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Willeman T, Bartolli M, Jourdil JF, Vial S, Eysseric-Guérin H, Stanke-Labesque F. Trends in drivers testing positive for drugs of abuse in oral fluid from 2018 to 2021 in France. Forensic Sci Int 2023; 352:111835. [PMID: 37748427 DOI: 10.1016/j.forsciint.2023.111835] [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: 06/13/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Driving under the influence of drugs (DUID) is a risk factor for traffic accidents. The testing of oral fluid by roadside immunochromatography and laboratory-confirmed chromatography coupled to mass spectrometry (LC-MS/MS) analysis to detect drug abuse has increased in France. The aim of this study was to describe the trends observed in drivers testing positive for illicit drugs in oral fluid and to investigate the concordance between the two analytical methods used. METHODS We received for confirmation 3051 oral fluid samples from drivers who had tested positive at the roadside with a Drugwipe-5S® device between 2018 and 2021 around Grenoble, France. Samples were collected with FLOQSwab® and analyzed by LC-MS/MS (THC, amphetamine, methamphetamine, MDMA and MDA, MDEA, cocaine and benzoylecgonine, morphine and 6-monoacetylmorphine) at Grenoble Alpes University Hospital, France. Binomial logistic regression was performed to evaluate consumption trends. RESULTS Most of the drivers were men (93.2%), with a median age of 26 years (range: 14-66 years). Cannabis (94.6%) cocaine (17.5%) and MDMA (2.5%) were the drugs most frequently detected. Poly-drug use was observed in 17.3% of drivers and involved cannabis and cocaine in 85.3% of these drivers. Poly-drug use was more frequent among drivers over the age of 32 years (OR, 3.48; 95% CI, 2.59-4.68; p ≤ .001), as was cocaine use (OR, 5.15; 95% CI, 3.75-7.08; p ≤ .001). The frequency of positive tests for amphetamines was higher in women than in men (OR, 2.53; 95% CI, 1.50-4.27; p ≤ .001). The positive predictive value of Drugwipe-5S was 98.2% for cannabis, 22.6% for amphetamines, 75.4% for cocaine and 17.3% for opiates. At least one discrepancy between Drugwipe-5S® and LC-MS/MS results was observed for 22.3% of the samples tested. CONCLUSION We report recent trends for drivers testing positive for illicit drugs in oral fluid in France. Cannabis was the most prevalent drug of abuse identified, suggesting that a general prevention program might be useful. Our results also highlight the need for LC-MS/MS confirmation when screening oral fluid for drugs of abuse.
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Affiliation(s)
- Théo Willeman
- Univ Grenoble Alpes, Laboratory of Pharmacology, Pharmacogenetics and Toxicology, Grenoble Alpes University Hospital, Grenoble, France; Univ Grenoble Alpes Clinical Forensic Medicine Department, Grenoble Alpes University Hospital, Grenoble, France.
| | - Mireille Bartolli
- Univ Grenoble Alpes, Laboratory of Pharmacology, Pharmacogenetics and Toxicology, Grenoble Alpes University Hospital, Grenoble, France
| | - Jean-François Jourdil
- Univ Grenoble Alpes, Laboratory of Pharmacology, Pharmacogenetics and Toxicology, Grenoble Alpes University Hospital, Grenoble, France
| | - Simon Vial
- Univ Grenoble Alpes, Laboratory of Pharmacology, Pharmacogenetics and Toxicology, Grenoble Alpes University Hospital, Grenoble, France
| | - Hélène Eysseric-Guérin
- Univ Grenoble Alpes, Laboratory of Pharmacology, Pharmacogenetics and Toxicology, Grenoble Alpes University Hospital, Grenoble, France; Univ Grenoble Alpes Clinical Forensic Medicine Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Françoise Stanke-Labesque
- Univ Grenoble Alpes, Laboratory of Pharmacology, Pharmacogenetics and Toxicology, Grenoble Alpes University Hospital, Grenoble, France; Univ Grenoble Alpes, HP2 INSERM U1300, Grenoble F-38041, France
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Harper CE, Mata DC, Lee D. The impact of fentanyl on DUIDs and traffic fatalities: Blood and oral fluid data. J Forensic Sci 2023; 68:1686-1697. [PMID: 37477181 DOI: 10.1111/1556-4029.15334] [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: 03/16/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/22/2023]
Abstract
Fentanyl has emerged as the most prolific drug in the ongoing opioid epidemic and has greatly impacted traffic safety in recent years. This study aimed to evaluate fentanyl prevalence and concentrations in blood and oral fluid in driving under the influence of drugs (DUID) cases in three different regions (i.e., Alabama, Orange County, CA, and Houston, TX) from 2017 to 2022. Furthermore, traffic fatalities were evaluated for Alabama and Orange County, CA. Fentanyl positivity in DUID and traffic fatalities increased for most years in this study. In Alabama, the prevalence of fentanyl DUID cases increased 4-fold in 2022 compared to 2017. Orange County's increase from 2017 to 2022 was 14-fold. In Houston, the increase was approximately 2-fold from 2019 to 2022. The greatest increase for all laboratories coincided with the start of the COVID-19 pandemic. In 2022, the median fentanyl DUID blood concentrations were 4.7, 11, and 4.7 ng/mL in Alabama, Orange County, and Houston, respectively. Most fentanyl cases were polydrug cases (≥90%). Methamphetamine, THC, and alprazolam were the most frequently detected drugs in combination with fentanyl. Alabama has collected oral fluid and blood in DUID cases since 2018. The detection of fentanyl in oral fluid was comparable to blood. However, 59% and 8.7% of fentanyl-positive cases had concentrations of >20 ng/mL in oral fluid and blood, respectively. Therefore, oral fluid as an alternative or supplemental specimen to blood is an attractive approach for fentanyl in DUID cases. This study contributes to understanding recent fentanyl trends and their impact on traffic safety.
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Affiliation(s)
- Curt E Harper
- Alabama Department of Forensic Sciences, Hoover, Alabama, USA
| | - Dani C Mata
- Orange County Crime Laboratory, Santa Ana, California, USA
| | - Dayong Lee
- Houston Forensic Science Center, Houston, Texas, USA
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Santangelo O, Baldwin JM, Stogner J. Does cannabis testing in the military drive synthetic cannabinoid use? Self-reported use motivations among justice-involved veterans. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 106:103756. [PMID: 35738030 DOI: 10.1016/j.drugpo.2022.103756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Though synthetic cannabinoid receptor agonists (SCRAs) were controlled after being introduced as a 'legal high,' SCRAs likely remain appealing to individuals subject to routine drug screens as not all testing programs consistently include SCRAs. Military populations have been linked to SCRAs due to the unconfirmed supposition that testing protocols led many to substitute SCRAs for cannabis. This study aimed to explore SCRA use prevalence, correlates, and use motivations among veterans, with a particular focus on whether United States military personnel substituted SCRAs for cannabis to subvert testing protocols. METHODS All veterans appearing in one of eight civilian criminal courts in three U.S. states were invited to answer questionnaire items related to military service, court functionality, and substance use. Of the 579 veterans eligible, 54.9% chose to participate, yielding a cross-sectional sample of 318 veterans charged with a criminal offense by civilian authorities. RESULTS Sixty-five (21.3%) justice-involved veterans reported lifetime SCRA use. Use while within the military was reported by 15.0% of veterans enlisting after 2008. Only eight (12.3%) reported SCRAs were used as a substitute for cannabis. Boredom (36.9%), experimentation (27.7%), and social aspects of SCRA use (32.3%) were more commonly reported motives. Logistic regression models indicated that use of cannabis (aPR=2.06, p<.05), hallucinogens (aPR=2.50, p<.01), and SCRAs (aPR=2.49, p<.05) while in the military were risk factors for SCRA use after leaving the military, whereas older age at time of military exist was a protective factor (aPR=.87, p<.01) CONCLUSIONS: Drug testing programs within the military do not appear to have the unintended consequence of routing individuals to more risky drugs; however, SCRAs appear to have been an underappreciated problem within the military. Further, use extends beyond the military with many only initiating use after discharge, suggesting SCRA use may jeopardize the health of veterans post-service.
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Affiliation(s)
- Orion Santangelo
- Department of Criminal Justice and Criminology, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC 28223-0001, United States; Loss Prevention Research Council, 747 SW 2nd Ave, Gainesville, FL 32601, United States
| | - Julie Marie Baldwin
- Department of Justice, Law & Criminology, American University, 4400 Massachusetts Avenue NW, Washington, DC 20016-8043, United States
| | - John Stogner
- Department of Criminal Justice and Criminology, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC 28223-0001, United States.
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Gish A, Dumestre-Toulet V, Richeval C, Wiart JF, Hakim F, Allorge D, Gaulier JM. Trends in pharmaceutical design of new psychoactive substances detected in oral fluid of drivers around a music festival in south-west France: comparison 2019/2017. Curr Pharm Des 2022; 28:1245-1249. [PMID: 35585812 DOI: 10.2174/1381612828666220517160545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/16/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE new psychoactive substance use (NPS) is a reality in France, including among drivers. This work aims (i) to report pharmaceutical design of NPS detected in oral fluid (OF) from drivers initially screened for drugs around a music festival in 2019, and (ii) to compare obtained results with those of a previous similar study carried out in 2017 in the same situation (and the same music festival) and according to the same methodology. METHODS OF specimens were recovered from the used devices of the salivary immunochemical tests used by the police during the controls carried out at the entering and leaving the festival. These OF were analyzed using a liquid chromatography coupled with tandem mass spectrometry and high-resolution mass spectrometry methods using mass spectra libraries of approximately 1700 substances including (in 2020) more than 650 NPS and metabolites. RESULTS NPS were detected in 14 out of the 265 collected OF specimens. Ten NPS were identified (number of identification): APINACA (1), AB-Chminaca (1), 5F-AMB (1), 5F-PB-22 (5), 2C-D (1), methoxetamine (2), ketamine (1), x-CMC (1), 4-MEC (2), ethylone (2). The prevalence of NPS detection in OF (5.2%) is in the same order than the observed one in 2017 (6.8%) but these results are marked by the majority and increasing proportion of synthetic cannabinoids (47% of identified NPS in 2019 vs 25% in 2017), an increase also in the proportion of cathinone derivatives (29% in 2019 vs 6 % in 2017), and a decrease in cyclohexanones (17% in 2019 vs 43% in 2017). CONCLUSION these pharmaceutical design trends (2019 vs 2017) observed in a population of drivers around a music festival seem to reflect those that can be seen in more general populations in France, with probably a rise in the consumption of synthetic cannabinoids.
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Affiliation(s)
- Alexandr Gish
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille, France
| | | | - Camille Richeval
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille, France.,Univ. Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Lille, France
| | | | - Florian Hakim
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille, France.,Univ. Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Lille, France
| | - Delphine Allorge
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille, France.,Univ. Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Lille, France
| | - Jean-Michel Gaulier
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille, France.,Univ. Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Lille, France
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Smith CR, Swortwood MJ. Analysis of methylphenidate, ethylphenidate, lisdexamfetamine, and amphetamine in oral fluid by liquid chromatography-tandem mass spectrometry. J Forensic Sci 2022; 67:669-675. [PMID: 34985135 DOI: 10.1111/1556-4029.14977] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 11/30/2022]
Abstract
Oral fluid is an alternative matrix that has proven to be useful for the detection of drugs. Oral fluid is easy to collect, noninvasive, and may indicate recent drug use. There are limited methods available that analyze cognitive stimulants in oral fluid. Cognitive stimulants are used to treat attention-deficit/hyperactivity disorder (ADHD), a neurological disorder that emerges from lack of dopamine in the brain. To combat this disorder, medications inhibit dopamine and norepinephrine reuptake by blocking transporters in the brain. Though commonly diagnosed in children, ADHD may extend beyond adolescence and abuse of medications in college students is not uncommon. The goal of this study was to develop and validate a quantitative method for methylphenidate, ethylphenidate, lisdexamfetamine, and amphetamine in oral fluid using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Analytes were isolated by solid-phase extraction and analyzed on an Agilent 1290 Infinity II Liquid Chromatograph coupled to an Agilent 6470 Triple Quadrupole Mass Spectrometer. The linear range was 0.5-100 ng/ml (except lisdexamfetamine at 5-500 ng/ml). Bias and between-run precision were acceptable (±11.0% bias and ±12.2%CV). No interferences or carryover were observed and dilution integrity was sustained. This validated method was applied to four authentic oral fluid samples collected with Quantisal® devices from college students. Lisdexamfetamine was quantified in one sample at 5.8 ng/ml while amphetamine was quantified in all four samples at 6.0-78.8 ng/ml. This is the first known quantitative method in oral fluid that includes these analytes using LC-MS/MS and may give rise to interpretive value in a forensic toxicology setting.
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Affiliation(s)
- Christina R Smith
- Department of Forensic Science, Sam Houston State University, Huntsville, Texas, USA
| | - Madeleine J Swortwood
- Department of Forensic Science, Sam Houston State University, Huntsville, Texas, USA
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