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Trif C, Harpaz D, Eltzov E, Parcharoen Y, Pechyen C, Marks RS. Detection of Cannabinoids in Oral Fluid Specimens as the Preferred Biological Matrix for a Point-of-Care Biosensor Diagnostic Device. BIOSENSORS 2024; 14:126. [PMID: 38534233 DOI: 10.3390/bios14030126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024]
Abstract
An increasing number of countries have started to decriminalize or legalize the consumption of cannabis for recreational and medical purposes. The active ingredients in cannabis, termed cannabinoids, affect multiple functions in the human body, including coordination, motor skills, memory, response time to external stimuli, and even judgment. Cannabinoids are a unique class of terpeno-phenolic compounds, with 120 molecules discovered so far. There are certain situations when people under the influence of cannabis may be a risk to themselves or the public safety. Over the past two decades, there has been a growing research interest in detecting cannabinoids from various biological matrices. There is a need to develop a rapid, accurate, and reliable method of detecting cannabinoids in oral fluid as it can reveal the recent intake in comparison with urine specimens, which only show a history of consumption. Significant improvements are continuously made in the analytical formats of various technologies, mainly concerning improving their sensitivity, miniaturization, and making them more user-friendly. Additionally, sample collection and pretreatment have been extensively studied, and specific devices for collecting oral fluid specimens have been perfected to allow rapid and effective sample collection. This review presents the recent findings regarding the use of oral fluid specimens as the preferred biological matrix for cannabinoid detection in a point-of-care biosensor diagnostic device. A critical review is presented, discussing the findings from a collection of review and research articles, as well as publicly available data from companies that manufacture oral fluid screening devices. Firstly, the various conventional methods used to detect cannabinoids in biological matrices are presented. Secondly, the detection of cannabinoids using point-of-care biosensors is discussed, emphasizing oral fluid specimens. This review presents the current pressing technological challenges and highlights the gaps where new technological solutions can be implemented.
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Affiliation(s)
- Călin Trif
- Avram and Stella Goldstein-Goren Department of Biotechnology Engineering, Faculty of Engineering Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
| | - Dorin Harpaz
- Institute of Biochemistry, Food Science and Nutrition, Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
- Department of Postharvest Science of Fresh Fruit, Volcani Center, Agricultural Research Organization, Rishon LeZion 7505101, Israel
| | - Evgeni Eltzov
- Department of Postharvest Science of Fresh Fruit, Volcani Center, Agricultural Research Organization, Rishon LeZion 7505101, Israel
| | - Yardnapar Parcharoen
- Chulabhorn International College of Medicine, Thammasat University, Klong Luang 12120, Pathum Thani, Thailand
| | - Chiravoot Pechyen
- Center of Excellence in Modern Technology and Advanced Manufacturing for Medical Innovation, Thammasat University, Klong Luang 12120, Pathum Thani, Thailand
- Department of Materials and Textile Technology, Faculty of Science and Technology, Thammasat University, Klong Luang 12120, Pathum Thani, Thailand
| | - Robert S Marks
- Avram and Stella Goldstein-Goren Department of Biotechnology Engineering, Faculty of Engineering Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
- The Ilse Katz Center for Meso and Nanoscale Science and Technology, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
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Wennberg E, Windle SB, Filion KB, Thombs BD, Gore G, Benedetti A, Grad R, Ells C, Eisenberg MJ. Roadside screening tests for cannabis use: A systematic review. Heliyon 2023; 9:e14630. [PMID: 37064483 PMCID: PMC10102219 DOI: 10.1016/j.heliyon.2023.e14630] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/20/2022] [Accepted: 03/13/2023] [Indexed: 04/04/2023] Open
Abstract
As more countries legalize recreational cannabis, roadside screening programs are imperative to detect and deter driving under the influence of cannabis. This systematic review evaluated roadside screening tests for cannabis use. We searched six databases (inception-March 2020) and grey literature sources for primary studies evaluating test characteristics of roadside screening tests for cannabis use compared to laboratory tests for cannabinoids in blood or oral fluid. The synthesis was focused on sensitivity and specificity of delta-9-tetrahydrocannabinol (THC) detection. 101 studies were included. Oral fluid tests were higher in specificity and lower in sensitivity compared to urine tests when evaluated against blood laboratory tests. Oral fluid tests were higher in sensitivity and similar in specificity compared to observational tests when evaluated against blood and oral fluid laboratory tests. Sensitivity was variable among oral fluid tests; two instrumented immunoassays (Draeger DrugTest 5000 [5 ng/mL THC cut-off] and Alere DDS 2 Mobile Test System) appeared to perform best, but definitive conclusions could not be drawn due to imprecise estimates. Specificities were similar. Overall, oral fluid tests showed the most promise for use in roadside screening for blood THC levels over legal limits; their continued development and testing are warranted. Urine tests are generally inadvisable, and observational tests require sensitivity improvements.
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Robertson MB, Li A, Yuan Y, Jiang A, Gjerde H, Staples JA, Brubacher JR. Correlation between oral fluid and blood THC concentration: A systematic review and discussion of policy implications. ACCIDENT; ANALYSIS AND PREVENTION 2022; 173:106694. [PMID: 35640367 DOI: 10.1016/j.aap.2022.106694] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/25/2022] [Accepted: 05/03/2022] [Indexed: 06/15/2023]
Abstract
Cannabis is the second most commonly used impairing substance by drivers, after alcohol. As more countries legalize cannabis, there is concern that cannabis-impaired driving will increase. In many countries, police use roadside devices to test for oral fluid THC (the primary psychotropic component in cannabis) to identify drivers who used cannabis; including in countries with non-zero per se limits for THC in blood. This practice is questioned as previous research demonstrates a poor correlation between oral fluid and blood THC concentrations at the individual level. We conducted a meta-analysis to identify all research that compared oral fluid with blood THC levels. We obtained individual-level data from study authors and analyzed pooled individual-level data to calculate sensitivity and specificity of oral fluid THC (at various cut-off values) to detect blood THC above different concentration limits. Finally, we explored practical implications of using oral fluid THC in an enforcement context. Our review found THC concentrations measured in over 18,000 paired samples of oral fluid and blood. We found a good correlation between the presence of THC in oral fluid and presence of THC in blood (sensitivity = 71.2%, specificity = 97.7%). However oral fluid THC, at commonly used cut-off values, is less sensitive and less specific when used as a biomarker to detect people with blood THC concentrations above commonly used per se limits (such as 5 ng/mL). As such, there will be a large number of "false positive" tests if oral fluid THC testing were used as a biomarker for "illegal" THC concentrations in randomly selected drivers. We argue that the adverse implications of false positive oral fluid THC tests in this context outweigh the possible road safety benefits and we recommend against oral fluid THC screening in randomly selected drivers in countries with non-zero per se limits for blood THC. In contrast, oral fluid THC tests appear to be useful for investigating "high-risk" drivers who come to police attention because of evidence of impairment.
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Affiliation(s)
| | - A Li
- University of Ottawa, Canada
| | - Y Yuan
- University of British Columbia, Canada
| | - A Jiang
- University of British Columbia, Canada
| | - H Gjerde
- Oslo University Hospital, Norway
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Salem TK, Wong WK, Min TS, Wong EK. One- and Five-Ringgit Malaysia banknotes reader with counterfeit detection for visually impaired person using backlight mechanism and image processing techniques. F1000Res 2022; 10:1098. [PMID: 38618192 PMCID: PMC11009568 DOI: 10.12688/f1000research.58446.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 04/16/2024] Open
Abstract
Visually impaired persons face challenges in running business activities, especially in handling banknotes. Malaysia researchers had proposed some Ringgit banknotes recognition systems to aid visually impaired persons recognize and classify Ringgit banknotes. However, these electronic banknote readers can only recognize Malaysian Banknotes' Ringgit value, they have no counterfeit detection features. The purpose of this study is to develop a banknote reader that not only can help visually impaired persons recognize the banknote value, but also to detect the counterfeit of the banknote, safeguarding their losses. This paper proposed a Malaysian banknote reader using backlight mechanism and image processing techniques to read and detect counterfeit for one Ringgit and five Ringgit Malaysian banknotes. The developed handheld banknote reader used visual type sensor to capture banknote image, passed to raspberry pi controller to perform image processing on banknote value and the extracted watermarks features. The developed image processing algorithm will trace out the region of interests: 1)see-thru windows, 2)Crescent and Star, 3)Perfect see though register and detect the watermarks features accordingly. The processed result will be passed back to the handheld banknote reader and broadcast on an attached mini speaker to aid the visually impaired understand the holding banknote, whether it is a real one Ringgit, real five Ringgit or none of them. The experimental result shown by this approach able to accomplish numerous round of banknote reading attempts with successful outcomes. Confusion matrix is further employed to study the performance of the banknote reader, in terms of true positive, true negative, false positive and false negative. Details analysis had been focused on the critical false positive cases (predicted real banknote and actually is fake banknote) and false negative cases (predicted fake banknote and it is actually real banknote).
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Affiliation(s)
- Turki Khaled Salem
- Faculty of Engineering and Technology, Multimedia University, BKT Beruang, Melaka, 75450, Malaysia
| | - Wai Kit Wong
- Faculty of Engineering and Technology, Multimedia University, BKT Beruang, Melaka, 75450, Malaysia
| | - Thu Soe Min
- Faculty of Engineering and Technology, Multimedia University, BKT Beruang, Melaka, 75450, Malaysia
| | - Eng Kiong Wong
- Faculty of Engineering and Technology, Multimedia University, BKT Beruang, Melaka, 75450, Malaysia
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Zhang L, Li X, Li Y, Yu HZ. A colorimetric immuno-microarray for the quantitation and direct visualization of illicit drugs in body fluids. Analyst 2020; 146:538-546. [PMID: 33165458 DOI: 10.1039/d0an01933j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The design and testing of integrated colorimetric microarray immunochips (immuno-microarrays) are reported for the quantitation and direct visual determination of multiple illicit drugs (e.g., morphine, cocaine and amphetamine) in body fluids. Such an immuno-microarray platform utilizes a competitive immunoassay format, which is based on silver staining for quantitative detection and multicolor staining for direct visualization (i.e., qualitative identification) of analytes present in the sample. Under optimized conditions, the dynamic response ranges of 3.7-1000, 1.1-300 and 1.5-300 ng mL-1 were achieved for amphetamine, cocaine, and morphine, respectively, which are wider towards low concentrations than those of standard enzyme-linked immunosorbent assay (ELISA) tests. The limits of detection (LODs) for morphine, cocaine, and amphetamine were determined to be 1.5 ± 0.1, 1.1 ± 0.1 and 3.7 ± 0.2 ng mL-1, respectively in oral fluids, which meet government regulations for law enforcement. The obvious advantages of multiplexing, simultaneous visual recognition, and accurate quantitation make the on-site detection feasible, confirming that such a colorimetric immuno-microarray holds promise for practical applications.
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Affiliation(s)
- Lingling Zhang
- College of Physics and Optoelectronics, Taiyuan University of Technology, Taiyuan, Shanxi 030024, China
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Are oral fluid testing devices effective for the roadside detection of recent cannabis use? A systematic review. Public Health 2019; 171:57-65. [DOI: 10.1016/j.puhe.2019.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 02/23/2019] [Accepted: 03/12/2019] [Indexed: 11/19/2022]
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Krotulski AJ, Mohr ALA, Friscia M, Logan BK. Field Detection of Drugs of Abuse in Oral Fluid Using the Alere™ DDS®2 Mobile Test System with Confirmation by Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS). J Anal Toxicol 2018; 42:170-176. [PMID: 29301050 DOI: 10.1093/jat/bkx105] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Indexed: 11/13/2022] Open
Abstract
The collection and analysis of drugs in oral fluid (OF) at the roadside has become more feasible with the introduction of portable testing devices such as the Alere™ DDS®2 Mobile Test System (DDS®2). The objective of this study was to compare the on-site results for the DDS®2 to laboratory-based confirmatory assays with respect to detection of drugs of abuse in human subjects. As part of a larger Institutional Review Board approved study, two OF samples were collected from each participant at a music festival in Miami, FL, USA. One OF sample was field screened using the DDS®2, and a confirmatory OF sample was collected using the Quantisal™ OF collection device and submitted to the laboratory for testing. In total, 124 subjects participated in this study providing two contemporaneous OF samples. DDS®2 field screening yielded positive results for delta-9-tetrahydrocannabinol (THC) (n = 27), cocaine (n = 12), amphetamine (n = 3), methamphetamine (n = 3) and benzodiazepine (n = 1). No opiate-positive OF samples were detected. For cocaine, amphetamine, methamphetamine and benzodiazepines, the DDS®2 displayed sensitivity, specificity and accuracy of 100%. For THC, the DDS®2 displayed sensitivity of 90%, specificity of 100% and accuracy of 97.5%, when the threshold for confirmation matched that of the manufacturers advertised cut-off. When this confirmatory threshold was lowered to the analytical limit of detection (i.e., 1 ng/mL), apparent device performance for THC was poorer due to additional samples testing positive by confirmatory assay that had tested negative on the DDS®2, demonstrating a need for correlation between manufacturer cut-off and analytical reporting limit. These results from drug-using subjects demonstrate the value of field-based OF testing, and illustrate the significance of selecting an appropriate confirmation cut-off concentration with respect to performance evaluation and detection of drug use.
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Affiliation(s)
- Alex J Krotulski
- Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA 19090, USA
| | - Amanda L A Mohr
- Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA 19090, USA
| | - Melissa Friscia
- Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA 19090, USA
| | - Barry K Logan
- Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA 19090, USA.,NMS Labs, 3701 Welsh Rd, Willow Grove, PA 19090, USA
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Scherer JN, Fiorentin TR, Borille BT, Pasa G, Sousa TRV, von Diemen L, Limberger RP, Pechansky F. Reliability of point-of-collection testing devices for drugs of abuse in oral fluid: A systematic review and meta-analysis. J Pharm Biomed Anal 2017; 143:77-85. [PMID: 28577420 DOI: 10.1016/j.jpba.2017.05.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/06/2017] [Accepted: 05/11/2017] [Indexed: 11/18/2022]
Abstract
Point-of-collection testing (POCT) devices for drugs of abuse are used to screen for the presence of psychoactive substances (PAS) in different types of settings and environments. However, these quick and advantageous tools also present disadvantages, including low-reliability measures in comparison to chromatographic assays. Therefore, this article presents a systematic review and meta-analysis of studies evaluating the reliability of measurements of PAS detection in oral fluid using POCT devices. The reliability measures for detection of the five most important drug classes - cocaine, amphetamines, benzodiazepines, cannabinoids and opioids, are reported. The article also presents a subgroup analysis considering the reliability estimates for the different POCT devices that were evaluated by the studies contemplated in the review. A discussion considering the strengths and limitations of POCT techniques was performed in order to guide policymakers, traffic agents and other professionals who also conduct such tests. The use of POCT devices often involves legal and moral aspects of the subjects tested, which demands critical evaluation of these devices before they are implemented in different settings.
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Affiliation(s)
- Juliana Nichterwitz Scherer
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvar Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
| | - Taís Regina Fiorentin
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul, Av. Ipiranga, 2752, 90610-000, Porto Alegre, RS, Brazil
| | - Bruna Tassi Borille
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul, Av. Ipiranga, 2752, 90610-000, Porto Alegre, RS, Brazil
| | - Graciela Pasa
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvar Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Tanara Rosangela Vieira Sousa
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvar Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Lisia von Diemen
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvar Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Renata Pereira Limberger
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul, Av. Ipiranga, 2752, 90610-000, Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvar Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
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Gentili S, Solimini R, Tittarelli R, Mannocchi G, Busardò FP. A Study on the Reliability of an On-Site Oral Fluid Drug Test in a Recreational Context. JOURNAL OF ANALYTICAL METHODS IN CHEMISTRY 2016; 2016:1234581. [PMID: 27610266 PMCID: PMC5005587 DOI: 10.1155/2016/1234581] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/15/2016] [Accepted: 07/26/2016] [Indexed: 06/06/2023]
Abstract
The reliability of DrugWipe 5A on site test for principal drugs of abuse (cannabis, amphetamines, cocaine, and opiates) detection in oral fluid was assessed by comparing the on-site results with headspace solid-phase microextraction (HS-SPME) gas chromatography-mass spectrometry (GC-MS) analysis on samples extracted by the device collection pad. Oral fluid samples were collected at recreational settings (e.g., discos, pubs, and music bars) of Rome metropolitan area. Eighty-three club goers underwent the on-site drug screening test with one device. Independently from the result obtained, a second device was used just to collect another oral fluid sample subsequently extracted and analyzed in the laboratory following HS-SPME procedure, gas chromatographic separation by a capillary column, and MS detection by electron impact ionization. DrugWipe 5A on-site test showed 54 samples (65.1%) positive to one or more drugs of abuse, whereas 75 samples (90.4%) tested positive for one or more substances following GC-MS assay. Comparing the obtained results, the device showed sensitivity, specificity, and accuracy around 80% for amphetamines class. Sensitivity (67 and 50%) was obtained for cocaine and opiates, while both sensitivity and accuracy were unsuccessful (29 and 53%, resp.) for cannabis, underlying the limitation of the device for this latter drug class.
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Affiliation(s)
- Stefano Gentili
- Drug Abuse and Doping Unit, Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Renata Solimini
- Drug Abuse and Doping Unit, Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Roberta Tittarelli
- Unit of Forensic Toxicology (UoFT), Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Giulio Mannocchi
- Unit of Forensic Toxicology (UoFT), Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesco Paolo Busardò
- Unit of Forensic Toxicology (UoFT), Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
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Gjerde H, Langel K, Favretto D, Verstraete AG. Detection of illicit drugs in oral fluid from drivers as biomarker for drugs in blood. Forensic Sci Int 2015; 256:42-5. [DOI: 10.1016/j.forsciint.2015.06.027] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/09/2015] [Accepted: 06/28/2015] [Indexed: 10/23/2022]
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Abstract
BACKGROUND Analysis of samples of oral fluid (mixed saliva) is increasingly being used to detect recent drug use. The aim of this investigation was to assess the suitability of testing oral fluid as a biomarker for the presence of 4 benzodiazepines in blood and its possible application in clinical settings and in research on drug use. METHODS Paired samples of oral fluid and blood from 4080 individuals in 4 European countries were collected and analyzed for benzodiazepines using gas or liquid chromatography with mass spectroscopic detection. RESULTS Concentration data for the 4 most commonly detected benzodiazepines were studied: alprazolam, clonazepam, diazepam, and nordiazepam. Large variations in oral fluid to blood concentration ratios were observed for the studied benzodiazepines. The interquartile ranges for the oral fluid to blood concentrations ratios corresponded to 88%-197% of the median values. Selecting cutoff concentrations in oral fluid that gave the best accuracy in identifying individuals with benzodiazepine concentrations in blood above chosen thresholds produced accuracies of 74%-85% and the fraction of false negatives was 9%-23%. CONCLUSIONS The concentration of the 4 studied benzodiazepines in oral fluid can neither be used to accurately estimate the concentrations in blood nor to correctly identify patients with blood drug concentrations below or above recommended therapeutic levels. When using analytical methods with limits of quantitation corresponding to concentrations less than 0.5 ng/mL in undiluted oral fluid, it may be used to confirm a recent intake of benzodiazepines. However, it is likely that some false negatives may occur.
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Desrosiers NA, Milman G, Mendu DR, Lee D, Barnes AJ, Gorelick DA, Huestis MA. Cannabinoids in oral fluid by on-site immunoassay and by GC-MS using two different oral fluid collection devices. Anal Bioanal Chem 2014; 406:4117-28. [PMID: 24828976 DOI: 10.1007/s00216-014-7813-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 03/27/2014] [Accepted: 04/03/2014] [Indexed: 11/27/2022]
Abstract
Oral fluid (OF) enables non-invasive sample collection for on-site drug testing, but performance of on-site tests with occasional and frequent smokers' OF to identify cannabinoid intake requires further evaluation. Furthermore, as far as we are aware, no studies have evaluated differences between cannabinoid disposition among OF collection devices with authentic OF samples after controlled cannabis administration. Fourteen frequent (≥4 times per week) and 10 occasional (less than twice a week) adult cannabis smokers smoked one 6.8% ∆(9)-tetrahydrocannabinol (THC) cigarette ad libitum over 10 min. OF was collected with the StatSure Saliva Sampler, Oral-Eze, and Draeger DrugTest 5000 test cassette before and up to 30 h after cannabis smoking. Test cassettes were analyzed within 15 min and gas chromatography-mass spectrometry cannabinoid results were obtained within 24 h. Cannabinoid concentrations with the StatSure and Oral-Eze devices were compared and times of last cannabinoid detection (t(last)) and DrugTest 5000 test performance were assessed for different cannabinoid cutoffs. 11-nor-9-Carboxy-THC (THCCOOH) and cannabinol concentrations were significantly higher in Oral-Eze samples than in Stat-Sure samples. DrugTest 5000 t(last) for a positive cannabinoid test were median (range) 12 h (4-24 h) and 21 h (1- ≥ 30 h) for occasional and frequent smokers, respectively. Detection windows in screening and confirmatory tests were usually shorter for occasional than for frequent smokers, especially when including THCCOOH ≥20 ng L(-1) in confirmation criteria. No differences in t(last) were observed between collection devices, except for THC ≥2 μg L(-1). We thus report significantly different THCCOOH and cannabinol, but not THC, concentrations between OF collection devices, which may affect OF data interpretation. The DrugTest 5000 on-site device had high diagnostic sensitivity, specificity, and efficiency for cannabinoids.
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Affiliation(s)
- Nathalie A Desrosiers
- Chemistry and Drug Metabolism Section, NIDA IRP, 251 Bayview Boulevard, Baltimore, MD, 21224, USA
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Performance evaluation of on-site oral fluid drug screening devices in normal police procedure in Germany. Forensic Sci Int 2014; 238:120-4. [DOI: 10.1016/j.forsciint.2014.02.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 01/24/2014] [Accepted: 02/09/2014] [Indexed: 11/23/2022]
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Gjerde H, Langel K, Favretto D, Verstraete AG. Estimation of equivalent cutoff thresholds in blood and oral fluid for drug prevalence studies. J Anal Toxicol 2014; 38:92-8. [PMID: 24451086 DOI: 10.1093/jat/bkt122] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Oral fluid is an easily available specimen for studying drug use in a cohort or population. The prevalence of drugs in samples of oral fluid is the same as the prevalence in blood if using equivalent cutoff concentrations. The cutoffs in oral fluid may be higher or lower than that in blood in accordance with the median oral fluid-to-blood (OF/B) concentration ratio, but it is also influenced by the skewness of the distribution of OF/B ratios. The aim of this study was to determine formulae for the estimation of equivalent cutoff concentrations in oral fluid and blood for 12 commonly used illegal and medicinal psychoactive drugs when oral fluid was collected with Statsure Saliva·Sampler™. Paired samples from 4,080 persons were collected and analyzed with chromatographic methods and mass spectroscopic detection. Regression formulae for the concentrations corresponding to selected percentiles in oral fluid versus the same concentration percentiles in blood were determined. The accuracy when multiplying the cutoff thresholds in blood with the average and median OF/B ratios to estimate equivalent cutoffs in oral fluid was also investigated. Prevalence regression gave the most accurate results. The regression formulae can be used to estimate equivalent cutoff concentrations in oral fluid and blood.
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Affiliation(s)
- Hallvard Gjerde
- 1Division of Forensic Medicine and Drug Abuse Research, Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway
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Simultaneous Determination of Fenproporex, Diethylpropione and Methylphenidate in Oral Fluid by LC-MS/MS. Chromatographia 2013. [DOI: 10.1007/s10337-013-2569-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Matzopoulos R, Lasarow A, Bowman B. A field test of substance use screening devices as part of routine drunk-driving spot detection operating procedures in South Africa. ACCIDENT; ANALYSIS AND PREVENTION 2013; 59:118-124. [PMID: 23770390 DOI: 10.1016/j.aap.2013.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 03/11/2013] [Accepted: 05/16/2013] [Indexed: 06/02/2023]
Abstract
This pilot study aimed to test four substance use screening devices developed in Germany under local South African conditions and assess their utility for detecting driving under the influence of drugs (DUID) as part of the standard roadblock operations of local law enforcement agencies. The devices were used to screen a sample of motorists in the Gauteng and Western Cape provinces. The motorists were diverted for screening at roadblocks at the discretion of the law enforcement agencies involved, as per their standard operating procedures. Fieldworkers also administered a questionnaire that described the screening procedure, as well as information about vehicles, demographic information about the motorists and their attitudes to the screening process during testing. Motorists tested positive for breath alcohol in 28% of the 261 cases tested. Oral fluid was screened for drugs as per the standard calibrated cut-offs of all four devices. There were 14 cases where the under-influence drivers tested positive for alcohol and drugs simultaneously, but 14% of the 269 drivers drug-screened tested positive for drugs only. After alcohol, amphetamine, methamphetamine and cocaine were the most common drugs of impairment detected. The results suggest that under normal enforcement procedures only 76% of drivers impaired by alcohol and other drugs would have been detected. In more than 70% of cases the tests were administered within 5 min and this is likely to improve with more regular use. It was clear that the pilot screening process meets global testing standards. Although use of the screening devices alone would not serve as a basis for prosecution and provisions would need to be made for the confirmation of results through laboratory testing, rollout of this screening process would improve operational efficiency in at least two ways. Firstly, the accuracy of the tests will substantially decrease confirmatory test loads. Secondly, laboratory drug testing can be restricted to specific drugs rather than a full panel analysis, which will reduce testing costs significantly.
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Affiliation(s)
- Richard Matzopoulos
- Burden of Disease Research Unit, South African Medical Research Council, South Africa; School of Public Health and Family Medicine, University of Cape Town, South Africa
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18
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Langel K, Gjerde H, Favretto D, Lillsunde P, Øiestad EL, Ferrara SD, Verstraete AG. Comparison of drug concentrations between whole blood and oral fluid. Drug Test Anal 2013; 6:461-71. [PMID: 24039237 DOI: 10.1002/dta.1532] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 08/08/2013] [Accepted: 08/08/2013] [Indexed: 11/10/2022]
Abstract
The relationship of drug concentrations between oral fluid and whole blood was evaluated by studying the linear correlation of concentrations and calculating the oral fluid to blood concentration ratios (OF/B) for different substances. Paired oral fluid and whole blood samples were collected from volunteers and persons suspected of drug use in four European countries. Oral fluid samples were collected with the Saliva∙Sampler™ device. All samples were analyzed for drugs of abuse and psychoactive medicines with validated gas and liquid chromatography-mass spectrometric methods. The median OF/B ratios were, for amphetamines 19-22, for opioids 1.8-11, for cocaine and metabolites 1.7-17, for tetrahydrocannabinol (THC) 14, for benzodiazepines 0.035-0.33, and for other psychoactive medicines 0.24-3.7. Most of the these results were close to theoretical values based on the physicochemical properties of the drugs and to values presented earlier, but there was a lot of inter-individual variation in the OF/B ratios. For all substances, except for lorazepam (R(2) = 0.031) and THC (R(2) = 0.030), a correlation between the oral fluid and whole blood concentrations was observed. Due to large variation seen here, drug findings in oral fluid should not be used to estimate the corresponding concentrations in whole blood (or vice versa). However, detection of drugs in oral fluid is a sign of recent drug use and oral fluid can be used for qualitative detection of several drugs, e.g. in epidemiological prevalence studies. By optimizing the sampling and the analytical cut-offs, the potential of oral fluid as a confirmation matrix could be enhanced.
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Affiliation(s)
- Kaarina Langel
- Department of Alcohol, Drugs, and Addiction, National Institute for Health and Welfare, Helsinki, Finland
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Arroyo A, Sanchez M, Barberia E, Barbal M, Marrón MT, Mora A. Comparison of the Cozart DDS 801 on-site drug test device and gas chromatography/mass spectrometry (GC/MS) confirmation results of cannabis and cocaine in oral fluid specimens. AUST J FORENSIC SCI 2013. [DOI: 10.1080/00450618.2013.832796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Moore C, Kelley-Baker T, Lacey J. Field testing of the Alere DDS2 Mobile Test System for drugs in oral fluid. J Anal Toxicol 2013; 37:305-7. [PMID: 23558436 DOI: 10.1093/jat/bkt022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A preliminary field evaluation of a second-generation handheld oral fluid testing device, the Alere DDS2 Mobile Test System (DDS2), is described. As part of a larger study, drivers were randomly stopped at various locations across California (in 2012) and asked to submit voluntarily to a questionnaire regarding their drug and alcohol use, a breath alcohol test and collection of oral fluid with the Quantisal device. The Quantisal-collected oral fluid samples were sent for laboratory-based analyses. At one location, 50 drivers were asked to submit an additional oral fluid sample using the DDS2 collection device; these samples were analyzed by using the DDS2 mobile test system. Thirty-eight donors (76%) provided specimens that were successfully run on the mobile system; in 12 cases (24%), the device failed to provide a valid result. Thirty-two of the 38 collected samples were negative for all drugs; five were positive for tetrahydrocannabinol and one was positive for methamphetamine using the mobile device. These results corresponded exactly with the laboratory-based results from the Quantisal oral fluid collection.
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Jang M, Chang H, Yang W, Choi H, Kim E, Yu BH, Oh Y, Chung H. Development of an LC–MS/MS method for the simultaneous determination of 25 benzodiazepines and zolpidem in oral fluid and its application to authentic samples from regular drug users. J Pharm Biomed Anal 2013; 74:213-22. [DOI: 10.1016/j.jpba.2012.11.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 10/31/2012] [Accepted: 11/01/2012] [Indexed: 11/29/2022]
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Fenproporex and Amphetamine Pharmacokinetics in Oral Fluid After Controlled Oral Administration of Fenproporex. Ther Drug Monit 2012; 34:545-53. [DOI: 10.1097/ftd.0b013e318263c6c5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Desrosiers NA, Lee D, Schwope DM, Milman G, Barnes AJ, Gorelick DA, Huestis MA. On-site test for cannabinoids in oral fluid. Clin Chem 2012; 58:1418-25. [PMID: 22912396 PMCID: PMC3846692 DOI: 10.1373/clinchem.2012.189001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Oral fluid (OF) testing offers noninvasive sample collection for on-site drug testing; however, to date, test performance for Δ(9)-tetrahydrocannabinol (THC) detection has had unacceptable diagnostic sensitivity. On-site tests must accurately identify cannabis exposure because this drug accounts for the highest prevalence in workplace drug testing and driving under the influence of drugs (DUID) programs. METHODS Ten cannabis smokers (9 males, 1 female) provided written informed consent to participate in this institutional review board-approved study and smoked 1 6.8%-THC cigarette ad libitum. OF was collected with the Draeger DrugTest(®) 5000 test cassette and Quantisal™ device 0.5 h before and up to 22 h after smoking. Test cassettes were analyzed within 15 min (n = 66), and Quantisal GC-MS THC results obtained within 24 h. Final THC detection times and test performances were assessed at different cannabinoid cutoffs. RESULTS Diagnostic sensitivity, diagnostic specificity, and efficiency at DrugTest 5000's 5 μg/L screening cutoff and various THC confirmation cutoffs were 86.2-90.7, 75.0-77.8, and 84.8-87.9%, respectively. Last detection times were >22 h, longer than previously suggested. Confirmation of 11-nor-9-carboxy-THC, absent in THC smoke, minimized the potential for passive OF contamination and still provided 22-h windows of detection, appropriate for workplace drug testing, whereas confirmation of cannabidiol, and/or cannabinol yielded shorter 6-h windows of detection, appropriate for DUID OF testing. CONCLUSIONS The DrugTest 5000 on-site device provided high diagnostic sensitivity for detection of cannabinoid exposure, and the selection of OF confirmation analytes and cutoffs provided appropriate windows of detection to meet the goals of different drug testing programs.
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Affiliation(s)
- Nathalie A. Desrosiers
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore
- Program in Toxicology, University of Maryland Baltimore, Baltimore, USA
| | - Dayong Lee
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore
- Program in Toxicology, University of Maryland Baltimore, Baltimore, USA
| | - David M. Schwope
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore
| | - Garry Milman
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore
| | - Allan J. Barnes
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore
| | - David A. Gorelick
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore
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Strano-Rossi S, Castrignanò E, Anzillotti L, Serpelloni G, Mollica R, Tagliaro F, Pascali JP, di Stefano D, Sgalla R, Chiarotti M. Evaluation of four oral fluid devices (DDS®, Drugtest 5000®, Drugwipe 5+® and RapidSTAT®) for on-site monitoring drugged driving in comparison with UHPLC–MS/MS analysis. Forensic Sci Int 2012; 221:70-6. [DOI: 10.1016/j.forsciint.2012.04.003] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 03/27/2012] [Accepted: 04/07/2012] [Indexed: 11/28/2022]
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Vanstechelman S, Isalberti C, Van der Linden T, Pil K, Legrand SA, Verstraete AG. Analytical evaluation of four on-site oral fluid drug testing devices. J Anal Toxicol 2012; 36:136-40. [PMID: 22337784 DOI: 10.1093/jat/bkr016] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The use of oral fluid (OF) as an alternative matrix for the detection of drugs of abuse has increased over the last decade, leading to the need for a rapid, simple, and reliable on-site OF testing device. Four on-site OF drug testing devices (Dräger DrugTest 5000, Cozart DDS, Mavand Rapid STAT, and Innovacon OrAlert) were evaluated on 408 volunteers at drug treatment centers. UPLC-MS-MS results were used as reference to determine sensitivity, specificity and accuracy for each device, applying Belgian legal confirmation cutoffs for benzoylecgonine, cocaine, and THC (10 ng/mL); morphine and 6-acetylmorphine (5 ng/mL); and amphetamine and 3,4-methylenedioxymethylamphetamine (25 ng/mL). Sensitivity for cocaine was 50%, 50%, 27%, and 11% for DrugTest, OrAlert, Rapid STAT, and DDS 806, respectively. For opiates, sensitivities were 84%, 73%, 77%, and 65%, respectively. For THC, the sensitivities were 81%, 23%, 43%, and 28%, respectively. For amphetamines, the sensitivities were 75%, 33%, 17%, and 67%, respectively. Specificity was >88% for opiates and THC, > 90% for amphetamines, and > 97% for cocaine. All tests showed good specificity. DrugTest had the highest sensitivity, although it was still low for some analytes.
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Affiliation(s)
- Sylvie Vanstechelman
- Department of Clinical Chemistry, Microbiology, and Immunology, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
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Presence of psychoactive substances in oral fluid from randomly selected drivers in Denmark. Forensic Sci Int 2012; 221:33-8. [PMID: 22554868 DOI: 10.1016/j.forsciint.2012.03.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 03/08/2012] [Accepted: 03/20/2012] [Indexed: 11/23/2022]
Abstract
This roadside study is the Danish part of the EU-project DRUID (Driving under the Influence of Drugs, Alcohol, and Medicines) and included three representative regions in Denmark. Oral fluid samples (n=3002) were collected randomly from drivers using a sampling scheme stratified by time, season, and road type. The oral fluid samples were screened for 29 illegal and legal psychoactive substances and metabolites as well as ethanol. Fourteen (0.5%) drivers were positive for ethanol (alone or in combination with drugs) at concentrations above 0.53g/l, which is the Danish legal limit. The percentage of drivers positive for medicinal drugs above the Danish legal concentration limit was 0.4%; while, 0.3% of the drivers tested positive for one or more illicit drug at concentrations exceeding the Danish legal limit. Tetrahydrocannabinol, cocaine, and amphetamine were the most frequent illicit drugs detected above the limit of quantitation (LOQ); while, codeine, tramadol, zopiclone, and benzodiazepines were the most frequent legal drugs. Middle aged men (median age 47.5 years) dominated the drunk driving group, while the drivers positive for illegal drugs consisted mainly of young men (median age 26 years). Middle aged women (median age 44.5 years) often tested positive for benzodiazepines at concentrations exceeding the legal limits. Interestingly, 0.6% of drivers tested positive for tramadol, at concentrations above the DRUID cut off; although, tramadol is not included in the Danish list of narcotic drugs. It can be concluded that driving under the influence of drugs is as serious a road safety problem as drunk driving.
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27
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Mura P, Saussereau E, Brunet B, Goullé JP. [Workplace testing of drugs of abuse and psychotropic drugs]. ANNALES PHARMACEUTIQUES FRANÇAISES 2012; 70:120-32. [PMID: 22655580 DOI: 10.1016/j.pharma.2012.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Revised: 02/20/2012] [Accepted: 03/03/2012] [Indexed: 11/18/2022]
Abstract
In France, workplace testing of drugs of abuse and psychotropic drugs is rarely performed; meanwhile it is a major public health problem. Furthermore, France is the European country that has been associated with the highest increase of the use of drugs of abuse, particularly cannabis. So workplace biological screening of drugs of abuse and of psychotropic drugs exposure is of major concern. New analytical techniques have been developed during the last years. The authors will consider analytical screening of drugs of abuse and particularly the comparison of analytical techniques applied to urine and saliva. The advantages and the disadvantages of these two matrices will be considered. Urinary and blood quantification will be reviewed, but also the interest of hair testing to explore chronic exposure. The research of psychotropic drugs in biological fluids is also a part of this paper. New analytical trends are promising and complete analysis of these substances will be soon routinely possible in blood using a single spot test.
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Affiliation(s)
- P Mura
- Laboratoire de toxicologie et de pharmacocinétique, centre hospitalier universitaire, BP 577, Poitiers cedex, France
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28
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Blencowe T, Pehrsson A, Mykkänen S, Gunnar T, Lillsunde P. Cannabis findings in drivers suspected of driving under the influence of drugs in Finland from 2006 to 2008. Forensic Sci Int 2012; 217:107-12. [DOI: 10.1016/j.forsciint.2011.10.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 10/03/2011] [Accepted: 10/04/2011] [Indexed: 10/16/2022]
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29
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30
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The incidence of drugs of impairment in oral fluid from random roadside testing. Forensic Sci Int 2012; 215:28-31. [DOI: 10.1016/j.forsciint.2011.05.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 05/11/2011] [Accepted: 05/11/2011] [Indexed: 11/13/2022]
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31
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Strano-Rossi S, Anzillotti L, Castrignanò E, Felli M, Serpelloni G, Mollica R, Chiarotti M. UHPLC-ESI-MS/MS method for direct analysis of drugs of abuse in oral fluid for DUID assessment. Anal Bioanal Chem 2011; 401:609-24. [DOI: 10.1007/s00216-011-5108-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 04/29/2011] [Accepted: 05/13/2011] [Indexed: 11/29/2022]
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32
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Bioanalytical methods for the determination of cocaine and metabolites in human biological samples. Bioanalysis 2011; 1:977-1000. [PMID: 21083066 DOI: 10.4155/bio.09.72] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Determination of cocaine and its metabolites in biological specimens is of great importance, not only in clinical and forensic toxicology, but also in workplace drug testing. These compounds are normally screened for using sensitive immunological methods. However, screening methods are unspecific and, therefore, the posterior confirmation of presumably positive samples by a specific technique is mandatory. Although GC-MS-based techniques are still the most commonly used for confirmation purposes of cocaine and its metabolites in biological specimens, the advent of LC-MS and LC-MS/MS has enabled the detection of even lower amounts of these drugs, which assumes particular importance when sample volume available is small, as frequently occurs with oral fluid. This paper will review recently-published papers that describe procedures for detection of cocaine and metabolites, not only in the most commonly used specimens, such as blood and urine, but also in other 'alternative' matrices (e.g., oral fluid and hair) with a special focus on sample preparation and chromatographic analysis.
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Barroso M, Gallardo E, Vieira DN, Queiroz JA, López-Rivadulla M. Bioanalytical procedures and recent developments in the determination of opiates/opioids in human biological samples. Anal Bioanal Chem 2011; 400:1665-90. [PMID: 21442365 DOI: 10.1007/s00216-011-4888-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Revised: 03/06/2011] [Accepted: 03/08/2011] [Indexed: 12/27/2022]
Abstract
The use and abuse of illegal drugs affects all modern societies, and therefore the assessment of drug exposure is an important task that needs to be accomplished. For this reason, the reliable determination of these drugs and their metabolites in biological specimens is an issue of utmost relevance for both clinical and forensic toxicology laboratories in their fields of expertise, including in utero drug exposure, driving under the influence of drugs and drug use in workplace scenarios. Most of the confirmatory analyses for abused drugs in biological samples are performed by gas chromatographic-mass spectrometric methods, but use of the more recent and sensitive liquid chromatography-(tandem) mass spectrometry technology is increasing dramatically. This article reviews recently published articles that describe procedures for the detection of opiates in the most commonly used human biological matrices, blood and urine, and also in unconventional ones, e.g. oral fluid, hair, and meconium. Special attention will be paid to sample preparation and chromatographic analysis.
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Affiliation(s)
- M Barroso
- Instituto Nacional de Medicina Legal-Delegação do Sul, Rua Manuel Bento de Sousa, 3, 1150-219 Lisboa, Portugal.
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Benzodiazepines and Sedative–Hypnotics in Blood of Drivers Under the Influence and Their Association With Other Common Illegal Drug Use and National Sales Figures. Ther Drug Monit 2011; 33:64-71. [DOI: 10.1097/ftd.0b013e3182030f91] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Saito K, Saito R, Kikuchi Y, Iwasaki Y, Ito R, Nakazawa H. Analysis of Drugs of Abuse in Biological Specimens. ACTA ACUST UNITED AC 2011. [DOI: 10.1248/jhs.57.472] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Koichi Saito
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Hoshi University
| | - Rieko Saito
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Hoshi University
| | - Yuu Kikuchi
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Hoshi University
| | - Yusuke Iwasaki
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Hoshi University
| | - Rie Ito
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Hoshi University
| | - Hiroyuki Nakazawa
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Hoshi University
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36
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Blencowe T, Pehrsson A, Lillsunde P, Vimpari K, Houwing S, Smink B, Mathijssen R, Van der Linden T, Legrand SA, Pil K, Verstraete A. An analytical evaluation of eight on-site oral fluid drug screening devices using laboratory confirmation results from oral fluid. Forensic Sci Int 2010; 208:173-9. [PMID: 21183299 DOI: 10.1016/j.forsciint.2010.11.026] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 11/01/2010] [Accepted: 11/26/2010] [Indexed: 11/27/2022]
Abstract
The performance of eight on-site oral fluid drug screening devices was studied in Belgium, Finland and the Netherlands as a part of the EU-project DRUID. The main objective of the study was to evaluate the reliability of the devices for testing drivers suspected of driving under the influence of drugs (DUID). The performance of the devices was assessed by their ability to detect substances using cut-offs which were set at sufficiently low levels to allow optimal detection of positive DUID cases. The devices were evaluated for the detection of amphetamine(s), cannabis, cocaine, opiates and benzodiazepines when the relevant test was incorporated. Methamphetamine, MDMA and PCP tests that were included in some devices were not evaluated since there were too few positive samples. The device results were compared with confirmation analysis results in oral fluid. The opiates tests appeared to perform relatively well with sensitivity results between 69 and 90%. Amphetamines and benzodiazepines tests had lower sensitivity, although the DrugWipe test evaluated was promising for amphetamine. In particular, it is evident that the cannabis and cocaine tests of the devices still lack sensitivity, although further testing of the cocaine tests is desirable due to the low prevalence and low concentrations encountered in this study.
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Affiliation(s)
- Tom Blencowe
- Alcohol and Drug Analytics Unit, National Institute for Health and Welfare, Helsinki, Finland.
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37
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Performance evaluation of the DrugWipe® 5/5+ on-site oral fluid screening device. Int J Legal Med 2010; 125:675-83. [DOI: 10.1007/s00414-010-0493-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Accepted: 07/06/2010] [Indexed: 10/19/2022]
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38
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Conventional and alternative matrices for driving under the influence of cannabis: recent progress and remaining challenges. Bioanalysis 2010; 2:791-806. [DOI: 10.4155/bio.10.29] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In the past decade much research concerning the impact of cannabis use on road safety has been conducted. More specifically, studies on effects of cannabis smoking on driving performance, as well as epidemiological studies and cannabis-detection techniques have been published. As a result, several countries have adopted driving under the influence of drugs (DUID) legislations, with varying approaches worldwide. A wide variety of bodily fluids have been utilized to determine the presence of cannabis. Urine and blood are the most widely used matrices for DUID legislations. However, more and more publications focus on the usability of oral fluid testing for this purpose. Each matrix provides different information about time and extent of use and likelihood of impairment. This review will focus on the practical aspects of implying a DUID legislation. The pros and cons of the different biological matrices used for Δ9-tetrahydrocannabinol screening and quantification will be discussed. In addition, a literature overview concerning (roadside) cannabinoid detection, as well as laboratory confirmation techniques is given. Finally, we will discuss important issues influencing interpretation of these data, such as oral fluid collection, choice of cut-offs, stability and proficiency testing.
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Goessaert AS, Pil K, Veramme J, Verstraete A. Analytical evaluation of a rapid on-site oral fluid drug test. Anal Bioanal Chem 2010; 396:2461-8. [PMID: 20140665 DOI: 10.1007/s00216-010-3463-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 12/30/2009] [Accepted: 01/06/2010] [Indexed: 11/26/2022]
Abstract
There is a need for a reliable rapid on-site oral fluid test that can be used in police controls to detect impaired drivers. We evaluated the Varian Oralab6 and collected two oral fluid samples from 250 subjects, one with the Varian Oralab6 and one with the StatSure Saliva Sampler. The Oralab6 can detect six drug types: amphetamines, methamphetamine, cocaine, opiates, delta9-tetrahydrocannabinol (THC), and phencyclidine (PCP). On-site results were obtained within 10 to 15 min. The sample collected with StatSure was analyzed using liquid chromatography-tandem mass spectrometry after liquid-liquid extraction and these results were used as a reference to determine prevalence, sensitivity, and specificity. Two cut-off values were used in the evaluation. The Varian cut-off values were: amphetamine 50 ng/mL, cocaine 20 ng/mL, opiates 40 ng/mL, and THC 50 ng/mL. The DRUID cut-offs were: amphetamine 25 ng/mL, cocaine 20 ng/mL, opiates 20 ng/mL, and THC 1 ng/mL. Applying the first cut-offs, prevalence, sensitivity, and specificity were: amphetamine 10%, 76%, 100%; cocaine 23%, 34%, 100%; opiates 38%, 83%, 94%; and THC 18%, 41%, 99%. The DRUID cut-off values gave the following results: amphetamine 14%, 56%, 100%; cocaine 28%, 34%, 100%; opiates 49%, 68%, 98%, and THC 45%, 16%, 99%. The specificity of the Oralab6 is generally good. For both cut-offs, sensitivity was low for cocaine and THC. Therefore, the Varian Oralab6 test is not sensitive enough to be applied during roadside police controls.
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Affiliation(s)
- An-Sofie Goessaert
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
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Wille SMR, Samyn N, Ramírez-Fernández MDM, De Boeck G. Evaluation of on-site oral fluid screening using Drugwipe-5(+), RapidSTAT and Drug Test 5000 for the detection of drugs of abuse in drivers. Forensic Sci Int 2009; 198:2-6. [PMID: 19913376 DOI: 10.1016/j.forsciint.2009.10.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Revised: 10/01/2009] [Accepted: 10/09/2009] [Indexed: 10/20/2022]
Abstract
Driving under the influence of drugs is a major problem worldwide. At the moment, several countries have adopted a 'per se' legislation to address this problem. One of the key elements in the enforcement process is the possibility of rapid on-site screening tests to take immediate administrative measures. In this study, the reliability of three oral fluid screening devices (Mavand RapidSTAT, Securetec Drugwipe-5(+), and Dräger DrugTest 5000) was assessed by comparing their on-site results with confirmatory GC-MS plasma analysis. Our results demonstrate that for amphetamine screening, the oral fluid on-site devices on the market today are certainly sensitive enough. RapidSTAT, Drugwipe-5(+), and DrugTest 5000 demonstrated respectively a sensitivity of 93%, 100% and 92% for amphetamine/MDMA. For cocaine screening, sensitivities of 75%, 78% and 67% were obtained for the RapidSTAT, Drugwipe-5(+), and DrugTest 5000 devices, respectively. The studied devices were able to detect about 70% of all cannabis users in a roadside setting. However, a newer version of the DrugTest 5000 test cassette demonstrated a sensitivity of 93%, indicating an increased detection of Delta(9)-tetrahydrocannabinol using 'new generation' oral fluid screening tests with lowered cut-offs. Due to these promising results police officers and judicial experts are keen to use oral fluid screening devices. They believe that their ease of use and diminished amount of false positive results in comparison with urine screening will lead to more roadside tests and more appropriate juridical measures.
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Affiliation(s)
- Sarah M R Wille
- Federal Public Service Justice, National Institute of Criminalistics and Criminology, Vilvoordsesteenweg 100, Brussels, Belgium.
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Badawi N, Simonsen KW, Steentoft A, Bernhoft IM, Linnet K. Simultaneous Screening and Quantification of 29 Drugs of Abuse in Oral Fluid by Solid-Phase Extraction and Ultraperformance LC-MS/MS. Clin Chem 2009; 55:2004-18. [DOI: 10.1373/clinchem.2008.122341] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background: The European DRUID (Driving under the Influence of Drugs, Alcohol And Medicines) project calls for analysis of oral fluid (OF) samples, collected randomly and anonymously at the roadside from drivers in Denmark throughout 2008–2009. To analyze these samples we developed an ultra performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) method for detection of 29 drugs and illicit compounds in OF. The drugs detected were opioids, amphetamines, cocaine, benzodiazepines, and Δ-9-tetrahydrocannabinol.
Method: Solid-phase extraction was performed with a Gilson ASPEC XL4 system equipped with Bond Elut Certify sample cartridges. OF samples (200 mg) diluted with 5 mL of ammonium acetate/methanol (vol/vol 90:10) buffer were applied to the columns and eluted with 3 mL of acetonitrile with aqueous ammonium hydroxide. Target drugs were quantified by use of a Waters ACQUITY UPLC system coupled to a Waters Quattro Premier XE triple quadrupole (positive electrospray ionization mode, multiple reaction monitoring mode).
Results: Extraction recoveries were 36%–114% for all analytes, including Δ-9-tetrahydrocannabinol and benzoylecgonine. The lower limit of quantification was 0.5 μg/kg for all analytes. Total imprecision (CV) was 5.9%–19.4%. With the use of deuterated internal standards for most compounds, the performance of the method was not influenced by matrix effects. A preliminary account of OF samples collected at the roadside showed the presence of amphetamine, cocaine, codeine, Δ-9-tetrahydrocannabinol, tramadol, and zopiclone.
Conclusions: The UPLC-MS/MS method makes it possible to detect all 29 analytes in 1 chromatographic run (15 min), including Δ-9-tetrahydrocannabinol and benzoylecgonine, which previously have been difficult to incorporate into multicomponent methods.
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Affiliation(s)
- Nora Badawi
- Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen
| | - Kirsten Wiese Simonsen
- Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen
| | - Anni Steentoft
- Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen
| | | | - Kristian Linnet
- Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen
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Abstract
BACKGROUND Oral fluid (OF) is an exciting alternative matrix for monitoring drugs of abuse in workplace, clinical toxicology, criminal justice, and driving under the influence of drugs (DUID) programs. During the last 5 years, scientific and technological advances in OF collection, point-of-collection testing devices, and screening and confirmation methods were achieved. Guidelines were proposed for workplace OF testing by the Substance Abuse and Mental Health Services Administration, DUID testing by the European Union's Driving under the Influence of Drugs, Alcohol and Medicines (DRUID) program, and standardization of DUID research. Although OF testing is now commonplace in many monitoring programs, the greatest current limitation is the scarcity of controlled drug administration studies available to guide interpretation. CONTENT This review outlines OF testing advantages and limitations, and the progress in OF that has occurred during the last 5 years in collection, screening, confirmation, and interpretation of cannabinoids, opioids, amphetamines, cocaine, and benzodiazepines. We examine controlled drug administration studies, immunoassay and chromatographic methods, collection devices, point-of-collection testing device performance, and recent applications of OF testing. SUMMARY Substance Abuse and Mental Health Services Administration approval of OF testing was delayed because questions about drug OF disposition were not yet resolved, and collection device performance and testing assays required improvement. Here, we document the many advances achieved in the use of OF. Additional research is needed to identify new biomarkers, determine drug detection windows, characterize OF adulteration techniques, and evaluate analyte stability. Nevertheless, there is no doubt that OF offers multiple advantages as an alternative matrix for drug monitoring and has an important role in DUID, treatment, workplace, and criminal justice programs.
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Affiliation(s)
- Wendy M. Bosker
- Maastricht University, Faculty of Psychology and Neuroscience, Neuropsychology & Psychopharmacology, Experimental Psychopharmacology Unit, Maastricht, The Netherlands
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, NIH, Baltimore, MD
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, NIH, Baltimore, MD
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Relationship Between Oral Fluid and Blood Concentrations of Drugs of Abuse in Drivers Suspected of Driving Under the Influence of Drugs. Ther Drug Monit 2009; 31:511-9. [DOI: 10.1097/ftd.0b013e3181ae46ea] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Drug oral fluid analysis was first used almost 30 years ago for the purpose of therapeutic drug monitoring. Since then, oral fluid bioanalysis has become more popular, mainly in the fields of pharmacokinetics, workplace drug testing, criminal justice, driving under the influence testing and therapeutic drug monitoring. In fact, oral fluid can provide a readily available and noninvasive medium, without any privacy loss by the examinee, which occurs, for instance, during the collection of urine samples. It is believed that drug concentrations in oral fluid may parallel those measured in blood. This feature makes oral fluid an alternative analytical specimen to blood, which assumes particular importance in roadside testing, the most published application of this sample. Great improvements in the development of accurate and reliable methods for sample collection, in situ detection devices (on-site drug detection kits), and highly sensitive and specific analytical methods for oral fluid testing of drugs have been observed in the last few years. However, without mass spectrometry-based analytical methods, such as liquid chromatography coupled to mass spectrometry (LC–MS) or tandem mass spectrometry (LC–MS/MS), the desired sensitivity would not be met, due to the low amounts of sample usually available for analysis. This review will discuss a series of published papers on the applicability of oral fluid in the field of analytical, clinical and forensic toxicology, with a special focus on its advantages and drawbacks over the normally used biological specimens and the main technological advances over the last decade, which have made oral fluid analysis of drugs possible.
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Affiliation(s)
- T. A. Brettell
- Department of Chemical and Physical Sciences, Cedar Crest College, 100 College Drive, Allentown, Pennsylvania 18104-6196
| | - J. M. Butler
- Biochemical Science Division, National Institute of Standards and Technology, Gaithersburg, Maryland 20899-8312
| | - J. R. Almirall
- Department of Chemistry and Biochemistry and International Forensic Research Institute, Florida International University, University Park, Miami, Florida 33199
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Verstraete A, Labat L. Utilisation des tests rapides de détection de drogues dans la salive au bord de la route et en santé au travail. ACTA ACUST UNITED AC 2009. [DOI: 10.1051/ata/2009030] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Keller T, Keller A, Tutsch-Bauer E, Monticelli F. Driving under the influence of drugs and alcohol in Salzburg and Upper Austria during the years 2003–2007. Leg Med (Tokyo) 2009; 11 Suppl 1:S98-9. [DOI: 10.1016/j.legalmed.2009.01.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 01/08/2009] [Indexed: 10/21/2022]
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Giroud C, Bollmann M, Thomas A, Mangin P, Favrat B. Consommation de cannabis: quels sont les risques ? ACTA ACUST UNITED AC 2009. [DOI: 10.1051/ata/2009021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Gallardo E, Queiroz JA. The role of alternative specimens in toxicological analysis. Biomed Chromatogr 2008; 22:795-821. [DOI: 10.1002/bmc.1009] [Citation(s) in RCA: 135] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
Analytical techniques for detection of drugs in oral fluid (OF) are reviewed with emphasis on applications used in European Union (EU) roadside testing projects. Oral fluid is readily accessible and collectible. It has become an interesting material because no medical personnel are needed for sampling. This matrix is especially applicable for preliminary drug testing in driving under the influence controls and for monitoring illicit drug use in drug treatment. Oral fluid is also an increasingly used specimen in epidemiologic studies and in workplace drug testing. Drugs are present at lower levels in OF than in urine. The window of detection of drugs in OF reflects the corresponding window in blood, suggesting OF as a specimen of choice for roadside testing. Saliva/blood ratios vary from drug to drug, from person to person, and even intraindividually making therapeutic drug monitoring in OF challenging. Several sensitive methods for drug testing in OF have been developed during the last years.
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Affiliation(s)
- Pirjo Lillsunde
- National Public Health Institute, Drug Research Unit, Helsinki, Finland.
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