The detection of illicit drugs in oral fluid: another potential strategy to reduce illicit drug-related harm

Artificial oral fluid characterisation: Potential for use as a reference matrix in drug testing

Quality assurance schemes for drug-screening programmes require access to large quantities of biological matrices for reference or control samples. This presents problems when the availability of a matrix, such as oral fluid (OF) for screening or for confirmatory purposes, limits the collection of large volumes. In such cases, synthetic alternatives of OF may provide a solution. The preparation of an artificial (synthetic) oral fluid (AOF) was conducted by dissolving its components (salts, surfactant, antimicrobial agent and mucin) in water. We characterised the physical properties of AOF to determine its suitability as a matrix for quality assurance purposes. The evaluation of pH, specific gravity (SG), conductivity (mS cm^-1 ), freezing point depression (°C), light-scattering and kinematic viscosity (mm² s^-1 ) showed AOF to be a stable, reliable matrix. Synthetic OF was prepared using components (mucin, surfactants and so on) obtained from different suppliers and a comparison was performed. Our results suggest that AOF is a feasible matrix for the preparation of quality assurance samples for confirmatory or drug screening programmes.

Concordance of self-reported drug use and saliva drug tests in a sample of emergency department patients

The purpose of this study was to assess the concordance of self-reports of cannabis, cocaine and amphetamines, and the utility of these, with a saliva point of collection drug test, the DrugWipe 5+, in an emergency department (ED) setting.

METHODS

A random sample of people admitted to either of two emergency departments at hospitals in British Columbia, Canada were asked to participate in an interview on their substance use and provide a saliva test for detection of drugs.

ANALYSES

Concordance of self-reports and drug tests were calculated. Prior DrugWipe 5+ sensitivity and specificity estimates were compared against a gold standard of mass spectrometry and chromatography (MS/GC). This was used as a basis to assess the truthfulness of self-reports for each drug.

RESULTS

Of the 1584 patients approached 1190 agreed to participate, a response rate of 75.1%. For cannabis, among those who acknowledged use only 21.1% had a positive test and 2.1% of those who reported no use had a positive test. For cocaine and amphetamines respectively, 50.0% and 57.1% tested positive among those reporting use, while 2.1% and 1.3%, respectively reported no use and tested positive. Self-reports of cannabis and amphetamines use appear more truthful than self-reports of cocaine use.