast, acetaminophen showed no change in blood concentration from AM to AD (6.8 and 6.0 mg/L, respectively). These data show large increases in THC concentration in the early postmortem period, followed by a decline, although the median blood concentrations at autopsy were similar to that obtained antemortem. In contrast, when blood was taken from the femoral region, subclavian and heart ventricles sites, in the same case, the THC concentrations, while variable, showed overall no significant difference. These dynamic changes reflect complex phenomenon occurring in deceased persons and will further serve to increase the uncertainty over any interpretation of postmortem THC concentrations.
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Affiliation(s)
- Mark Chu
- Department of Forensic Medicine, Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia.,Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Matthew Di Rago
- Department of Forensic Medicine, Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia.,Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Dylan Mantinieks
- Department of Forensic Medicine, Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia.,Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Linda Glowacki
- Department of Forensic Medicine, Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Noel W Woodford
- Department of Forensic Medicine, Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia.,Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Dimitri Gerostamoulos
- Department of Forensic Medicine, Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia.,Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Olaf H Drummer
- Department of Forensic Medicine, Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia.,Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
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15
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Schaefer N, Nordmeier F, Kröll AK, Körbel C, Laschke MW, Menger MD, Maurer HH, Meyer MR, Schmidt PH. Is adipose tissue suitable for detection of (synthetic) cannabinoids? A comparative study analyzing antemortem and postmortem specimens following pulmonary administration of JWH-210, RCS-4, as well as ∆9-tetrahydrocannabinol to pigs. Arch Toxicol 2020; 94:3421-3431. [PMID: 32666126 PMCID: PMC7502066 DOI: 10.1007/s00204-020-02843-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/09/2020] [Indexed: 11/30/2022]
Abstract
Examining fatal poisonings, chronic exposure may be reflected by the concentration in tissues known for long-term storage of drugs. Δ9-tetrahydrocannabinol (THC) persists in adipose tissue (AT), but sparse data on synthetic cannabinoids (SC) are available. Thus, a controlled pig study evaluating antemortem (AM) disposition and postmortem (PM) concentration changes of the SC 4-ethylnaphthalene-1-yl-(1-pentylindole-3-yl)methanone (JWH-210) and 2-(4-methoxyphenyl)-1-(1-pentyl-indole-3-yl)methanone (RCS-4) as well as THC in AT was performed. The drugs were administered pulmonarily (200 µg/kg body weight) to twelve pigs. Subcutaneous (s.c.) AT specimens were collected after 15 and 30 min and then hourly up to 8 h. At the end, pigs were sacrificed and s.c., perirenal, and dorsal AT specimens were collected. The carcasses were stored at room temperature (RT; n = 6) or 4 °C (n = 6) and specimens were collected after 24, 48, and 72 h. After homogenization in acetonitrile and standard addition, LC-MS/MS was performed. Maximum concentrations were reached 0.5-2 h after administration amounting to 21 ± 13 ng/g (JWH-210), 24 ± 13 ng/g (RCS-4), and 22 ± 20 ng/g (THC) and stayed at a plateau level. Regarding the metabolites, very low concentrations of N-hydroxypentyl-RCS-4 (HO-RCS-4) were detected from 0.5 to 8 h. PM concentrations of parent compounds did not change significantly (p > 0.05) over time under both storage conditions. Concentrations of HO-RCS-4 significantly (p < 0.05) increased in perirenal AT during storage at RT. These results suggest a rapid distribution and persistence in s.c. AT. Furthermore, AT might be resistant to PM redistribution of parent compounds. However, significant PM increases of metabolite concentrations might be considered in perirenal AT.
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Affiliation(s)
- Nadine Schaefer
- Institute of Legal Medicine, Saarland University, Building 49.1, 66421, Homburg, Germany.
| | - Frederike Nordmeier
- Institute of Legal Medicine, Saarland University, Building 49.1, 66421, Homburg, Germany
| | - Ann-Katrin Kröll
- Institute of Legal Medicine, Saarland University, Building 49.1, 66421, Homburg, Germany
| | - Christina Körbel
- Institute for Clinical and Experimental Surgery, Saarland University, Building 65/66, 66421, Homburg, Germany
| | - Matthias W Laschke
- Institute for Clinical and Experimental Surgery, Saarland University, Building 65/66, 66421, Homburg, Germany
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University, Building 65/66, 66421, Homburg, Germany
| | - Hans H Maurer
- Department of Experimental and Clinical Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Building 46, 66421, Homburg, Germany
| | - Markus R Meyer
- Department of Experimental and Clinical Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Building 46, 66421, Homburg, Germany
| | - Peter H Schmidt
- Institute of Legal Medicine, Saarland University, Building 49.1, 66421, Homburg, Germany
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16
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Masud M, Chan H, Erdelyi S, Yuan Y, Brubacher JR. Epidemiology of drug driving: protocol from a national Canadian study measuring levels of cannabis, alcohol and other substances in injured drivers. BMC Public Health 2020; 20:1070. [PMID: 32631283 PMCID: PMC7339401 DOI: 10.1186/s12889-020-09176-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/28/2020] [Indexed: 11/11/2022] Open
Abstract
Background Drug driving is an emerging global road safety problem. As the prevalence of alcohol-impaired driving decreases, and as more jurisdictions decriminalize or legalize cannabis, it is increasingly important for policy makers to have accurate information on the prevalence and pattern of drug driving. Unfortunately, this data is not widely available and the World Health Organization identifies lack of accurate data on the prevalence of drug driving as an important knowledge gap. Methods In this paper, we discuss the limitations of current methods of monitoring drug use in drivers. We then present a novel methodology from a multi-centre study that monitors the prevalence and pattern of drug use in injured drivers across Canada. This study uses “left-over” blood taken as part of routine medical care to quantify cannabis and other drugs in non-fatally injured drivers who present to participating emergency departments after a collision. Toxicology testing is done with waiver of consent as we have procedures that prevent results from being linked to any individual. These methods minimize non-response bias and have the advantages of measuring drug concentrations in blood obtained shortly after a collision. Discussion Our methods can be applied in other jurisdictions and provide a consistent approach to collect data on drug driving. Consistent methods allow comparison of drug driving prevalence from different regions. Data from this research can be used to inform policies designed to prevent driving under the influence of cannabis and other impairing drugs.
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Affiliation(s)
- Manal Masud
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, 828 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Herbert Chan
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, 828 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Shannon Erdelyi
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, 828 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Yue Yuan
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, 828 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Jeffrey R Brubacher
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, 828 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.
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17
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Time- and temperature-dependent postmortem concentration changes of the (synthetic) cannabinoids JWH-210, RCS-4, as well as ∆9-tetrahydrocannabinol following pulmonary administration to pigs. Arch Toxicol 2020; 94:1585-1599. [PMID: 32189036 PMCID: PMC7261730 DOI: 10.1007/s00204-020-02707-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/09/2020] [Indexed: 12/29/2022]
Abstract
In forensic toxicology, interpretation of postmortem (PM) drug concentrations might be complicated due to the lack of data concerning drug stability or PM redistribution (PMR). Regarding synthetic cannabinoids (SC), only sparse data are available, which derived from single case reports without any knowledge of dose and time of consumption. Thus, a controlled pig toxicokinetic study allowing for examination of PMR of SC was performed. Twelve pigs received a pulmonary dose of 200 µg/kg BW each of 4-ethylnaphthalene-1-yl-(1-pentylindole-3-yl)methanone (JWH-210), 2-(4-methoxyphenyl)-1-(1-pentyl-indole-3-yl)methanone (RCS-4), and Δ9-tetrahydrocannabinol via an ultrasonic nebulizer. Eight hours after, the pigs were put to death with T61 and specimens of relevant tissues and body fluids were collected. Subsequently, the animals were stored at room temperature (n = 6) or 4 °C (n = 6) and further samples were collected after 24, 48, and 72 h each. Concentrations were determined following enzymatic cleavage and solid-phase extraction by liquid-chromatography tandem mass spectrometry applying the standard addition approach. High concentrations of the parent compounds were observed in lung, liver, kidney and bile fluid/duodenum content as well as brain. HO-RCS-4 was the most prevalent metabolite detected in PM specimens. In general, changes of PM concentrations were found in every tissue and body fluid depending on the PM interval as well as storage temperature.
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18
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Brubacher JR, MacDonald S, Mann R, Eppler J, Asbridge M, Chan H. Reply to Beckson et al. (2019): Cannabis, crashes, and blood: challenges for observational research. Addiction 2020; 115:590-591. [PMID: 31783429 DOI: 10.1111/add.14913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Jeffrey R Brubacher
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Scott MacDonald
- School of Health Information Science, University of Victoria, Victoria, BC, Canada
| | - Robert Mann
- Centre for Addiction and Mental Health - Social and Epidemiological Research, Toronto, ON, Canada
| | - Jeffrey Eppler
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.,Emergency Department, Kelowna General Hospital, Kelowna, BC, Canada
| | - Mark Asbridge
- Department of Community health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Herbert Chan
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
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19
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Brubacher JR, Chan H, Erdelyi S, Macdonald S, Asbridge M, Mann RE, Eppler J, Lund A, MacPherson A, Martz W, Schreiber WE, Brant R, Purssell RA. Cannabis use as a risk factor for causing motor vehicle crashes: a prospective study. Addiction 2019; 114:1616-1626. [PMID: 31106494 PMCID: PMC6771478 DOI: 10.1111/add.14663] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/21/2019] [Accepted: 05/10/2019] [Indexed: 11/30/2022]
Abstract
AIM We conducted a responsibility analysis to determine whether drivers injured in motor vehicle collisions who test positive for Δ-9-tetrahydrocannabinol (THC) or other drugs are more likely to have contributed to the crash than those who test negative. DESIGN Prospective case-control study. SETTING Trauma centres in British Columbia, Canada. PARTICIPANTS Injured drivers who required blood tests for clinical purposes following a motor vehicle collision. MEASUREMENTS Excess whole blood remaining after clinical use was obtained and broad-spectrum toxicology testing performed. The analysis quantified alcohol and THC and gave semiquantitative levels of other impairing drugs and medications. Police crash reports were analysed to determine which drivers contributed to the crash (responsible) and which were 'innocently involved' (non-responsible). We used unconditional logistic regression to determine the likelihood (odds ratio: OR) of crash responsibility in drivers with 0 < THC < 2 ng/ml, 2 ng/ml ≤ THC < 5 ng/ml and THC ≥ 5 ng/ml (all versus THC = 0 ng/ml). Risk estimates were adjusted for age, sex and presence of other impairing substances. FINDINGS We obtained toxicology results on 3005 injured drivers and police reports on 2318. Alcohol was detected in 14.4% of drivers, THC in 8.3%, other drugs in 8.9% and sedating medications in 19.8%. There was no increased risk of crash responsibility in drivers with THC < 2 ng/ml or 2 ≤ THC < 5 ng/ml. In drivers with THC ≥ 5 ng/ml, the adjusted OR was 1.74 [95% confidence interval (CI) = 0.59-6.36; P = 0.35]. There was significantly increased risk of crash responsibility in drivers with blood alcohol concentration (BAC) ≥ 0.08% (OR = 6.00;95% CI = 3.87-9.75; P < 0.01), other recreational drugs detected (OR = 1.82;95% CI = 1.21-2.80; P < 0.01) or sedating medications detected (OR = 1.45; 95%CI = 1.11-1.91; P < 0.01). CONCLUSIONS In this sample of non-fatally injured motor vehicle drivers in British Columbia, Canada, there was no evidence of increased crash risk in drivers with Δ-9-tetrahydrocannabinol < 5 ng/ml and a statistically non-significant increased risk of crash responsibility (odds ratio = 1.74) in drivers with Δ-9-tetrahydrocannabinol ≥ 5 ng/ml.
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Affiliation(s)
| | | | | | | | | | - Robert E. Mann
- Centre for Addiction and Mental Health, Toronto and University of TorontoTorontoOntarioCanada
| | - Jeffrey Eppler
- Kelowna General Hospital and University of British ColumbiaKelownaBCCanada
| | - Adam Lund
- Royal Columbian Hospital and University of British ColumbiaNew WestminsterBCCanada
| | - Andrew MacPherson
- Victoria General Hospital and University of British ColumbiaVictoriaBCCanada
| | - Walter Martz
- Institute of Forensic Medicine, Justus Liebig UniversityGiessenGermany
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20
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Richter JS, Quenardelle V, Rouyer O, Raul JS, Beaujeux R, Gény B, Wolff V. A Systematic Review of the Complex Effects of Cannabinoids on Cerebral and Peripheral Circulation in Animal Models. Front Physiol 2018; 9:622. [PMID: 29896112 PMCID: PMC5986896 DOI: 10.3389/fphys.2018.00622] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/08/2018] [Indexed: 12/11/2022] Open
Abstract
While cannabis is perceived as a relatively safe drug by the public, accumulating clinical data suggest detrimental cardiovascular effects of cannabinoids. Cannabis has been legalized in several countries and jurisdictions recently. Experimental studies specifically targeting cannabinoids' effects on the cerebral vasculature are rare. There is evidence for transient vasoconstrictive effects of cannabinoids in the peripheral and cerebral vasculature in a complex interplay of vasodilation and vasoconstriction. Vasoreactivity to cannabinoids is dependent on the specific molecules, their metabolites and dose, baseline vascular tone, and vessel characteristics as well as experimental conditions and animal species. We systematically review the currently available literature of experimental results in in vivo and in vitro animal studies, examining cannabinoids' effects on circulation and reactive vasodilation or vasoconstriction, with a particular focus on the cerebral vascular bed.
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Affiliation(s)
- J. Sebastian Richter
- Department of Interventional Neuroradiology, University Hospital of Strasbourg, Strasbourg, France
- Institute of Image-Guided Surgery (IHU), Strasbourg, France
- Equipe d'Accueil 3072, University of Strasbourg, Strasbourg, France
| | - Véronique Quenardelle
- Equipe d'Accueil 3072, University of Strasbourg, Strasbourg, France
- Stroke Unit, University Hospital, Strasbourg, France
| | - Olivier Rouyer
- Equipe d'Accueil 3072, University of Strasbourg, Strasbourg, France
- Stroke Unit, University Hospital, Strasbourg, France
- Department of Physiology and Functional Explorations, University Hospital of Strasbourg, Strasbourg, France
| | | | - Rémy Beaujeux
- Department of Interventional Neuroradiology, University Hospital of Strasbourg, Strasbourg, France
- Institute of Image-Guided Surgery (IHU), Strasbourg, France
| | - Bernard Gény
- Equipe d'Accueil 3072, University of Strasbourg, Strasbourg, France
- Department of Physiology and Functional Explorations, University Hospital of Strasbourg, Strasbourg, France
| | - Valérie Wolff
- Equipe d'Accueil 3072, University of Strasbourg, Strasbourg, France
- Stroke Unit, University Hospital, Strasbourg, France
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Schaefer N, Kettner M, Laschke MW, Schlote J, Ewald AH, Menger MD, Maurer HH, Schmidt PH. Distribution of Synthetic Cannabinoids JWH-210, RCS-4 and Δ 9-Tetrahydrocannabinol After Intravenous Administration to Pigs. Curr Neuropharmacol 2018; 15:713-723. [PMID: 27834143 PMCID: PMC5771047 DOI: 10.2174/1570159x15666161111114214] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/19/2016] [Accepted: 10/03/2016] [Indexed: 12/23/2022] Open
Abstract
Background: Synthetic cannabinoids (SCs) have become an increasing issue in forensic toxicology. Controlled human studies evaluating pharmacokinetic data of SCs are lacking and only few animal studies have been published. Thus, an interpretation of analytical results found in intoxicated or poisoned individuals is difficult. Therefore, the distribution of two selected SCs, namely 4-ethylnaphthalen-1-yl-(1-pentylindol-3-yl)methanone (JWH-210) and 2-(4-methoxyphenyl)-1-(1-pentyl-indol-3-yl)methanone (RCS-4) as well as ∆9-tetrahydrocannabinol (THC) as reference were examined in pigs. Methods: Pigs (n = 6 per drug) received a single intravenous 200 µg/kg BW dose of JWH-210, RCS-4, or THC. Six hours after administration, the animals were exsanguinated and relevant organs, important body fluids such as bile, and tissues such as muscle and adipose tissue, as well as the bradytrophic specimens dura and vitreous humor were collected. After hydrolysis and solid phase extraction, analysis was performed by LC-MS/MS. To overcome matrix effects of the LC-MS/MS analysis, a standard addition method was applied for quantification. Results: The parent compounds could be detected in every analyzed specimen with the exception of THC that was not present in dura and vitreous humor. Moderate concentrations were present in brain, the site of biological effect. Metabolite concentrations were highest in tissues involved in metabolism and/or elimination. Conclusions: Besides kidneys and lungs routinely analyzed in postmortem toxicology, brain, adipose, and muscle tissue could serve as alternative sources, particularly if other specimens are not available. Bile fluid is the most appropriate specimen for SCs and THC metabolites detection.
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Affiliation(s)
- Nadine Schaefer
- Institute of Legal Medicine, Saarland University, Building 80.2, D-66421 Homburg (Saar). Germany
| | - Mattias Kettner
- Institute of Legal Medicine, Saarland University, Building 80.2, D-66421 Homburg (Saar). Germany
| | - Matthias W Laschke
- Institute for Clinical & Experimental Surgery, Saarland University, D-66421 Homburg (Saar). Germany
| | - Julia Schlote
- Institute of Legal Medicine, Saarland University, Building 80.2, D-66421 Homburg (Saar). Germany
| | - Andreas H Ewald
- Institute of Legal Medicine, Saarland University, Building 80.2, D-66421 Homburg (Saar). Germany
| | - Michael D Menger
- Institute for Clinical & Experimental Surgery, Saarland University, D-66421 Homburg (Saar). Germany
| | - Hans H Maurer
- Department of Experimental and Clinical Toxicology, Saarland University, Building 46 D-66421 Homburg (Saar). Germany
| | - Peter H Schmidt
- Institute of Legal Medicine, Saarland University, Building 80.2, D-66421 Homburg (Saar). Germany
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Abstract
Cause of Death: 'Intoxication' - a Matter of the Concentration? Abstract. Elucidation of the cause of death is one of the main reasons for medico-legal investigations. In clinical toxicology, the severity of a given poisoning is typically assessed with the blood concentration of a pharmacologically or toxicologically active compound. Such an interpretation proves to be difficult or even impossible in postmortem toxicology. Numerous biochemical and biological processes beginning immediately after death may render the calculated drug concentration unreliable. Concentrations obtained from postmortem samples do not necessarily reflect the blood concentration at the time of death. A prediction if and to what extent such postmortem changes might have occurred is still impossible for individual cases. Interpretation therefore needs to be done with care, considering case circumstances and all available information.
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Affiliation(s)
- Andrea E Steuer
- 1 Abteilung für Forensische Pharmakologie und Toxikologie, Institut für Rechtsmedizin, Universität Zürich
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Shintani‐Ishida K, Saka K, Nakamura M, Yoshida K, Ikegaya H. Experimental Study on the Postmortem Redistribution of the Substituted Phenethylamine, 25B‐NBOMe. J Forensic Sci 2017. [DOI: 10.1111/1556-4029.13583] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Kaori Shintani‐Ishida
- Department of Forensic Medicine Graduate School of Medical Science Kyoto Prefectural University of Medicine 465 Kajii‐cho Kamigyo‐ku Kyoto 602‐8566 Japan
| | - Kanju Saka
- Department of Forensic Medicine Graduate School of Medicine The University of Tokyo 7‐3‐1 Hongo Bunkyo‐ku Tokyo 113‐0033 Japan
| | - Mami Nakamura
- Department of Forensic Medicine Graduate School of Medical Science Kyoto Prefectural University of Medicine 465 Kajii‐cho Kamigyo‐ku Kyoto 602‐8566 Japan
| | - Ken‐ichi Yoshida
- Department of Forensic Medicine Tokyo Medical University 6‐1‐1 Shinjuku Shinjuku‐ku Tokyo 160‐8402 Japan
| | - Hiroshi Ikegaya
- Department of Forensic Medicine Graduate School of Medical Science Kyoto Prefectural University of Medicine 465 Kajii‐cho Kamigyo‐ku Kyoto 602‐8566 Japan
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Bévalot F, Cartiser N, Bottinelli C, Fanton L, Guitton J. État de l’art de l’analyse de la bile en toxicologie médicolégale. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2017. [DOI: 10.1016/j.toxac.2016.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Martinez-Quiroz J, Melendez-Camargo E, Lopez-Meraz L. Course of exogenous ethanol in the first hours after death – two experimental approaches. AUST J FORENSIC SCI 2016. [DOI: 10.1080/00450618.2016.1231839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Joel Martinez-Quiroz
- Departamento de Farmacia, ENCB-Instituto Politecnico Nacional, Mexico City, Mexico
- Dirección General de los Servicios Periciales FGE, Xalapa, Veracruz, Mexico
| | | | - Leonor Lopez-Meraz
- Centro de Investigaciones Cerebrales, Universidad Veracruzana, Xalapa, Veracruz, Mexico
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Schaefer N, Helfer AG, Kettner M, Laschke MW, Schlote J, Ewald AH, Meyer MR, Menger MD, Maurer HH, Schmidt PH. Metabolic patterns of JWH-210, RCS-4, and THC in pig urine elucidated using LC-HR-MS/MS: Do they reflect patterns in humans? Drug Test Anal 2016; 9:613-625. [DOI: 10.1002/dta.1995] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/19/2016] [Accepted: 04/19/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Nadine Schaefer
- Institute of Legal Medicine; Saarland University; Building 80.2 D-66421 Homburg (Saar) Germany
| | - Andreas G. Helfer
- Department of Experimental and Clinical Toxicology; Saarland University; Building 46 D-66421 Homburg (Saar) Germany
| | - Mattias Kettner
- Institute of Legal Medicine; Saarland University; Building 80.2 D-66421 Homburg (Saar) Germany
| | - Matthias W. Laschke
- Institute for Clinical & Experimental Surgery; Saarland University; Building 65/66 D-66421 Homburg (Saar) Germany
| | - Julia Schlote
- Institute of Legal Medicine; Saarland University; Building 80.2 D-66421 Homburg (Saar) Germany
| | - Andreas H. Ewald
- Institute of Legal Medicine; Saarland University; Building 80.2 D-66421 Homburg (Saar) Germany
| | - Markus R. Meyer
- Department of Experimental and Clinical Toxicology; Saarland University; Building 46 D-66421 Homburg (Saar) Germany
- Department of Clinical Pharmacology and Pharmacoepidemiology; Heidelberg University Hospital; Im Neuenheimer Feld 410 D-69120 Heidelberg Germany
| | - Michael D. Menger
- Institute for Clinical & Experimental Surgery; Saarland University; Building 65/66 D-66421 Homburg (Saar) Germany
| | - Hans H. Maurer
- Department of Experimental and Clinical Toxicology; Saarland University; Building 46 D-66421 Homburg (Saar) Germany
| | - Peter H. Schmidt
- Institute of Legal Medicine; Saarland University; Building 80.2 D-66421 Homburg (Saar) Germany
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Schaefer N, Wojtyniak JG, Kettner M, Schlote J, Laschke MW, Ewald AH, Lehr T, Menger MD, Maurer HH, Schmidt PH. Pharmacokinetics of (synthetic) cannabinoids in pigs and their relevance for clinical and forensic toxicology. Toxicol Lett 2016; 253:7-16. [DOI: 10.1016/j.toxlet.2016.04.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/19/2016] [Accepted: 04/22/2016] [Indexed: 01/11/2023]
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Pélissier-Alicot AL. La redistribution post mortem : état des lieux en 2016. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2016. [DOI: 10.1016/j.toxac.2015.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bévalot F, Cartiser N, Bottinelli C, Guitton J, Fanton L. State of the art in bile analysis in forensic toxicology. Forensic Sci Int 2016; 259:133-54. [DOI: 10.1016/j.forsciint.2015.10.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 10/17/2015] [Accepted: 10/26/2015] [Indexed: 02/07/2023]
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Development of CT-guided biopsy sampling for time-dependent postmortem redistribution investigations in blood and alternative matrices—proof of concept and application on two cases. Anal Bioanal Chem 2015; 408:1249-58. [DOI: 10.1007/s00216-015-9234-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022]
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Scientific Opinion on the risks for human health related to the presence of tetrahydrocannabinol (THC) in milk and other food of animal origin. EFSA J 2015. [DOI: 10.2903/j.efsa.2015.4141] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Postmortem redistribution of the heroin metabolites morphine and morphine-3-glucuronide in rabbits over 24 h. Int J Legal Med 2015; 130:519-31. [DOI: 10.1007/s00414-015-1185-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 03/24/2015] [Indexed: 10/23/2022]
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Kemp PM, Cardona PS, Chaturvedi AK, Soper JW. Distribution of ∆9-Tetrahydrocannabinol and 11-Nor-9-Carboxy-∆9-Tetrahydrocannabinol Acid in Postmortem Biological Fluids and Tissues From Pilots Fatally Injured in Aviation Accidents. J Forensic Sci 2015; 60:942-9. [DOI: 10.1111/1556-4029.12751] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 06/13/2014] [Accepted: 06/25/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Philip M. Kemp
- Federal Aviation Administration; Civil Aerospace Medical Institute; 6500 South MacArthur Boulevard Oklahoma City OK
| | - Patrick S. Cardona
- Federal Aviation Administration; Civil Aerospace Medical Institute; 6500 South MacArthur Boulevard Oklahoma City OK
| | - Arvind K. Chaturvedi
- Federal Aviation Administration; Civil Aerospace Medical Institute; 6500 South MacArthur Boulevard Oklahoma City OK
| | - John W. Soper
- Federal Aviation Administration; Civil Aerospace Medical Institute; 6500 South MacArthur Boulevard Oklahoma City OK
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Schaefer N, Kettner M, Laschke MW, Schlote J, Peters B, Bregel D, Menger MD, Maurer HH, Ewald AH, Schmidt PH. Simultaneous LC-MS/MS determination of JWH-210, RCS-4, ∆9-tetrahydrocannabinol, and their main metabolites in pig and human serum, whole blood, and urine for comparing pharmacokinetic data. Anal Bioanal Chem 2015; 407:3775-86. [DOI: 10.1007/s00216-015-8605-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/19/2015] [Accepted: 02/26/2015] [Indexed: 10/23/2022]
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Tetrahydrocannabinol induces brain mitochondrial respiratory chain dysfunction and increases oxidative stress: a potential mechanism involved in cannabis-related stroke. BIOMED RESEARCH INTERNATIONAL 2015; 2015:323706. [PMID: 25654095 PMCID: PMC4310259 DOI: 10.1155/2015/323706] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 09/15/2014] [Accepted: 09/22/2014] [Indexed: 12/02/2022]
Abstract
Cannabis has potential therapeutic use but tetrahydrocannabinol (THC), its main psychoactive component, appears as a risk factor for ischemic stroke in young adults. We therefore evaluate the effects of THC on brain mitochondrial function and oxidative stress, key factors involved in stroke. Maximal oxidative capacities Vmax (complexes I, III, and IV activities), Vsucc (complexes II, III, and IV activities), Vtmpd (complex IV activity), together with mitochondrial coupling (Vmax/V0), were determined in control conditions and after exposure to THC in isolated mitochondria extracted from rat brain, using differential centrifugations. Oxidative stress was also assessed through hydrogen peroxide (H2O2) production, measured with Amplex Red. THC significantly decreased Vmax (−71%; P < 0.0001), Vsucc (−65%; P < 0.0001), and Vtmpd (−3.5%; P < 0.001). Mitochondrial coupling (Vmax/V0) was also significantly decreased after THC exposure (1.8±0.2 versus 6.3±0.7; P < 0.001). Furthermore, THC significantly enhanced H2O2 production by cerebral mitochondria (+171%; P < 0.05) and mitochondrial free radical leak was increased from 0.01±0.01 to 0.10±0.01% (P < 0.001). Thus, THC increases oxidative stress and induces cerebral mitochondrial dysfunction. This mechanism may be involved in young cannabis users who develop ischemic stroke since THC might increase patient's vulnerability to stroke.
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Grassin-Delyle S, Naline E, Buenestado A, Faisy C, Alvarez JC, Salvator H, Abrial C, Advenier C, Zemoura L, Devillier P. Cannabinoids inhibit cholinergic contraction in human airways through prejunctional CB1 receptors. Br J Pharmacol 2014; 171:2767-77. [PMID: 24467410 DOI: 10.1111/bph.12597] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 12/11/2013] [Accepted: 01/08/2014] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND PURPOSE Marijuana smoking is widespread in many countries, and the use of smoked synthetic cannabinoids is increasing. Smoking a marijuana joint leads to bronchodilation in both healthy subjects and asthmatics. The effects of Δ(9) -tetrahydrocannabinol and synthetic cannabinoids on human bronchus reactivity have not previously been investigated. Here, we sought to assess the effects of natural and synthetic cannabinoids on cholinergic bronchial contraction. EXPERIMENTAL APPROACH Human bronchi isolated from 88 patients were suspended in an organ bath and contracted by electrical field stimulation (EFS) in the presence of the phytocannabinoid Δ(9) -tetrahydrocannabinol, the endogenous 2-arachidonoylglycerol, the synthetic dual CB1 and CB2 receptor agonists WIN55,212-2 and CP55,940, the synthetic, CB2 -receptor-selective agonist JWH-133 or the selective GPR55 agonist O-1602. The receptors involved in the response were characterized by using selective CB1 and CB2 receptor antagonists (SR141716 and SR144528 respectively). KEY RESULTS Δ(9) -tetrahydrocannabinol, WIN55,212-2 and CP55,940 induced concentration-dependent inhibition of cholinergic contractions, with maximum inhibitions of 39, 76 and 77% respectively. JWH-133 only had an effect at high concentrations. 2-Arachidonoylglycerol and O-1602 were devoid of any effect. Only CB1 receptors were involved in the response because the effects of cannabinoids were antagonized by SR141716, but not by SR144528. The cannabinoids did not alter basal tone or contractions induced by exogenous Ach. CONCLUSIONS AND IMPLICATIONS Activation of prejunctional CB1 receptors mediates the inhibition of EFS-evoked cholinergic contraction in human bronchus. This mechanism may explain the acute bronchodilation produced by marijuana smoking.
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Affiliation(s)
- S Grassin-Delyle
- Laboratoire de Pharmacologie Respiratoire, UPRES EA220, Hôpital Foch, Suresnes, France; Laboratoire de Pharmacologie-Toxicologie, Hôpital Raymond Poincaré, Garches, France
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Rohrig TP, Hicks CA. Brain Tissue: A Viable Postmortem Toxicological Specimen. J Anal Toxicol 2014; 39:137-9. [DOI: 10.1093/jat/bku139] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Murrell MD, Cruz DA, Javors MA, Thompson PM. Distribution of venlafaxine, O-desmethylvenlafaxine, and O-desmethylvenlafaxine to venlafaxine ratio in postmortem human brain tissue. J Forensic Sci 2014; 59:683-9. [PMID: 24502274 DOI: 10.1111/1556-4029.12393] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 03/08/2013] [Accepted: 03/24/2013] [Indexed: 12/01/2022]
Abstract
Venlafaxine (VEN) and its metabolite O-desmethylvenlafaxine (ODV) inhibit reuptake of serotonin and norepinephrine. This study examines whether VEN is differentially distributed in postmortem brain and examines relationships between brain and femoral blood concentrations from donors prescribed VEN for treatment of depression. Using high-pressure liquid chromatography-ultraviolet detection, VEN and ODV concentrations were measured in temporal, occipital, and cerebellar cortex of six postmortem brains. The ODV/VEN ratio was calculated as a relative measure of drug metabolism within each region where higher ratios indicated a greater conversion of VEN to ODV. Compared to the other regions examined, the cerebellum showed decreased VEN (p = 0.056), ODV (p = 0.006), and ODV/VEN (p = 0.027) ratios. In parts per million, VEN was higher in temporal and occipital cortex, but not cerebellum, as compared to femoral blood concentration. These observations suggest that VEN and ODV are differentially distributed in the brain, and metabolism of VEN to ODV may vary across brain regions.
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Affiliation(s)
- Meredith D Murrell
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229
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Brunet B, Mura P. L’humeur vitrée en toxicologie médico-légale : revue de la littérature et applications. ACTA ACUST UNITED AC 2012. [DOI: 10.1051/ata/2012004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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41
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Holland MG, Schwope DM, Stoppacher R, Gillen SB, Huestis MA. Postmortem redistribution of Δ9-tetrahydrocannabinol (THC), 11-hydroxy-THC (11-OH-THC), and 11-nor-9-carboxy-THC (THCCOOH). Forensic Sci Int 2011; 212:247-51. [PMID: 21764230 DOI: 10.1016/j.forsciint.2011.06.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2011] [Revised: 06/20/2011] [Accepted: 06/26/2011] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Postmortem redistribution (PMR), a well-described phenomenon in forensic toxicology for certain drugs, can result in increased central blood concentrations relative to peripheral blood concentrations. Δ(9)-tetrahydrocannabinol (THC), the primary psychoactive component in cannabis or marijuana, is the illicit substance most commonly implicated in driving under the influence of drugs (DUID) cases and fatally-injured drivers. No investigation of PMR of THC in human blood has been reported to date. METHODS Matched heart and iliac postmortem blood specimens were collected from 19 medical examiner cases (16 Males, 3 Females) with positive cannabinoid urine immunoassay screens. THC, its equipotent metabolite 11-hydroxy-THC (11-OH-THC) and non-psychoactive metabolite 11-nor-9-carboxy-THC (THCCOOH) were quantified by two-dimensional gas chromatography-mass spectrometry with cryofocusing, with 0.5 ng/mL limits of quantification (LOQ) for all analytes. RESULTS 10 cases had quantifiable THC and 11-OH-THC; THCCOOH was present in all 19. Median (range) heart:iliac blood ratios were 1.5 for THC (range: 0.3-3.1); 1.6 for 11-OH-THC (range: 0.3-2.7); and 1.8 for THCCOOH (range: 0.5-3.0). DISCUSSION Cannabinoids, in general, exhibited a mean and median central:peripheral (C:P) concentration ratio of less than 2 following death. A trend was observed for greater PMR with increasing postmortem interval between death and sampling. To our knowledge, these are the first data on THC PMR in humans, providing important scientific data to aid in the interpretation of postmortem cannabinoid concentrations in medico-legal investigations.
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Affiliation(s)
- Michael G Holland
- Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, United States.
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A preliminary investigation on the distribution of cannabinoids in man. Forensic Sci Int 2011; 210:e7-e11. [DOI: 10.1016/j.forsciint.2011.04.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 04/04/2011] [Accepted: 04/09/2011] [Indexed: 11/19/2022]
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