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Holt AK, Anbil A, Combs MM, Sales ER, Boone EL, Poklis JL, Greer EL, Karaoghlanian N, Breland AB, Peace MR. The impact of vaping ethanol-containing electronic cigarette liquids on roadside impairment investigations. J Anal Toxicol 2023; 47:737-745. [PMID: 37522607 PMCID: PMC10627344 DOI: 10.1093/jat/bkad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/19/2023] [Accepted: 07/28/2023] [Indexed: 08/01/2023] Open
Abstract
Legal professionals and others have suggested that vaping electronic cigarettes (e-cigs) prior to or during ethanol breath testing may produce false positives. Preliminary breath tests (PBTs) and evidentiary breath tests (EBTs) measure ethanol in exhaled breath and standardized field sobriety tests (SFSTs) are used to assess impairment. Ethanol has been identified in e-cig liquids (e-liquids). Presented are a series of experiments designed to determine the mechanics of vaping ethanol using an e-cig and the effects of vaping ethanol on the SFSTs and breath tests used by law enforcement officers (LEO). Twelve participants (five females, age: 21-32 and seven males, age: 21-55), vaped either one or ten puffs of an e-liquid (0% or 20% ethanol). LEOs assessed impairment using SFSTs (12 and 42 min), PBTs (<1, 27, 32, 37 and 57 min) and EBTs (2, 29, 34, 39 and 59 min) post-vaping. A self-assessment test was administered post-vaping (22 and 52 min). Baseline responses for all measures were collected prior to vaping. Results demonstrated that ethanol in the e-liquids was aerosolized by e-cigs and produced particles that could reach the deep lung tissue based on mean-mass diameter. Ethanol was detected by PBT <3 min after participants vaped one (0.007-0.030 g/210 L) or ten puffs (013-0.074 g/210 L) of a 20% ethanol e-liquid. Ethanol was not detected by PBT at any subsequent time point. Ethanol was not detected by the EBT under any condition. Impairment was not indicated by the SFST. Some subjective effects were reported, but few statistically significant differences between conditions were indicated. A wait period prior to ethanol breath testing is not always mandated, depending on jurisdiction, or observed in all applications, such as workplace testing. The results demonstrate that a wait period must be employed to prevent vaping-related false-positive breath ethanol results.
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Affiliation(s)
- Alaina K Holt
- Department of Forensic Science, Virginia Commonwealth University, 1015 W Main Street, Room 2015, Richmond, VA 23284, United States
- Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, PO Box 842030, Richmond, VA 23284, United States
| | - Akansha Anbil
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, PO Box 842018, Richmond, VA 23284, United States
| | - Madison M Combs
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, PO Box 842018, Richmond, VA 23284, United States
| | - Erica R Sales
- Department of Forensic Science, Virginia Commonwealth University, 1015 W Main Street, Room 2015, Richmond, VA 23284, United States
| | - Edward L Boone
- Department of Statistical Sciences & Operations Research, Virginia Commonwealth University, 1015 Floyd Avenue, PO Box 843083, Richmond, VA 23284, United States
| | - Justin L Poklis
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, 1112 East Clay Street, PO Box 980613, Richmond, VA 23298, United States
| | - Edgar L Greer
- Virginia Commonwealth University Police Department, 224 East Broad Street, Richmond, VA 23219, United States
| | - Nareg Karaoghlanian
- Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, PO Box 11-0236, Riad El-Solh 1107 2020, Beirut, Lebanon
| | - Alison B Breland
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, PO Box 842018, Richmond, VA 23284, United States
| | - Michelle R Peace
- Department of Forensic Science, Virginia Commonwealth University, 1015 W Main Street, Room 2015, Richmond, VA 23284, United States
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Holt AK, Karin KN, Butler SN, Ferreira AR, Krotulski AJ, Poklis JL, Peace MR. Cannabinoid-based vaping products and supplement formulations reported by consumers to precipitate adverse effects. Drug Test Anal 2023; 15:1067-1076. [PMID: 35347865 PMCID: PMC10062403 DOI: 10.1002/dta.3253] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 01/26/2023]
Abstract
Cannabinoid-based products submitted by consumers experiencing adverse effects were analyzed to identify and quantitate ingredients. Product testing identified several synthetic cannabinoids and products with inaccurate or incomplete labeling.
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Affiliation(s)
- Alaina K. Holt
- Department of Forensic Science, Virginia Commonwealth University, Richmond, Virginia, USA
- Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kimberly N. Karin
- Department of Forensic Science, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Shelle N. Butler
- Department of Forensic Science, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Amanda R. Ferreira
- Department of Forensic Science, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Alex J. Krotulski
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, Willow Grove, Pennsylvania, USA
| | - Justin L. Poklis
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michelle R. Peace
- Department of Forensic Science, Virginia Commonwealth University, Richmond, Virginia, USA
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Holt AK, Rudy AK, Sawyer AN, Poklis JL, Breland AB, Peace MR. Survey of U.S. Residents and Their Usage of Electronic Cigarettes with Drugs Other Than Nicotine. J Psychoactive Drugs 2023:1-10. [PMID: 37632360 PMCID: PMC10895069 DOI: 10.1080/02791072.2023.2250353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/23/2023] [Accepted: 06/29/2023] [Indexed: 08/28/2023]
Abstract
Electronic cigarettes (e-cigs), originally intended to be used as cigarette substitutes, have evolved into discreet devices for consuming drugs other than nicotine (DOTNs). Presented are the results of an exploratory survey in which information regarding demographics, e-cig device type, DOTN use, frequency and context of use was collected. The average reported age of respondents was 27.4 years of age (SD = 12.0), and respondents predominantly identified as male (73%). Vape pens (disposable or refillable) were the most reported device across all DOTN classes. Cannabinoids were the most reported class of DOTN used, for both lifetime and past 30-day use. Other DOTNs reported included herbal supplements, amphetamines, caffeine, kratom, vitamins, opiates, DMT, fentanyl, and ketamine. Combinations of DOTNs used in e-cigs and trends in poly-substance use were reported. The most commonly reported context was vaping alone, followed by with friends, at home, and at social events; less commonly reported contexts included when driving, at work, and at school. Results from this study are useful for developing future national surveys to consider a comprehensive substance use-focused strategy that includes vaping, building awareness of DOTN e-cig use, and highlighting public safety issues in driving impairment, crime scene investigations, and death investigations.
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Affiliation(s)
- Alaina K Holt
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
- Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, Richmond, VA, USA
| | - Alyssa K Rudy
- Department of Psychology, Center for the Study of Tobacco Products, Richmond, VA, USA
| | - Ashlee N Sawyer
- Department of Psychology, Center for the Study of Tobacco Products, Richmond, VA, USA
| | - Justin L Poklis
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, VA, USA
| | - Alison B Breland
- Department of Psychology, Center for the Study of Tobacco Products, Richmond, VA, USA
| | - Michelle R Peace
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
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Holt AK, Poklis JL, Peace MR. The history, evolution, and practice of cannabis and E-cigarette industries highlight necessary public health and public safety considerations. J Safety Res 2023; 84:192-203. [PMID: 36868647 PMCID: PMC10829760 DOI: 10.1016/j.jsr.2022.10.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/29/2022] [Accepted: 10/25/2022] [Indexed: 06/18/2023]
Affiliation(s)
- Alaina K Holt
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, United States; Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, Richmond, VA, United States.
| | - Justin L Poklis
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, VA, United States.
| | - Michelle R Peace
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, United States.
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Akinola LS, Rahman Y, Ondo O, Cobb CO, Holt AK, Peace MR, Damaj MI. Impact of tobacco flavoring on oral nicotine consumption in C57BL/6J mice. Drug Alcohol Depend 2022; 241:109685. [PMID: 36370533 DOI: 10.1016/j.drugalcdep.2022.109685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The continued use of flavors in tobacco products has been a prominent factor in their popularity, yet little is known regarding their role in nicotine dependence. This study aimed to investigate the impact of tobacco flavoring on oral nicotine consumption in mice using the two-bottle choice (2BC) test and assessed the potential impact of age and sex in their interactions. METHODS Adolescent and adult male and female C57BL/6J mice were used. First, voluntary consumption of tobacco flavor concentrate from a commercial electronic cigarette liquid vendor (Avail Vapor LLC) was measured; then, the effects of tobacco flavoring in combination with nicotine were examined. In one approach, tobacco flavor concentration was kept constant while nicotine concentration varied, and in the second, nicotine was kept constant while the tobacco flavor concentration varied. RESULTS Overall, tobacco flavoring decreased oral nicotine consumption in mice, and its effects were sex- and age-dependent. Although females consumed the tobacco-flavored solution at a slightly higher rate than males, male mice were more sensitive to the effects of the combination (nicotine + tobacco). Furthermore, adolescent mice showed a starker reduction in nicotine consumption in the presence of tobacco flavoring compared to adult mice. This attenuation was most likely due to a basal aversion to the tobacco flavoring itself, thus, creating a negative synergistic effect with nicotine. CONCLUSIONS Tobacco flavoring increases aversion to nicotine in the 2BC test in C57BL6J mice, suggesting that some flavors may diminish rather than enhance oral nicotine consumption in rodents.
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Affiliation(s)
- Lois S Akinola
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA.
| | - Yumna Rahman
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
| | - Olivia Ondo
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
| | - Caroline O Cobb
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Alaina K Holt
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
| | - Michelle R Peace
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
| | - M Imad Damaj
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
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Holt AK, Poklis JL, Peace MR. ∆8-THC, THC-O Acetates and CBD-di-O Acetate: Emerging Synthetic Cannabinoids Found in Commercially Sold Plant Material and Gummy Edibles. J Anal Toxicol 2022; 46:940-948. [PMID: 35674405 PMCID: PMC9564187 DOI: 10.1093/jat/bkac036] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/12/2022] [Accepted: 06/07/2022] [Indexed: 01/26/2023] Open
Abstract
Presented is the analysis of four cannabinoid-based products. These products were part of a case involving visual and auditory hallucinations that precipitated the commission of a felony and subsequent arrest. The products were labeled to contain ∆8-tetrahydrocannabinol (∆8-THC) or THC acetate (THC-O-A). Primary reference materials were not available for ∆8-THC-O-A, ∆10-THC-O-A, cannabidiol di-acetate (CBD-di-O-A) or respective deuterated internal standards. THC-O-A and CBD-di-O-A standards were prepared by derivatizing ∆8-THC, ∆9-THC, ∆10-THC, CBD, ∆9-THC-d3 and CBD-d3 using acetic anhydride. The cannabinoid-based products were determined to contain ∆8-THC, ∆8-THC-O-A, ∆9-THC-O-A and CBD-di-O-A and/or other phytocannabinoids using three different analytical techniques. Direct analysis in real-time-time-of-flight mass spectrometry was used for identifying exact masses. A gas chromatograph-mass spectrometer was used for the identification of compounds and to quantitate THC-O-As in the products. A liquid chromatograph-tandem mass spectrometer was used to identify and quantitate phytocannabinoids and CBD-di-O-A in the products. To the authors' knowledge, this is the first case report involving the identification of THC-O-As and CBD-di-O-A in commercially available products. Minimal clinical/pharmacological data is available for these emerging synthetic cannabinoids/novel psychoactive substances.
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Affiliation(s)
- Alaina K Holt
- Department of Forensic Science, Virginia Commonwealth University, 1015 Floyd Avenue, Room 2015, Richmond, VA 23284, USA,Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, PO Box 84230, Richmond, VA 23284, USA
| | - Justin L Poklis
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, PO Box 980613, Richmond, VA 23298, USA
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Holt AK, Poklis JL, Peace MR. A Retrospective Analysis of Chemical Constituents in Regulated and Unregulated E-Cigarette Liquids. Front Chem 2021; 9:752342. [PMID: 34778207 PMCID: PMC8581558 DOI: 10.3389/fchem.2021.752342] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/27/2021] [Indexed: 01/26/2023] Open
Abstract
E-cigarette or vaping use-associated lung injury (EVALI) was identified with the incidents of a multi-state outbreak of acute lung injuries associated with the use of electronic cigarettes (e-cigs) and attributed to vitamin E acetate in off-market cannabis-based e-liquids. Aside from EVALI, hypersecretion of mucus, irritated nasal passages, and watery, red eyes have been defined as complaints associated with vaping standard nicotine-based e-liquids. The chemical composition of e-liquids varies between manufacturers and robust oversight of ingredients is lacking. Manufacturers use chemicals deemed "generally recognized as safe" (GRAS) by the FDA, a designation for chemicals used in foodstuffs to be ingested. Most "GRAS" chemicals are associated with at least one Global Harmonization System (GHS) warning class, ranging from irritant to toxic. Untargeted chemical analysis is critical to evaluate e-liquid products to determine chemical composition; equally important is the quantitation of components to help elucidate the potential harms from exceeding recommended exposure limits. Untargeted screening of e-liquids was accomplished using gas chromatography-mass spectrometry (GC-MS) and Direct Analysis in Real Time-AccuTOF™ mass spectrometry (DART-ToF-MS) and has identified 350 chemical constituents from 241 products analyzed. Nicotine, caffeine, menthol, and vitamin E were confirmed and quantitated by GC-MS, ethanol was confirmed and quantitated by headspace-gas chromatography-dual flame ionization detection (HS-GC-FID), and olivetol and cannabinoids were confirmed and quantitated by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Maximum identified concentrations of nicotine, caffeine, menthol, vitamin E, ethanol, olivetol, Δ9-tetrahydrocannabinol, and cannabidiol were 56.4, 26.9, 4.28, 307.9, 217.2, 399.6, 497.7, and 332.6 mg/ml, respectively. Evaluation of untargeted analysis and quantitation of unlabeled chemical components of e-liquids is essential to improving etiology of acute lung injury and less severe impacts of vaping, both short-term and long-term. The historical documentation of unlabeled ingredients can provide some insight for a retrospective analysis of health consequences and inform policy discussions.
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Affiliation(s)
- Alaina K. Holt
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, United States,Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, Richmond, VA, United States
| | - Justin L. Poklis
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, United States
| | - Michelle R. Peace
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, United States,*Correspondence: Michelle R. Peace,
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Holt AK, Poklis JL, Cobb CO, Peace MR. The Identification of Gamma-Butyrolactone in JUUL Liquids. J Anal Toxicol 2021; 45:892-900. [PMID: 34100536 DOI: 10.1093/jat/bkab067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/14/2021] [Accepted: 06/07/2021] [Indexed: 11/15/2022] Open
Abstract
Gamma-Butyrolactone (GBL), a commonly used industrial solvent, is used recreationally as a central nervous system (CNS) depressant and, therefore, a United States Drug Enforcement Agency (DEA) List 1 chemical of the Controlled Substances Act. GBL was identified presumptively in the liquid from JUUL Virginia Tobacco flavored pods during routine untargeted screening analysis of e-cigarette products by gas chromatography-mass spectrometry (GC-MS). Methods for the confirmation and quantitation of GBL were developed for GC-MS and liquid chromatography-tandem mass spectrometry (LC-MS-MS) in the liquids and the aerosol generated from the liquid. Three flavors of JUUL pods available at the time of analysis were obtained by direct purchase from the manufacturer, purchase from a local vape shop, and via submission from a 3rd party. The only liquid flavor to contain GBL was Virginia Tobacco, with an average of 0.37 mg/mL of GBL, and it was detected in the aerosol. Studies evaluating the pharmacological effects of inhaling GBL do not exist, however a case report of chronic oral GBL ingestion indicates acute lung injury. The identification of GBL in an e-cigarette product purportedly compliant with federal regulation continues to demonstrate public health and public safety concerns.
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Affiliation(s)
- Alaina K Holt
- Department of Forensic Science.,Integrative Life Sciences Doctoral Program
| | | | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Dudley ME, Nishimura MI, Holt AK, Rosenberg SA. Antitumor immunization with a minimal peptide epitope (G9-209-2M) leads to a functionally heterogeneous CTL response. J Immunother 1999; 22:288-98. [PMID: 10404430 DOI: 10.1097/00002371-199907000-00002] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The goal of experimental clinical protocols using peptide antigen for active vaccination and treatment of patients with metastatic cancer is to induce a vigorous cytotoxic T lymphocyte (CTL) response against the immunizing antigen, and thereby against tumor cells expressing the antigen. However, the magnitude and breadth of human CTL responses induced by peptide immunization, and in particular against antigens expressed by normal tissues as well as tumors, is not well characterized. This issue was examined by characterizing CTL cloids derived from peripheral blood mononuclear cells of three patients who received peptide immunization as treatment for metastatic melanoma. All patients received G9-209-2M peptide, a modified epitope of the gp100 melanoma-associated antigen. The results indicated that the CTL response induced by this peptide antigen was highly heterogeneous both in terms of avidity toward the peptide antigen and recognition of tumor cell lines. Furthermore, avidity of each CTL cloid for the native peptide was highly predictive of tumor reactivity. These results are discussed in terms of their implications for peptide vaccination and adoptive tumor immunotherapy.
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Affiliation(s)
- M E Dudley
- Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-1502, USA
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