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Marchei E, Graziano S, Varì MR, Minutillo A, Aquilina V, Pichini S, Rotolo MC. NPS-EQA PART I: Four years' experience in external quality assessment program in Italy for classical and new psychoactive substances analysis in oral fluid. J Pharm Biomed Anal 2024; 243:116084. [PMID: 38452420 DOI: 10.1016/j.jpba.2024.116084] [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: 01/23/2024] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024]
Abstract
In 2019, Italian National Institute of Health established an external quality assessment program (EQA) to evaluate the performance of oral fluid testing for classical and new psychoactive substances by laboratories participating in the National Early Warning System collaborative centres. This report presents the results of four rounds between 2019 and 2023. Eleven oral fluid specimens, including 3 blank samples, were prepared by adding different classes of and new psychoactive drugs at known concentrations to pre-screened drug-free oral fluid. False-negative and false-positive results were calculated for the qualitative data evaluation. The quantitative evaluation measured the imprecision and accuracy of the results, in terms of coefficient of variation (CV%) and percent error (ERR%), respectively, with respect to a mean value obtained by reference laboratories. Z-score values were then calculated. Over the years, there has been a significant improvement in false-negative results (from 42.7% in the first year to 19.4% in the last year), but not in false-positive results (from 33.3% in the first year to 22.2% in the last one). In addition to the classic drugs of abuse (e.g. cocaine, amphetamine, methadone), the substances found in false positive samples belonged to the class of synthetic cannabinoids (e.g 5-fluoro CUMYL-PINACA and 5-fluoro-EDMB-PICA), synthetic opioids (e.g butyrylfentanyl) and tryptamines (e.g. 5-methoxy-N-methyl-N-isopropyltryptamine). The four rounds yielded a mean ERR% of approximately 22.1% and a mean CV% of around 41.5%. The participating laboratories demonstrated variable performances in relation to the class of analysed psychoactive substances, as evidenced by the calculated Z-scores. Between 25% and 60% of the reported results in all rounds should be considered satisfactory. EQA is a crucial element of laboratory quality management systems. It promotes continuous improvement and maintains high standards in the field of forensic and clinical drug testing.
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Affiliation(s)
- Emilia Marchei
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Graziano
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Rosaria Varì
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Adele Minutillo
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Valeria Aquilina
- Investigation, Crime and International Security, Università degli Studi Internazionali di Roma - UNINT, Rome, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy.
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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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Harper CE, Hudson JS, Tidwell K, Boswell R, Yong HL, Maxwell AJ. Implementation of the first comprehensive state oral fluid drug testing program for roadside screening and laboratory testing in DUID cases-A 5-year review. J Anal Toxicol 2023; 47:694-702. [PMID: 37526020 DOI: 10.1093/jat/bkad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/07/2023] [Accepted: 07/31/2023] [Indexed: 08/02/2023] Open
Abstract
Oral fluid (OF) is a valuable specimen for driving under the influence of drugs (DUID) applications. This study demonstrates the implementation of the first comprehensive OF drug testing program in the United States, including approved roadside screening OF devices for law enforcement and validated liquid chromatography-tandem mass spectrometry (LC-MS-MS) confirmation methods. Three roadside OF screening devices were evaluated: the Dräger DrugTest® 5000, Abbott SoToxa®, and Randox Evidence MultiSTAT™. Two qualitative LC-MS-MS confirmation methods were validated per ASB Standard 036. The first method utilized an automated dispersive pipette extraction extraction using Integra and Hamilton STARlet platforms for drugs of abuse. The second method used a liquid-liquid extraction to detect cannabinoids. The prevalence of drugs in blood and OF was monitored over 5 years of casework. Calibration curves were analyzed with each batch to monitor OF concentrations for research purposes. Three roadside OF screening devices were deemed fit for purpose. Devices demonstrated appropriate sensitivity, specificity, positive and negative predictive values, and accuracy above 80% for targeted drugs except for benzodiazepines (DrugTest® 5000) and amphetamine (SoToxa®). The validated LC-MS-MS OF confirmation methods met the National Safety Council-recommended cutoffs for 18/21 (86%) of the targets. Over 5 years of casework, THC and cocaine were detected at a positivity rate of 90% and 97% in OF versus 75% and 44% in blood, respectively. OF:blood ratios exceeded unity for parent drugs. Median concentrations of THC in OF and blood were 31 and 3.5 ng/mL, respectively. OF is a viable alternative or supplemental specimen for DUID investigations. Collecting OF close to the driving event increases the opportunity to identify pharmacologically active substances, and when combined with blood analysis results, an elevated OF:blood ratio provides valuable information for DUID investigation purposes.
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Affiliation(s)
- Curt E Harper
- Alabama Department of Forensic Sciences, 2026 Valleydale Rd, Hoover, AL 35244, USA
| | - Jason S Hudson
- Quest Diagnostics, 10101 Renner Blvd, Lenexa, KS 66219, USA
| | - Kristin Tidwell
- Alabama Department of Forensic Sciences, 2026 Valleydale Rd, Hoover, AL 35244, USA
| | - Rebekah Boswell
- Alabama Department of Forensic Sciences, 2026 Valleydale Rd, Hoover, AL 35244, USA
| | - Hui Liu Yong
- Alabama Department of Forensic Sciences, 2026 Valleydale Rd, Hoover, AL 35244, USA
| | - Antoinette J Maxwell
- Alabama Department of Forensic Sciences, 2026 Valleydale Rd, Hoover, AL 35244, USA
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Nieddu M, Baralla E, Sodano F, Boatto G. Analysis of 2,5-dimethoxy-amphetamines and 2,5-dimethoxy-phenethylamines aiming their determination in biological matrices: a review. Forensic Toxicol 2023; 41:1-24. [PMID: 36652064 PMCID: PMC9849320 DOI: 10.1007/s11419-022-00638-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/19/2022] [Indexed: 01/22/2023]
Abstract
PURPOSE The present review aims to provide an overview of methods for the quantification of 2,5-dimethoxy-amphetamines and -phenethylamines in different biological matrices, both traditional and alternative ones. METHODS A complete literature search was carried out with PubMed, Scopus and the World Wide Web using relevant keywords, e.g., designer drugs, amphetamines, phenethylamines, and biological matrices. RESULTS Synthetic phenethylamines represent one of the largest classes of "designer drugs", obtained through chemical structure modifications of psychoactive substances to increase their pharmacological activities. This practice is also favored by the fact that every new synthetic compound is not considered illegal by existing legislation. Generally, in a toxicological laboratory, the first monitoring of drugs of abuse is made by rapid screening tests that sometimes can occur in false positive or false negative results. To reduce evaluation errors, it is mandatory to submit the positive samples to confirmatory methods, such as gas chromatography or liquid chromatography combined to mass spectrometry, for a more specific qualitative and quantitative analysis. CONCLUSIONS This review highlights the great need for updated comprehensive analytical methods, particularly when analyzing biological matrices, both traditional and alternative ones, for the search of newly emerging designer drugs.
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Affiliation(s)
- Maria Nieddu
- Department of Chemistry and Pharmacy, University of Sassari, 07100, Sassari, Italy.
| | - Elena Baralla
- grid.11450.310000 0001 2097 9138Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy
| | - Federica Sodano
- grid.4691.a0000 0001 0790 385XDepartment of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
| | - Gianpiero Boatto
- grid.11450.310000 0001 2097 9138Department of Chemistry and Pharmacy, University of Sassari, 07100 Sassari, Italy
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Savage T, Sanders T, Pieters R, Miles A, Barkholtz H. Suitability of SoToxa® Oral Fluid Screening Over Time: Re-examination of Drugged Driving in Wisconsin. J Anal Toxicol 2022; 46:825-834. [PMID: 35767245 DOI: 10.1093/jat/bkac047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/11/2022] [Accepted: 06/28/2022] [Indexed: 11/15/2022] Open
Abstract
Drug impaired driver detection is a critical element of traffic safety. However, shifting drug use patterns over time and geography may limit long-term reliability of assay-based screening tools. In this work, we compare qualitative results from the Abbott SoToxa® oral fluid (OF) screening device to Quantisal™ OF and whole blood. Our objective was to examine these three qualitative toxicological approaches, scope applicability of OF collection at the roadside, and compare to a previous analysis of SoToxa® in Wisconsin. OF specimens were screened with the SoToxa® for six drugs or drug classes including amphetamine, benzodiazepines, cocaine, methamphetamine, opioids, and tetrahydrocannabinol (THC). OF and blood specimens were collected from 106 participants. Quantisal™ OF and blood specimens were screened for drugs on ultra-performance liquid chromatography coupled to quadrupole time-of-flight high-resolution mass spectrometry (UPLC-QToF-HRMS) using a data independent acquisition mode. UPLC-QToF-HRMS data was compared to comprehensive spectral libraries and drugs were qualitatively identified. Drug Recognition Expert evaluations were performed, and face sheets submitted for 21 participants in this work. In general, the SoToxa® results were consistent with the combined qualitative results observed in Quantisal™ OF specimens and whole blood specimens. Limitations were uncovered for benzodiazepines, opioids, and THC. The SoToxa® benzodiazepine assay has high cutoff concentrations for diazepam and clonazepam, limiting its sensitivity and positive predictive value when considering these drugs. SoToxa® opioid screening did not detect fentanyl, which is increasingly prevalent among drug users. Finally, ∆9-THC and its major metabolite 11-nor-9-carboxy-∆9-THC are lipophilic, limiting partitioning into oral fluid. Despite these limitations, the SoToxa® instrument may be useful in assisting law enforcement with identifying individuals driving under the influence of drugs and establishing probable cause at roadside for making impaired driving arrests. Furthermore, Quantisal™ OF may be useful as screening specimens due to their ease of collection and results consistent with whole blood.
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Affiliation(s)
- Theodore Savage
- University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, Forensic Toxicology Section, 2601 Agriculture Drive, Madison, WI 53718, USA
| | - Therese Sanders
- Wisconsin Department of Transportation, Bureau of Transportation Safety and Technical Services, Chemical Testing Section, 3502 Kinsman Boulevard, Madison, WI 53704, USA
| | - Ryan Pieters
- University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, Forensic Toxicology Section, 2601 Agriculture Drive, Madison, WI 53718, USA
| | - Amy Miles
- University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, Forensic Toxicology Section, 2601 Agriculture Drive, Madison, WI 53718, USA
| | - Heather Barkholtz
- University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, Forensic Toxicology Section, 2601 Agriculture Drive, Madison, WI 53718, USA.,Pharmaceutical Sciences Division, University of Wisconsin-Madison, School of Pharmacy, 777 Highland Avenue, Madison, WI 53705, USA
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Shi Q, Fu J, Chen J, Wang J, Luo Y, Xie W. Rapid On-Site Detection of Various Amphetamine-Type Drugs in Human Urine and Hair by Portable Pulsed Direct Current Electrospray Ionization Mass Spectrometry. JOURNAL OF ANALYTICAL CHEMISTRY 2022. [DOI: 10.1134/s1061934822060132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Liut J, Bott U, Madea B, Krämer M, Maas A. Evaluation of RapidSTAT®, DrugWipe® 6S, DrugScreen® 5TK and DrugScreen® 7TR for on-site drug testing in German police roadside traffic patrol. Drug Test Anal 2022; 14:1407-1416. [PMID: 35343088 DOI: 10.1002/dta.3262] [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: 11/11/2021] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 11/07/2022]
Abstract
Driving under the influence of drugs (DUID) remains a subject of concern worldwide, and its increasing trend is likely to continue. Therefore, there is a constant need for reliable on-site drug tests to identify drugged drivers during roadside patrols. Performance and reliability of four on-site drug tests were evaluated among a high number of DUID cases in Germany. Results of oral fluid (OF) (RapidSTAT®, DrugWipe® 6S) and urine (DrugScreen® 5TK and 7TR) test devices were compared with corresponding serum/plasma results obtained by confirmation analyses in consideration of recommended analytical limits for substances pertaining the annex of the German Road Traffic Code ('Straßenverkehrsgesetz', StVG) s. 24a (2). Overall, the screening devices performed well for individual drugs; however, none of the test devices assessed in this study fulfilled the ROSITA-1 criteria (sensitivity, specificity ≥ 90%, and accuracy ≥ 95%) for all substances. Our data demonstrated that both urine tests showed high sensitivities for most compounds. DrugWipe® 6S (94%) and RapidSTAT® (93%) revealed high sensitivities, especially for amphetamine screening. Poor specificities (< 90%) and accuracies (< 95%) were observed for all tests except for low-prevalent substances (e.g. opiates). For drug testing in OF, Δ9 -tetrahydrocannabinol (THC) still seems to be a compound of concern due to poor sensitivity (RapidSTAT®, 77%; DrugWipe® 6S, 85%), although the results indicate improvements compared to previously reported data. Although the obtained data indicate reliable detection for some substances, deployment of trained police officers is inevitable to identify DUID suspects by signs of recent use and recognizing impairment.
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Affiliation(s)
- Jennifer Liut
- Institute of Forensic Medicine, Forensic Toxicology, University Hospital Bonn, Bonn, Germany
| | - Ulrich Bott
- North-Rhine Westphalia Police Force Central Support Services Bureau, Duisburg, Germany
| | - Burkhard Madea
- Institute of Forensic Medicine, Forensic Toxicology, University Hospital Bonn, Bonn, Germany
| | - Michael Krämer
- Institute of Forensic Medicine, Forensic Toxicology, University Hospital Bonn, Bonn, Germany
| | - Alexandra Maas
- Institute of Forensic Medicine, Forensic Toxicology, University Hospital Bonn, Bonn, Germany
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Emerging trends in point-of-care sensors for illicit drugs analysis. Talanta 2022; 238:123048. [PMID: 34801905 DOI: 10.1016/j.talanta.2021.123048] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/03/2021] [Accepted: 11/06/2021] [Indexed: 12/18/2022]
Abstract
Consumption of illicit narcotic drugs and fatal or criminal activities under their influence has become an utmost concern worldwide. These drugs influence an individual's feelings, perceptions, and emotions by altering the state of consciousness and thus can result in serious safety breaches at critical workplaces. Point-of-care drug-testing devices have become the need-of-the-hour for many sections such as the law enforcement agencies, the workplaces, etc. for safety and security. This review focuses on the recent progress on various electrochemical and optical nanosensors developed for the analysis of the most common illicit drugs (or their metabolites) such as tetrahydrocannabinol (THC), cocaine (COC), opioids (OPs), amphetamines & methamphetamine, and benzodiazepine (BZDs). The paper also highlights the sensitivity and selectivity of various sensing modalities along with evolving parameters such as real-time monitoring and measurement via a smart user interface. An overall outlook of recent technological advances in point of care (POC) devices and guided insights and directions for future research is presented.
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Anzillotti L, Dagoli S, Calò L, Maglietta G, Cecchi R. Road traffic deaths: A retrospective analysis (2009-2019) in the north of the Italian region Emilia Romagna. TRAFFIC INJURY PREVENTION 2021; 23:29-33. [PMID: 34882488 DOI: 10.1080/15389588.2021.2002853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 09/24/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE International literature and several national studies demonstrate that alcohol and illicit drugs impair driving abilities, diminishing the level of attention, and cause traffic accidents. In Italy, driving under the influence of alcohol or drugs is regulated by Articles 186 and 187 of the National Street Code, which defines penalties and fines for the convicted. The aim of this study was the collection of all available data from 2009 to 2019 focusing on deaths related to road accidents in the Unit of Legal Medicine of Department of Medicine and Surgery at the University of Parma, in order to assess any consumption of alcohol, illicit drugs, and medicinal drugs among drivers. METHODS Data were retrieved from autopsy reports found at the Unit of Legal Medicine of Parma University related to 327 subjects who died following road accidents in the Italian areas of Parma, Reggio-Emilia, and Piacenza. The population was divided into subgroups according to age, gender, crash time, and drug positivity. RESULTS Those in the age group 46 to 65 years old were involved in the most accidents, whereas the category with fewest members included subjects under 26 years old. The majority of road accidents occurred during the daytime and on weekends. Among the toxicological investigations carried out (only for drivers), the highest prevalence was found for alcohol (43.1%), followed by illicit drugs (14.4%) and medicinal drugs (7.8%). The prevalence of alcohol and illicit drugs in combination was 11.8%. Regarding subjects positive for alcohol and illicit drugs in combination, 44.4% had a blood alcohol concentration (BAC) > 1.5 g/L and overall, in 61.1% of the total cases a BAC > 0.81 g/L was detected. CONCLUSIONS Our results are in line with national and international studies highlighting the prevalence of high BAC levels in most of the cases. Confirmation analyses on blood collected from people who died following road accidents showed levels of BAC above 0.8 g/L (threshold for penal sanctions) in the majority of the subjects who tested positive for alcohol. They also revealed cocaine, cannabis, and benzodiazepines as the most common illicit drugs and medicinal drugs used, respectively, as demonstrated in several international studies.
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Affiliation(s)
- L Anzillotti
- Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - S Dagoli
- Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - L Calò
- Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Maglietta
- Research and Innovation Unit, University Hospital of Parma, Parma, Italy
| | - R Cecchi
- Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
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Knott J, Yap C, Mitra B, Gerdtz M, Daniel C, Braitberg G. Screening major trauma patients for prevalence of illicit drugs. Drug Alcohol Rev 2021; 41:285-292. [PMID: 34263497 DOI: 10.1111/dar.13355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Australasian emergency departments (ED) routinely test patient alcohol levels following major trauma, but assessment for illicit drugs is uncommon. METHODS A prospective cross-sectional study of major motor-vehicle-related trauma patients attending both adult major trauma centres in Victoria, Australia. All eligible patients had point-of-care saliva testing to determine the prevalence of common illicit drugs. RESULTS Over 12 months, 1411 patients were screened, 36 refused (2.6%) and 63 were excluded. Of the final 1312 cases included, 173 (13.2%; 95% confidence interval 11.5, 15.1) tested positive to at least one illicit substance, with 133 (76.9%; 69.7, 82.8) positive for meth/amphetamines. One in five had more than one illicit substance detected. Patients testing positive were most frequently in motor vehicles (91.9% vs. 85.6%) and least frequently cyclists (2.3% vs. 4.2%) or pedestrians (5.2% vs. 10.3%), compared to those testing negative. They were younger (mean age 35.4 vs. 43.1 years), more likely to arrive overnight (27.2% vs. 12.1%) or after single vehicle crashes (54.3% vs. 42.3%). Although the initial disposition from ED did not differ, those testing positive were more likely to re-present within 28 days (13.9% vs. 5.4%). DISCUSSION AND CONCLUSIONS A high prevalence of potentially illicit substances among patients presenting with suspected major trauma supports the need for urgent preventive strategies. The low rate of patient refusal and large numbers screened by ED staff suggests that point-of care testing for illicit substances in major trauma is acceptable and feasible. This study and ongoing surveillance may be used to inform driver education strategies.
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Affiliation(s)
- Jonathan Knott
- Emergency Department, Royal Melbourne Hospital, Melbourne, Australia
| | - Celene Yap
- Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Biswadev Mitra
- Emergency Department, Alfred Hospital, Melbourne, Australia
| | - Marie Gerdtz
- Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Catherine Daniel
- Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - George Braitberg
- Department of Medicine, Royal Melbourne Hospital, Melbourne, Australia
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Positivity to Cocaine and/or Benzoylecgonine in Confirmation Analyses for On-Road Tests in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105371. [PMID: 34070008 PMCID: PMC8157855 DOI: 10.3390/ijerph18105371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 11/16/2022]
Abstract
We are using real-life data in order to determine the prevalence of driving with the presence of cocaine and/or benzoylecgonine (BZE), their concentrations, and their use in combination with other drugs. This study assessed data on Spanish drivers with confirmed drug-positive results recorded by the Spanish National Traffic Agency from 2011-2016. Frequencies of positivity for cocaine and/or BZE and concentration of such substances were obtained. Comparisons and univariate and multivariate regression analyses were performed. Drivers who tested positive for cocaine and/or BZE accounted for 48.59% of the total positive results for drugs. In positive cases for both cocaine and BZE, other substances were detected in 81.74%: delta-9-tetrahydrocannabinol (THC) (68.19%), opioids (20.78%) and amphetamine-like substances (16.76%). In the multivariate logistic regression analysis, the frequency of cocaine and/or BZE positive cases decreased with age (OR:0.97) and were less likely among women (OR:0.63). Concentrations (ng/mL) of cocaine (249.30) and BZE (137.90) were higher when both substances were detected together than when detected alone. Positivity to cocaine represented an important proportion among Spanish drivers who tested positive for drugs, and polysubstance use was especially observed in more than 8 out of 10 positive cases for cocaine and/or BZE.
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Avcioglu G, Yilmaz G, Yalcin Sahiner S, Kozaci LD, Bal C, Yilmaz FM. Evaluation of the diagnostic performance of an oral fluid screening test device for substance abuse at traffic controls. Clin Biochem 2021; 93:112-118. [PMID: 33882283 DOI: 10.1016/j.clinbiochem.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 03/22/2021] [Accepted: 04/03/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the analytical performance of the Kite Biotechnology Oral fluid (OF) screening test device, which is used for roadside screening of cannabis, opiates, amphetamines, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), cocaine and benzodiazepines by comparing samples with matched plasma samples, analysed via liquid chromatography-tandem mass spectrometry (LC-MS/MS) for confirmation. METHODS OF and plasma samples were obtained simultaneously from a total of 100 subjects. OF samples were analysed by OF screening test based on immunochromatography. The OF screening test cut-off values were 50 ng/mL for amphetamines (d-amphetamine) and methamphetamine/MDMA (d-methamphetamine), 30 ng/mL for cocaine (benzoylecgonine), 40 ng/mL for opiates (morphine), 20 ng/mL for benzodiazepines (nordazepam), and 25 ng/mL for cannabis (Δ9-tetrahydrocannabinol). LC-MS/MS method validation was performed according to the CLSI C62-A recommendations with the following parameters: matrix effect, lower limit of quantification (LLOQ), linearity, intra-day and inter-day precision and accuracy. RESULTS The overall specificity, accuracy and negative predictive values (NPV) were acceptable and met the DRUID standard of >80%. The OF screening test device showed good sensitivity for cocaine, amphetamines and opiates, whereas it indicated poor sensitivity for methamphetamine/MDMA (66.7%) and failed to detect cannabis and benzodiazepines. CONCLUSION The present study is the first report to evaluate the Kite Biotechnology OF screening test device. The diagnostic performance of the OF screening test device was acceptable for opiates, cocaine and amphetamines, but it was insufficient for methamphetamine/MDMA, benzodiazepines and cannabis because of sensitivity issues.
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Affiliation(s)
- Gamze Avcioglu
- Department of Medical Biochemistry, Karadeniz Ereğli State Hospital, Zonguldak, Turkey.
| | - Gulsen Yilmaz
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | | | - L Didem Kozaci
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Ceylan Bal
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Fatma Meric Yilmaz
- Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
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Alcañiz M, Guillen M, Santolino M. Differences in the risk profiles of drunk and drug drivers: Evidence from a mandatory roadside survey. ACCIDENT; ANALYSIS AND PREVENTION 2021; 151:105947. [PMID: 33385961 DOI: 10.1016/j.aap.2020.105947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 10/31/2020] [Accepted: 12/09/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The study assesses the prevalence rates of alcohol- and drug-involved driving in Catalonia (Spain). METHOD Drivers were randomly selected for roadside testing using a stratified random sampling procedure representative of all vehicles circulating on non-urban roads. Mandatory alcohol and drug tests were performed during autumn 2017. A sample of 6860 drivers were tested for alcohol use, of these 671 were also tested for drugs. Standard procedures were employed by traffic officers to detect alcohol and drug use. Alcohol breath tests were performed with breathalyser devices and on-site drug screening systems were used to test for drugs. RESULTS The prevalence of alcohol use above the legal limit and drug use were 1.2 % (95 % CI: 0.9-1.5 %) and 8.3 % (95 % CI: 5.8-11.2 %), respectively. The most frequent drugs detected were THC (5.6 %, 95 % CI: 3.7-8.0 %), cocaine (3.5 %, 95 % CI: 2.0-5.5 %) and amphetamines (1.6 %, 95 % CI: 0.6-3.4 %). Alcohol use was detected more frequently on conventional roads, at weekends and during night-time hours. Drug use was detected more frequently in young males during daytime hours. CONCLUSIONS Driver risk profiles associated with alcohol use and drug use differ. Positive alcohol use is not a predictor of drug use when controlling for all other factors.
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Affiliation(s)
- Manuela Alcañiz
- Department of Econometrics Riskcenter-IREA, University of Barcelona, Barcelona, Spain
| | - Montserrat Guillen
- Department of Econometrics Riskcenter-IREA, University of Barcelona, Barcelona, Spain
| | - Miguel Santolino
- Department of Econometrics Riskcenter-IREA, University of Barcelona, Barcelona, Spain.
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14
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Alvarez JC, Hartley S, Etting I, Ribot M, Derridj-Ait-Younes N, Verstuyft C, Larabi IA, Simon N. Population pharmacokinetic model of blood THC and its metabolites in chronic and occasional cannabis users and relationship with on-site oral fluid testing. Br J Clin Pharmacol 2021; 87:3139-3149. [PMID: 33386756 DOI: 10.1111/bcp.14724] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/01/2020] [Accepted: 12/26/2020] [Indexed: 10/22/2022] Open
Abstract
AIMS To develop a population pharmacokinetic (PP) model of delta-9-tetrahydrocannabinol (THC) and its metabolites in blood and to determine the relationship between blood THC pharmacokinetics and results of on-site oral fluid (OF) testing in chronic (CC) and occasional (OC) cannabis users. METHODS Fifteen CC (1-2 joints/day) and 15 OC (1-2 joints/week) aged 18-34 years were included, genotyped for their CYP2C9 polymorphisms. Twelve measurements of blood THC, 11-OH-THC and THC-COOH were carried out during the 24-hour period after controlled cross-over random inhalation of placebo, 10 mg or 30 mg of THC. OF tests (DrugWipe® 5S) were performed up to 6 hours and then stopped after two successive negative results. The blood concentrations and their relationship to OF testing results were analysed using a PP approach with NONMEM® and R. RESULTS A three-compartment model described the pharmacokinetics of THC, with zero-order absorption, and a two-compartment model the metabolites. The fraction of THC converted to 11-OH-THC was 0.27 and the fraction of 11-OH-THC to THC-COOH was 0.86. Smoking 30 mg of THC decreased the THC bioavailability to 0.68 compared to 10 mg. CC showed a 2.41 greater bioavailability than OC, leading to higher Cmax and AUC for the three compounds for the same dose. The best model describing the probability of a positive OF test included THC blood concentration and the group as covariate: for a similar THC blood concentration, a CC was less likely to be positive than an OC. CONCLUSION OC are more likely to screen positive than CC for a similar blood concentration.
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Affiliation(s)
- Jean Claude Alvarez
- Service de Pharmacologie Toxicologie, Assistance Publique-Hôpitaux de Paris, Hôpital Raymond Poincaré, Garches, France.,MasSpecLab, Plateforme de Spectrométrie de Masse, INSERM U-1173, Université Paris Saclay, Montigny-le-Bretonneux, France
| | - Sarah Hartley
- Sleep Centre, Service d'Explorations Fonctionnelles, Inserm U-1179, Assistance Publique-Hôpitaux de Paris, Hôpital Raymond Poincaré, Garches, France
| | - Isabelle Etting
- Service de Pharmacologie Toxicologie, Assistance Publique-Hôpitaux de Paris, Hôpital Raymond Poincaré, Garches, France
| | - Mégane Ribot
- Service de Pharmacologie Toxicologie, Assistance Publique-Hôpitaux de Paris, Hôpital Raymond Poincaré, Garches, France
| | - Nawal Derridj-Ait-Younes
- Unité de Recherche Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | - Céline Verstuyft
- Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, EquipeMoods, INSERM U-1178, CESP, Université Paris-Sud, Le Kremlin Bicêtre, France
| | - Islam-Amine Larabi
- Service de Pharmacologie Toxicologie, Assistance Publique-Hôpitaux de Paris, Hôpital Raymond Poincaré, Garches, France.,MasSpecLab, Plateforme de Spectrométrie de Masse, INSERM U-1173, Université Paris Saclay, Montigny-le-Bretonneux, France
| | - Nicolas Simon
- APHM, INSERM, IRD, SESSTIM, Hôpital Sainte Marguerite Pharmacologie Clinique CAP-TV, Aix Marseille Univ, Marseille, France
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15
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Desharnais B, Lajoie MJ, Laquerre J, Mireault P, Skinner CD. A threshold LC-MS/MS method for 92 analytes in oral fluid collected with the Quantisal® device. Forensic Sci Int 2020; 317:110506. [PMID: 33035929 DOI: 10.1016/j.forsciint.2020.110506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 11/30/2022]
Abstract
A study of impaired driving rates in the province of Québec is currently planned following the legalization of recreational cannabis in Canada. Oral fluid (OF) samples are to be collected with a Quantisal® device and sent to the laboratory for analysis. In order to prepare for this project, a qualitative decision point analysis method monitoring for the presence of 97 drugs and metabolites in OF was developed and validated. This high throughput method uses incubation with a precipitation solvent (acetone:acetonitrile 30:70 v:v) to boost drug recovery from the collecting device and improve stability of benzodiazepines (e.g., α-hydroxyalprazolam, clonazepam, 7-aminoclonazepam, flunitrazepam, 7-aminoflunitrazepam, N-desmethylflunitrazepam, nitrazepam). The Quantisal® device has polyglycol in its stabilizing buffer, but timed use of the mass spectrometer waste valve proved sufficient to avoid the glycol interferences for nearly all analytes. Interferences from OF matrices and 140 potentially interfering compounds, carryover, ion ratios, stability, recovery, reproducibility, robustness, false positive rate, false negative rate, selectivity, sensitivity and reliability rates were tested in the validation process. Five of the targeted analytes (olanzapine, oxazepam, 7-aminoclonazepam, flunitrazepam and nitrazepam) did not meet the set validation criteria but will be monitored for identification purposes (no comparison to a cut-off level). Blind internal proficiency testing was performed, where six OF samples were tested and analytes were classified as "negative", "likely positive" or "positive" with success. The final validated OF qualitative decision point method covers 92 analytes, and the presence of 5 additional analytes is screened in this high throughput analysis.
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Affiliation(s)
- Brigitte Desharnais
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec, H2K 3S7, Canada; Concordia University, Department of Chemistry & Biochemistry, 7141 Sherbrooke Street West, Montréal, Québec, H4B 1R6, Canada.
| | - Marie-Jo Lajoie
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec, H2K 3S7, Canada
| | - Julie Laquerre
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec, H2K 3S7, Canada
| | - Pascal Mireault
- Laboratoire de sciences judiciaires et de médecine légale, Department of Toxicology, 1701 Parthenais Street, Montréal, Québec, H2K 3S7, Canada
| | - Cameron D Skinner
- Concordia University, Department of Chemistry & Biochemistry, 7141 Sherbrooke Street West, Montréal, Québec, H4B 1R6, Canada
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16
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Scherer J, Schuch J, Rabelo-da-Ponte F, Silvestrin R, Ornell R, Sousa T, Limberger R, Pechansky F. Analytical reliability of four oral fluid point-of-collection testing devices for drug detection in drivers. Forensic Sci Int 2020; 315:110434. [DOI: 10.1016/j.forsciint.2020.110434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/21/2022]
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17
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Lobegeier V, Chaseling J, Cresswell S, Krosch MN, Wright K. Comparison of in-scene presumptive tests for the detection of Cannabis traces on the inner surfaces of clip seal plastic bags. AUST J FORENSIC SCI 2020. [DOI: 10.1080/00450618.2020.1823474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Vanessa Lobegeier
- Scientific Section, Forensic Services Group, Queensland Police Service, Cairns, Australia
| | - Janet Chaseling
- School of Environment and Science, Griffith University, Nathan, Australia
| | - Sarah Cresswell
- School of Environment and Science, Griffith University, Nathan, Australia
| | - Matt N. Krosch
- Quality Management Section, Forensic Services Group, Queensland Police Service, Brisbane, Australia
| | - Kirsty Wright
- Genomics Research Centre, Institute of Health & Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia
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18
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Klimuntowski M, Alam MM, Singh G, Howlader MMR. Electrochemical Sensing of Cannabinoids in Biofluids: A Noninvasive Tool for Drug Detection. ACS Sens 2020; 5:620-636. [PMID: 32102542 DOI: 10.1021/acssensors.9b02390] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Cannabinoid sensing in biofluids provides great insight into the effects of medicinal cannabis on the body. The prevalence of cannabis for pain management and illicit drug use necessitates knowledge translation in cannabinoids. In this Review, we provide an overview of the current detection methods of cannabinoids in bodily fluids emphasizing electrochemical sensing. First, we introduce cannabinoids and discuss the structure and metabolism of Δ9-THC and its metabolites in relation to blood, urine, saliva, sweat, and breath. Next, we briefly discuss lab based techniques for cannabinoids in biofluids. While these techniques are highly sensitive and specific, roadside safety requires a quick, portable, and cost-effective sensing method. These needs motivated a comprehensive review of advantages, disadvantages, and future directions for electrochemical sensing of cannabinoids. The literature shows the lowest limit of detection to be 3.3 pg of Δ9-THC/mL using electrochemical immunosensors, while electrodes fabricated with low cost methods such as screen-printing and carbon paste can detect as little as 25 and 1.26 ng of Δ9-THC/mL, respectively. Future research will include nanomaterial modified working electrodes, for simultaneous sensing of multiple cannabinoids. Additionally, there should be an emphasis on selectivity for cannabinoids in the presence of interfering compounds. Sensors should be fully integrated on biocompatible substrates with control electronics and intelligent components for wearable diagnostics. We hope this Review will prove to be the seminal work in the electrochemical sensing of cannabinoids.
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Affiliation(s)
- Martin Klimuntowski
- Department of Electrical and Computer Engineering, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada
| | - Maksud M. Alam
- Department of Electrical and Computer Engineering, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada
| | - Gurmit Singh
- Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada
| | - Matiar M. R. Howlader
- Department of Electrical and Computer Engineering, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada
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19
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Herrera-Gómez F, García-Mingo M, Álvarez FJ. Benzodiazepines in the oral fluid of Spanish drivers. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:18. [PMID: 32093743 PMCID: PMC7038549 DOI: 10.1186/s13011-020-00260-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 02/11/2020] [Indexed: 12/11/2022]
Abstract
Background Driving under the influence of alcohol, illicit drugs and certain medicines is not allowed worldwide. Roadside drug testing is considered an important tool for determining such behavior. In Spain, mandatory roadside oral fluid drug testing is carried out regularly. The aim of this study was to determine the prevalence of benzodiazepines and benzodiazepines in combination with other drugs in drivers, examine benzodiazepine concentrations in drivers, and analyze the association of these factors with age and sex. Methods This study assessed data on Spanish drivers with confirmed drug-positive results recorded by the Spanish National Traffic Agency (Dirección General de Tráfico) between 2011 and 2016, accounting for 179,645 tests and 65,244 confirmed drug-positive tests. Results Benzodiazepines were confirmed in 4.3% of all positive roadside drug tests. In most of those cases (97.1%), other substances were also detected, particularly cocaine (75.3%) and cannabis (64.0%). The frequency of benzodiazepine-positive drivers (OR, 1.094; 95% CI, 1.088–1.100) increased with age, while the frequency of drivers who tested positive for benzodiazepines in conjunction with other substances, compared with drivers who tested positive for benzodiazepines alone, decreased with age (OR, 0.903; 95% CI, 0.825–0.988). Nordiazepam (54.8%) and alprazolam (46.9%) were the most common benzodiazepines detected. Conclusion Concomitant use of benzodiazepines and other psychoactive substances was found to be a common behavior among drivers who tested positive on the road. It is important to raise awareness of all those involved in the consumption of driving-impairing substances (authorities, healthcare providers, patients and their families, etc.): roadside detection of driving-impairing substances is suggested, in addition to promoting the use of fewer driving-impairing medications and the provision of clear information to patients.
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Affiliation(s)
- Francisco Herrera-Gómez
- Pharmacological Big Data Laboratory, Pharmacology, Faculty of Medicine, University of Valladolid, Valladolid, Spain.,Nephrology, Hospital Virgen de la Concha - Sanidad de Castilla y León, Zamora, Spain
| | - Mercedes García-Mingo
- Pharmacological Big Data Laboratory, Pharmacology, Faculty of Medicine, University of Valladolid, Valladolid, Spain
| | - F Javier Álvarez
- Pharmacological Big Data Laboratory, Pharmacology, Faculty of Medicine, University of Valladolid, Valladolid, Spain. .,CEIm, Hospital Clínico Universitario de Valladolid - Sanidad de Castilla y León, Valladolid, Spain.
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20
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Risoluti R, Gullifa G, Buiarelli F, Materazzi S. Real time detection of amphetamine in oral fluids by MicroNIR/Chemometrics. Talanta 2020; 208:120456. [PMID: 31816788 DOI: 10.1016/j.talanta.2019.120456] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/03/2019] [Accepted: 10/07/2019] [Indexed: 01/29/2023]
Abstract
In this work, a novel coupled approach MicroNIR/Chemometrics based on a miniaturized and portable spectrometer is proposed for the on site detection of amphetamines (AMP) in non pretreated oral fluids. In particular, the coupling of MicroNIR with chemometrics was investigated with the aim of developing a fast and accurate approach able to perform the on-site prediction of AMP abuse. A predictive model to be used in real cases was developed by collecting specimens from volunteers and spiked samples with increasing amounts of AMP were prepared to optimize calibration. Partial Least Square-Discriminant Analysis (PLS-DA) and Partial Least Square regression (PLS) were involved to detect and quantify AMP. Results demonstrated that MicroNIR/Chemometric platform is statistically able to identify AMP abuse in simulated oral fluid samples containing, with the accuracy and sensitivity of the actual proposed official reference methods. The method was checked against false positive and true positive response and results proved to be those required for confirmatory analyses. This method would permit to simplify AMP abuse monitoring for roadside drug testing or workplace surveillance and may be of help at first aid points.
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Affiliation(s)
- Roberta Risoluti
- Department of Chemistry -"Sapienza" University of Rome, P.le A.Moro 5, 00185, Rome, Italy.
| | - Giuseppina Gullifa
- Department of Chemistry -"Sapienza" University of Rome, P.le A.Moro 5, 00185, Rome, Italy
| | - Francesca Buiarelli
- Department of Chemistry -"Sapienza" University of Rome, P.le A.Moro 5, 00185, Rome, Italy
| | - Stefano Materazzi
- Department of Chemistry -"Sapienza" University of Rome, P.le A.Moro 5, 00185, Rome, Italy
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21
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Accioni F, Nieddu M, Corona P, Boatto G. Hexanol-Based Supramolecular Solvents Tool for the Determination of 11 Illicit Phenethylamines in Oral Fluid by LC-MS/MS. J Anal Toxicol 2020; 44:15-21. [PMID: 31095695 DOI: 10.1093/jat/bkz039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/19/2019] [Accepted: 04/18/2019] [Indexed: 11/14/2022] Open
Abstract
Monitoring of new phenethylamine designer drugs in oral fluid (OF) is a crucial aim in workplace testing and driving under the influence of drug programs. In this study a simple and very quick method for the quantification of 11 illicit drugs in OF, which gave negative results to immunoassay tests, is proposed. Sample treatment and extraction of analytes were simultaneously achieved by applying supramolecular solvents (SUPRAS) tool. Chromatographic separation and compounds quantification were carried out by liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Efficacy of cleaning-up/extraction of this SUPRAS approach was fully confirmed by recovery and matrix effect results. The entire analytical procedure was validated following the international guidelines. The SUPRAS extraction coupled with LC-MS/MS resulted in powerful tool for the control of phenethylamines abuse, with rapid run time and minimal sample preparation. The use of this methodology could be easily extended to monitoring of other drugs of abuse.
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Affiliation(s)
- Francesca Accioni
- Department of Chemistry and Pharmacy, University of Sassari, Italy.,Department of Analytical Chemistry, Institute of Fine Chemistry and Nanochemistry, University of Córdoba, Spain
| | - Maria Nieddu
- Department of Chemistry and Pharmacy, University of Sassari, Italy
| | - Paola Corona
- Department of Chemistry and Pharmacy, University of Sassari, Italy
| | - Gianpiero Boatto
- Department of Chemistry and Pharmacy, University of Sassari, Italy
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22
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Potential analytical methods for on-site oral drug test: Recent developments and applications. Trends Analyt Chem 2019. [DOI: 10.1016/j.trac.2019.115649] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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23
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Bianchi F, Agazzi S, Riboni N, Erdal N, Hakkarainen M, Ilag LL, Anzillotti L, Andreoli R, Marezza F, Moroni F, Cecchi R, Careri M. Novel sample-substrates for the determination of new psychoactive substances in oral fluid by desorption electrospray ionization-high resolution mass spectrometry. Talanta 2019; 202:136-144. [DOI: 10.1016/j.talanta.2019.04.057] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 11/28/2022]
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24
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Desrosiers NA, Huestis MA. Oral Fluid Drug Testing: Analytical Approaches, Issues and Interpretation of Results. J Anal Toxicol 2019; 43:415-443. [DOI: 10.1093/jat/bkz048] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/12/2019] [Accepted: 05/23/2019] [Indexed: 12/19/2022] Open
Abstract
AbstractWith advances in analytical technology and new research informing result interpretation, oral fluid (OF) testing has gained acceptance over the past decades as an alternative biological matrix for detecting drugs in forensic and clinical settings. OF testing offers simple, rapid, non-invasive, observed specimen collection. This article offers a review of the scientific literature covering analytical methods and interpretation published over the past two decades for amphetamines, cannabis, cocaine, opioids, and benzodiazepines. Several analytical methods have been published for individual drug classes and, increasingly, for multiple drug classes. The method of OF collection can have a significant impact on the resultant drug concentration. Drug concentrations for amphetamines, cannabis, cocaine, opioids, and benzodiazepines are reviewed in the context of the dosing condition and the collection method. Time of last detection is evaluated against several agencies' cutoffs, including the proposed Substance Abuse and Mental Health Services Administration, European Workplace Drug Testing Society and Driving Under the Influence of Drugs, Alcohol and Medicines cutoffs. A significant correlation was frequently observed between matrices (i.e., between OF and plasma or blood concentrations); however, high intra-subject and inter-subject variability precludes prediction of blood concentrations from OF concentrations. This article will assist individuals in understanding the relative merits and limitations of various methods of OF collection, analysis and interpretation.
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Affiliation(s)
| | - Marilyn A Huestis
- Lambert Center for the Study of Medicinal Cannabis and Hemp, Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA, USA
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25
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Renaud-Young M, Mayall RM, Salehi V, Goledzinowski M, Comeau FJ, MacCallum JL, Birss VI. Development of an ultra-sensitive electrochemical sensor for Δ9-tetrahydrocannabinol (THC) and its metabolites using carbon paper electrodes. Electrochim Acta 2019. [DOI: 10.1016/j.electacta.2019.02.117] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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26
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Hu B, Zheng B, Rickert D, Gómez-Ríos GA, Bojko B, Pawliszyn J, Yao ZP. Direct coupling of solid phase microextraction with electrospray ionization mass spectrometry: A Case study for detection of ketamine in urine. Anal Chim Acta 2019; 1075:112-119. [PMID: 31196416 DOI: 10.1016/j.aca.2019.05.044] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 12/28/2022]
Abstract
Electrospray ionization mass spectrometry (ESI-MS) is a commonly used technique for analysis of various samples. Solid phase microextraction (SPME) is a simple and efficient technique that combines both sampling and sample preparation into one consolidated step, preconcentrating extracted analytes for ultra-sensitive analysis. Historically, SPME has been coupled with chromatography-based techniques for sample separation prior to analysis, however more recently, the chromatographic step has been omitted, with the SPME device directly coupled with the mass spectrometer. In this study, direct coupling of SPME with ESI-MS was developed, and extensively validated to quantitate ketamine from human urine, employing a practical experimental workflow and no extensive hardware modification to the equipment. Among the different fibers evaluated, SPME device coated with C18/benzenesulfonic acid particles was selected for the analysis due to its good selectivity and signal response. Different approaches, including desorption spray, dripping, desorption ESI and nano-ESI were attempted for elution and ionization of the analytes extracted using the SPME fibers. The results showed that the desorption spray and nano-ESI methods offered better signal response and signal duration than the others that were evaluated. The analytical performance of the SPME-nano-ESI-MS setup was excellent, including limit of detection (LOD) of 0.027 ng/mL, limit of quantitation (LOQ) of 0.1 ng/mL, linear range of 0.1-500.0 ng/mL (R2 = 0.9995) and recoveries of 90.8-109.4% with RSD 3.4-10.6% for three validation points at 4.0, 40.0 and 400.0 ng/mL, far better than the performance of conventional methods. The results herein presented, demonstrated that the direct coupling of SPME fibers with ESI-MS-based systems allowed for the simple and ultra-sensitive determination of analytes from raw samples such as human urine.
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Affiliation(s)
- Bin Hu
- State Key Laboratory of Chemical Biology and Drug Discovery, Food Safety and Technology Research Centre and Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, China; State Key Laboratory of Chinese Medicine and Molecular Pharmacology (Incubation) and Shenzhen Key Laboratory of Food Biological Safety Control, Shenzhen Research Institute of The Hong Kong Polytechnic University, Shenzhen, 518057, China; Institute of Mass Spectrometer and Atmospheric Environment, Guangdong Provincial Engineering Research Center for On-line Source Apportionment System of Air Pollution, Jinan University, Guangzhou, 510632, China
| | - Bo Zheng
- State Key Laboratory of Chemical Biology and Drug Discovery, Food Safety and Technology Research Centre and Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, China; State Key Laboratory of Chinese Medicine and Molecular Pharmacology (Incubation) and Shenzhen Key Laboratory of Food Biological Safety Control, Shenzhen Research Institute of The Hong Kong Polytechnic University, Shenzhen, 518057, China
| | - Daniel Rickert
- Department of Chemistry, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | | | - Barbara Bojko
- Department of Chemistry, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Janusz Pawliszyn
- Department of Chemistry, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.
| | - Zhong-Ping Yao
- State Key Laboratory of Chemical Biology and Drug Discovery, Food Safety and Technology Research Centre and Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, China; State Key Laboratory of Chinese Medicine and Molecular Pharmacology (Incubation) and Shenzhen Key Laboratory of Food Biological Safety Control, Shenzhen Research Institute of The Hong Kong Polytechnic University, Shenzhen, 518057, China.
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Ng TT, So PK, Hu B, Yao ZP. Rapid detection and quantitation of drugs-of-abuse by wooden-tip electrospray ionization mass spectrometry. J Food Drug Anal 2019; 27:428-438. [PMID: 30987714 PMCID: PMC9296206 DOI: 10.1016/j.jfda.2018.09.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/13/2018] [Accepted: 09/13/2018] [Indexed: 12/05/2022] Open
Abstract
Determination of drugs-of-abuse in body fluids of drug abusers is important for the law enforcement as well as the treatment and rehabilitation. In this study, wooden-tip electrospray ionization mass spectrometry (WT-ESI-MS), a simple and cost-effective technique, was developed for rapid detection and quantitation of common drugs-of-abuse, including methamphetamine, methylenedioxymethamphetamine (MDMA), cocaine, heroin and tetrahydrocannabinol (THC), in urine and oral fluid, following our previous successful demonstration for rapid and sensitive detection of ketamine and nor-ketamine in urine and oral fluid by this technique. It was found that the limit-of-detection for methamphetamine could fully fulfill the cut-off value requirements of the international standards, and those of MDMA and cocaine could fulfill some of the requirements. The linear range, accuracy and precision for quantitation of the drugs were generally satisfactory, except for THC for which the analytical performance still needs to be improved. Analysis of one sample could typically be completed within minutes. These results indicated that WT-ESI-MS could be used for rapid screening of drugs-of-abuse in urine, oral fluid as well as other body fluids.
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Pechansky F, Scherer JN, Schuch JB, Roglio V, Telles YM, Silvestrin R, Pasa G, Sousa T. User experience and operational feasibility of four point-of-collection oral fluid drug-testing devices according to Brazilian traffic agents. TRAFFIC INJURY PREVENTION 2019; 20:30-36. [PMID: 30822144 DOI: 10.1080/15389588.2018.1537486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Traffic fatalities in Brazil still rank among the highest worldwide, with an overall rate of 23.4 deaths/100,000 inhabitants/year. Although alcohol and drug use play an important role in traffic accidents, national data about their relative influence are scarce. Drug screening is not routinely performed by traffic agents because alcohol is the only substance regularly investigated in roadblocks. Therefore, we aimed to describe the initial traffic agent user experience for 4 handheld point-of-collection oral fluid drug testing devices used in routine roadblocks in Brazil, focusing on usage perceptions in hopes of generalizing this approach for other developing countries. METHODS Four different oral fluid collection devices were evaluated: The DDS2, the DOA MultiScreen, the Dräger DrugTest 5000, and the Multi-Drug Multi-Line Twist Screen Device. Fourteen trained traffic agents obtained oral fluid from 164 drivers and performed 37 qualitative evaluations of the devices. Traffic agents filled out a questionnaire focusing on 9 feasibility criteria: Overall simplicity for roadside operation; operational success; saliva sample collection time; sample analysis time; ease of sample preparation and analysis; agreement with observed clinical signs; overall hygiene and safety; sufficient operating instructions; and hygiene of saliva collection. These were weighted based on an expert panel and yielded an overall composite device experience score that ranged from 1 (poor) to 100 (excellent). RESULTS Ease of use, operational success, and acceptable collection and analysis time were considered the most important criteria by the expert panel. The results ranged from 27.3 to 88.9% for simplicity of use; 45.5 to 100.0% for operational success; 27.3 to 100% for acceptable collection time; and 36.4 to 100.0% for acceptable analysis time. The final device scores, based on the agents' user experiences, ranked as follows: DOA MultiScreen: 49.3/100; Dräger DrugTest 5000: 82.4/100; Multi-Drug Multi-Line Twist Screen Device: 84.3/100; DDS2: 88.4/100. CONCLUSION Based on the selected criteria, 3 of the 4 devices were considered useful by traffic agents in routine roadblock operations. The weighted evaluations suggest that their ease of use (handling, sampling analysis, and reliability), as well as their agreement with findings obtained by other means, defined their utility to traffic agents, although such appraisals must be further analyzed in future studies.
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Affiliation(s)
- Flavio Pechansky
- a Center for Drug and Alcohol Research , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | | | - Jaqueline B Schuch
- a Center for Drug and Alcohol Research , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - Vinícius Roglio
- a Center for Drug and Alcohol Research , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - Yeger Moreschi Telles
- a Center for Drug and Alcohol Research , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - Roberta Silvestrin
- a Center for Drug and Alcohol Research , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - Graciela Pasa
- a Center for Drug and Alcohol Research , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - Tanara Sousa
- a Center for Drug and Alcohol Research , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
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Affiliation(s)
- Heesun Chung
- Graduate School of Analytical Science and Technology, Chungnam National University, Daejeon, Korea
| | - Sanggil Choe
- Forensic Toxicology Section, Seoul Institute, National Forensic Service, Seoul, Korea
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Lema-Atán JÁ, de Castro A, Lendoiro E, López-Rivadulla M, Cruz A. Toxicological oral fluid results among Spanish drivers testing positive on on-site drug controls from 2013 to 2015. Drug Alcohol Depend 2019; 195:106-113. [PMID: 30611978 DOI: 10.1016/j.drugalcdep.2018.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/09/2018] [Accepted: 12/06/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Driving under the influence of drugs (DUID) increases the risk of serious injury or death in traffic accidents. The aim of this study was to provide information about DUID in Spanish drivers. METHODS 10,064 oral fluid samples were collected from Spanish drivers that tested positive on the roadside using the Dräger DrugTest 5000 (DDT5000) between 2013 and 2015. Samples were collected using Quantisal™ and analysed by LC-MS/MS at the Toxicology Laboratory of the Institute of Forensic Science of the University of Santiago de Compostela. RESULTS Drivers were mainly young men (85.1% male, 29.7 ± 8.1 years old). In 98.5% of cases, LC-MS/MS results confirmed at least one of the positive results detected on the roadside. Cannabis (82.4%) and cocaine (42.1%) were the most commonly detected drugs. Poly-drug use was observed in 42.7% of drivers, mostly for all illicit drugs (>80%) except for cannabis (42.6%). Illicit drug and single-drug use was more frequent among drivers under 35 years old, and medicines and poly-drug use more common among drivers older than 35 years old. The on-site device performance was calculated using both the DDT5000 cut-offs and the LC-MS/MS method LOQs. Sensitivity (>73% vs >58%), specificity [>94% for all the compounds regardless the cut-offs used, except for cannabis (71%)] and accuracy (>87.5% with both cut-offs) fulfilled the DRUID Project requirements in all cases. CONCLUSION LC-MS/MS confirmation result was negative in only 1.5% of the cases. The DUID driver profile was a young man, consuming cannabis or a combination of cannabis and cocaine.
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Affiliation(s)
- José Ángel Lema-Atán
- Servicio de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, C/San Francisco, s/n, Santiago de Compostela, Spain.
| | - Ana de Castro
- Servicio de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, C/San Francisco, s/n, Santiago de Compostela, Spain.
| | - Elena Lendoiro
- Servicio de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, C/San Francisco, s/n, Santiago de Compostela, Spain.
| | - Manuel López-Rivadulla
- Servicio de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, C/San Francisco, s/n, Santiago de Compostela, Spain.
| | - Angelines Cruz
- Servicio de Toxicología, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, C/San Francisco, s/n, Santiago de Compostela, Spain.
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Affiliation(s)
- Maude Marillier
- Department of Continuing Education of the Faculty of Medicine Lille University Lille France
| | - Alain G. Verstraete
- Department of Diagnostic Sciences Ghent University Ghent Belgium
- Department of Laboratory Medicine Ghent University Hospital Ghent Belgium
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Gjerde H, Clausen GB, Andreassen E, Furuhaugen H. Evaluation of Dräger DrugTest 5000 in a Naturalistic Setting. J Anal Toxicol 2018; 42:248-254. [PMID: 29409046 DOI: 10.1093/jat/bky003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Indexed: 12/15/2022] Open
Abstract
Reliable field testing devices for psychoactive drugs would be useful tools for the police for detecting drug-impaired drivers. The Norwegian Mobile Police Service (NMPS) started using Dräger DrugTest 5000 (DDT5000) in 2015 as an on-site screening instrument for drugs in samples of oral fluid. The aim of this study was to compare the results of field testing of DDT5000 with drug findings in blood and oral fluid samples taken from drivers suspected for driving under the influence of drugs (DUID). In total, 369 drivers were included in this field testing; blood samples were obtained from all of them, while oral fluid samples were collected with the Intercept device from 301 of them. The median time from field testing with DDT5000 and collection of blood and oral fluid samples was 50 min. The proportions of false positive results with DDT5000 compared to findings in blood samples above the Norwegian legal per se limits were for cannabis 14.5%, amphetamine 23.2%, methamphetamine 38.4%, cocaine 87.1%, opiates 65.9% and benzodiazepines 36.4%. The proportions of false negatives were for cannabis 13.4%, amphetamine 4.9%, methamphetamine 6.1%, cocaine 0.0%, opiates 0.0% and benzodiazepines 18.8%. Among drivers who had drug concentrations above the legal limits in blood, the proportion who tested positive using DDT5000 was 82.9% for THC, 90.8% for amphetamine, 75.7% for methamphetamine, 100.0% for cocaine, 100.0% for opiates and 37.2% for benzodiazepines. In cases with false-positive DDT5000 results compared to blood, traces of drugs were most often found in oral fluid. The DDT5000 did not absolutely correctly identify DUID offenders due to fairly large proportions of false-positive or false-negative results compared to drug concentrations in blood. The police reported that DDT5000 was still a valuable tool in identifying possible DUID offenders, resulting in more than doubling the number of apprehended DUID offenders.
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Affiliation(s)
- Hallvard Gjerde
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950 Nydalen, NO-0424 Oslo, Norway
| | | | | | - Håvard Furuhaugen
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950 Nydalen, NO-0424 Oslo, Norway
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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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Tang MHY, Ching CK, Poon S, Chan SSS, Ng WY, Lam M, Wong CK, Pao R, Lau A, Mak TWL. Evaluation of three rapid oral fluid test devices on the screening of multiple drugs of abuse including ketamine. Forensic Sci Int 2018; 286:113-120. [PMID: 29574346 DOI: 10.1016/j.forsciint.2018.03.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/23/2018] [Accepted: 03/02/2018] [Indexed: 11/28/2022]
Abstract
Rapid oral fluid testing (ROFT) devices have been extensively evaluated for their ability to detect common drugs of abuse; however, the performance of such devices on simultaneous screening for ketamine has been scarcely investigated. The present study evaluated three ROFT devices (DrugWipe® 6S, Ora-Check® and SalivaScreen®) on the detection of ketamine, opiates, methamphetamine, cannabis, cocaine and MDMA. A liquid chromatography tandem mass spectrometry (LCMS) assay was firstly established and validated for confirmation analysis of the six types of drugs and/or their metabolites. In the field test, the three ROFT devices were tested on subjects recruited from substance abuse clinics/rehabilitation centre. Oral fluid was also collected using Quantisal® for confirmation analysis. A total of 549 samples were collected in the study. LCMS analysis on 491 samples revealed the following drugs: codeine (55%), morphine (49%), heroin (40%), methamphetamine (35%), THC (8%), ketamine (4%) and cocaine (2%). No MDMA-positive cases were observed. Results showed that the overall specificity and accuracy were satisfactory and met the DRUID standard of >80% for all 3 devices. Ora-Check® had poor sensitivities (ketamine 36%, methamphetamine 63%, opiates 53%, cocaine 60%, THC 0%). DrugWipe® 6S showed good sensitivities in the methamphetamine (83%) and opiates (93%) tests but performed relatively poorly for ketamine (41%), cocaine (43%) and THC (22%). SalivaScreen® also demonstrated good sensitivities in the methamphetamine (83%) and opiates (100%) tests, and had the highest sensitivity for ketamine (76%) and cocaine (71%); however, it failed to detect any of the 28 THC-positive cases. The test completion rate (proportion of tests completed with quality control passed) were: 52% (Ora-Check®), 78% (SalivaScreen®) and 99% (DrugWipe® 6S).
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Affiliation(s)
| | - C K Ching
- Hospital Authority Toxicology Reference Laboratory, Hong Kong, China.
| | - Simon Poon
- Hospital Authority Toxicology Reference Laboratory, Hong Kong, China.
| | - Suzanne S S Chan
- Hospital Authority Toxicology Reference Laboratory, Hong Kong, China.
| | - W Y Ng
- Hospital Authority Toxicology Reference Laboratory, Hong Kong, China.
| | - M Lam
- Department of General Adult Psychiatry, Castle Peak Hospital, Hong Kong, China.
| | - C K Wong
- Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
| | - Ronnie Pao
- Substance Abuse Assessment Unit, Kwai Chung Hospital, Hong Kong, China.
| | - Angus Lau
- The Society of Rehabilitation and Crime Prevention, Hong Kong, China.
| | - Tony W L Mak
- Hospital Authority Toxicology Reference Laboratory, Hong Kong, China.
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Rohrig TP, Moore CM, Stephens K, Cooper K, Coulter C, Baird T, Garnier M, Miller S, Tuyay J, Osawa K, Chou J, Nuss C, Collier J, Wittman KC. Roadside drug testing: An evaluation of the Alere DDS®2 mobile test system. Drug Test Anal 2017; 10:663-670. [DOI: 10.1002/dta.2297] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 08/31/2017] [Accepted: 09/01/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Timothy P. Rohrig
- Sedgwick County Regional Forensic Science Center; Wichita Kansas USA
| | | | - Kimberly Stephens
- Sedgwick County Regional Forensic Science Center; Wichita Kansas USA
| | - Kelsey Cooper
- Sedgwick County Regional Forensic Science Center; Wichita Kansas USA
| | | | - Tyson Baird
- Sedgwick County Regional Forensic Science Center; Wichita Kansas USA
| | | | - Samuel Miller
- Sedgwick County Regional Forensic Science Center; Wichita Kansas USA
| | - James Tuyay
- Immunalysis Corporation; Pomona California USA
| | - Kei Osawa
- Sedgwick County Regional Forensic Science Center; Wichita Kansas USA
| | - Joshua Chou
- Immunalysis Corporation; Pomona California USA
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Scherer JN, Fiorentin TR, Sousa TRV, Limberger RP, Pechansky F. Oral Fluid Testing for Cocaine: Analytical Evaluation of Two Point-of-Collection Drug Screening Devices. J Anal Toxicol 2017; 41:392-398. [PMID: 28334841 DOI: 10.1093/jat/bkx018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 02/13/2017] [Indexed: 12/19/2022] Open
Abstract
The use of point-of-collection testing (POCT) devices for drugs of abuse in oral fluid (OF) is an advantageous tool that has been used for different purposes-particularly traffic enforcement. However, even with the widespread report of cocaine consumption, the reliability of POCT devices has been reported in different magnitudes. This study evaluated the reliability of two POCT devices for the detection of cocaine in OF samples of 110 cocaine users: (i) the DDS2™ (cutoff = 30 ng/mL) and (ii) the Multi-Drugs Multi-Line-Twist Screen Test Device™ (MDML) (cutoff = 20 ng/mL). Results of the screening tests were compared with a Liquid Chromatography-Mass Spectrometry (LC-MS) assay. Sensitivity, specificity and accuracy of DDS2™ were 100, 77.77 and 80% when compared with LC-MS with a cutoff of 30 ng/mL, and 88.89, 89.15 and 89.09% with a cutoff of 10 ng/mL. The MDML™ device achieved sensitivity, specificity and accuracy of 100, 65.6 and 70.9% when compared with LC-MS with a cutoff of 20 ng/mL, and 92.6, 71.1 and 76.6% with a cutoff of 10 ng/mL. When compared with a 10 ng/mL cutoff, the DDS2™ achieved reliability parameters higher than 80%. On the other hand, the MDML™ device did not achieve the minimal recommendation of 80% for all parameters at the same time. Taking into consideration the reliability results showed here, the authors believe that the use of these POCT devices seems to be suitable for cocaine detection in forensic tests only if all positive specimens are further confirmed by a validated method.
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Affiliation(s)
- Juliana Nichterwitz Scherer
- Center for Drug and Alcohol Research, Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro 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
| | - Tanara Rosangela Vieira Sousa
- Center for Drug and Alcohol Research, Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro 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, Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020 Porto Alegre, RS, Brazil
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Swortwood MJ, Newmeyer MN, Andersson M, Abulseoud OA, Scheidweiler KB, Huestis MA. Cannabinoid disposition in oral fluid after controlled smoked, vaporized, and oral cannabis administration. Drug Test Anal 2017; 9:905-915. [PMID: 27647820 PMCID: PMC5357602 DOI: 10.1002/dta.2092] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/15/2016] [Accepted: 09/15/2016] [Indexed: 11/09/2022]
Abstract
Oral fluid (OF) is an important matrix for monitoring drugs. Smoking cannabis is common, but vaporization and edible consumption also are popular. OF pharmacokinetics are available for controlled smoked cannabis, but few data exist for vaporized and oral routes. Frequent and occasional cannabis smokers were recruited as participants for four dosing sessions including one active (6.9% Δ9 -tetrahydrocannabinol, THC) or placebo cannabis-containing brownie, followed by one active or placebo cigarette, or one active or placebo vaporized cannabis dose. Only one active dose was administered per session. OF was collected before and up to 54 (occasional) or 72 (frequent) h after dosing from cannabis smokers. THC, 11-hydroxy-THC (11-OH-THC), 11-nor-9-carboxy-THC (THCCOOH), tetrahydrocannabivarin (THCV), cannabidiol (CBD), and cannabigerol (CBG) were quantified by liquid chromatography-tandem mass spectrometry. OF cannabinoid Cmax occurred during or immediately after cannabis consumption due to oral mucosa contamination. Significantly greater THC Cmax and significantly later THCV, CBD, and CBG tlast were observed after smoked and vaporized cannabis compared to oral cannabis in frequent smokers only. No significant differences in THC, 11-OH-THC, THCV, CBD, or CBG tmax between routes were observed for either group. For occasional smokers, more 11-OH-THC and THCCOOH-positive specimens were observed after oral dosing than after inhaled routes, increasing % positive cannabinoid results and widening metabolite detection windows after oral cannabis consumption. Utilizing 0.3 µg/L THCV and CBG cut-offs resulted in detection windows indicative of recent cannabis intake. OF pharmacokinetics after high potency CBD cannabis are not yet available precluding its use currently as a marker of recent use. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Madeleine J. Swortwood
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutics Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD
| | - Matthew N. Newmeyer
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutics Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD
- Program in Toxicology, University of Maryland Baltimore, Baltimore, MD
| | - Maria Andersson
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutics Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD
| | - Osama A. Abulseoud
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutics Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD
| | - Karl B. Scheidweiler
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutics Branch, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD
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Doucette ML, Frattaroli S, Vernick JS. Oral fluid testing for marijuana intoxication: enhancing objectivity for roadside DUI testing. Inj Prev 2017; 24:78-80. [DOI: 10.1136/injuryprev-2016-042264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/23/2017] [Accepted: 03/29/2017] [Indexed: 11/04/2022]
Abstract
Reducing marijuana-impaired driving is an important part of any strategy to prevent motor vehicle traffic injuries. In Colorado, the first of eight US states and the District of Columbia to legalise marijuana for recreational use, drivers with positive tests for the presence of marijuana accounted for a larger proportion of fatal MVCs after marijuana commercialisation. The use of blood tests to screen for marijuana intoxication, in Colorado and elsewhere in the USA, poses a number of challenges. Many high-income countries use oral fluid drug testing (OF) to provide roadside evidence of marijuana intoxication. A 2009 Belgium policy implementing OF roadside testing increased true positives and decreased false positives of suspected marijuana-related driving under the influence (DUI) arrests. US policy-makers should consider using roadside OF to increase objectivity and reliability for tests used in marijuana-related DUI arrests.
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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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40
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Newmeyer MN, Swortwood MJ, Andersson M, Abulseoud OA, Scheidweiler KB, Huestis MA. Cannabis Edibles: Blood and Oral Fluid Cannabinoid Pharmacokinetics and Evaluation of Oral Fluid Screening Devices for Predicting Δ9-Tetrahydrocannabinol in Blood and Oral Fluid following Cannabis Brownie Administration. Clin Chem 2017; 63:647-662. [DOI: 10.1373/clinchem.2016.265371] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/21/2016] [Indexed: 01/03/2023]
Abstract
Abstract
BACKGROUND
Roadside oral fluid (OF) Δ9-tetrahydrocannabinol (THC) detection indicates recent cannabis intake. OF and blood THC pharmacokinetic data are limited and there are no on-site OF screening performance evaluations after controlled edible cannabis.
CONTENT
We reviewed OF and blood cannabinoid pharmacokinetics and performance evaluations of the Draeger DrugTest®5000 (DT5000) and Alere™ DDS®2 (DDS2) on-site OF screening devices. We also present data from a controlled oral cannabis administration session.
SUMMARY
OF THC maximum concentrations (Cmax) were similar in frequent as compared to occasional smokers, while blood THC Cmax were higher in frequent [mean (range) 17.7 (8.0–36.1) μg/L] smokers compared to occasional [8.2 (3.2–14.3) μg/L] smokers. Minor cannabinoids Δ9-tetrahydrocannabivarin and cannabigerol were never detected in blood, and not in OF by 5 or 8 h, respectively, with 0.3 μg/L cutoffs. Recommended performance (analytical sensitivity, specificity, and efficiency) criteria for screening devices of ≥80% are difficult to meet when maximizing true positive (TP) results with confirmation cutoffs below the screening cutoff. TPs were greatest with OF confirmation cutoffs of THC ≥1 and ≥2 μg/L, but analytical sensitivities were <80% due to false negative tests arising from confirmation cutoffs below the DT5000 and DDS2 screening cutoffs; all criteria were >80% with an OF THC ≥5 μg/L cutoff. Performance criteria also were >80% with a blood THC ≥5 μg/L confirmation cutoff; however, positive OF screening results might not confirm due to the time required to collect blood after a crash or police stop. OF confirmation is recommended for roadside OF screening.
ClinicalTrials.gov identification number: NCT02177513
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Affiliation(s)
- Matthew N Newmeyer
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD
- Program in Toxicology, University of Maryland Baltimore, Baltimore, MD
| | - Madeleine J Swortwood
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD
- Department of Forensic Science, College of Criminal Justice, Sam Houston State University, Huntsville, TX
| | - Maria Andersson
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Osama A Abulseoud
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD
| | - Karl B Scheidweiler
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD
| | - Marilyn A Huestis
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD
- University of Maryland School of Medicine, Baltimore, MD
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41
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Abstract
Laboratory testing for drugs of abuse has become standard practice in many settings both forensic and clinical. Urine is the predominant specimen, but other specimens are possible including hair, nails, sweat, and oral fluid. Point-of-care test kits provide for rapid analysis at the site where specimens are collected allowing for immediate action on the results. POCT is based on immunochromatography where the drug in the patient's sample competes with drug and antibody conjugates in the test to develop or block the development of a colored line. Most POCTs are visually interpreted in a few minutes. The potential for false positives is possible due to drug cross-reactivity with the antibodies in the test. False negatives are also possible due to dilution of the sample and the potential for adulteration or sample substitution by the patient. POCT shows more variability than central laboratory testing because of the variety of operators involved in the testing process, but POCT has good agreement for most tests with mass spectrometry provided comparable cutoffs and cross-reactivity of drugs/metabolites are considered. Validation of the test performance with the intended operators will identify potential interferences and operational issues before implementing the test in routine practice. POCT offers faster turnaround of test results provided the limitations and challenges of the test are considered.
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Affiliation(s)
- Joesph R Wiencek
- Vanderbilt University Medical Center, Nashville, TN, United States
| | - Jennifer M Colby
- Vanderbilt University Medical Center, Nashville, TN, United States
| | - James H Nichols
- Vanderbilt University Medical Center, Nashville, TN, United States.
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42
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Beirness DJ, Smith DR. An assessment of oral fluid drug screening devices. CANADIAN SOCIETY OF FORENSIC SCIENCE JOURNAL 2016. [DOI: 10.1080/00085030.2017.1258212] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Douglas J. Beirness
- Canadian Centre on Substance Abuse, Ottawa, ON, Canada
- Canadian Society of Forensic Science, Drugs and Driving Committee
| | - D'Arcy R. Smith
- Royal Canadian Mounted Police, National Drug Evaluation and Classification Program, Dartmouth, NS, Canada
- Canadian Society of Forensic Science, Drugs and Driving Committee
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43
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Plouffe BD, Murthy SK. Fluorescence-based lateral flow assays for rapid oral fluid roadside detection of cannabis use. Electrophoresis 2016; 38:501-506. [PMID: 27862053 DOI: 10.1002/elps.201600075] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 10/31/2016] [Accepted: 11/07/2016] [Indexed: 11/10/2022]
Abstract
With the recent worldwide changes in the legalization of marijuana, there is a significant need for rapid, roadside screening test for driving under the influence of drugs. A robust, sensitive, lateral flow assay has been developed to detect recent use via oral-fluid testing for Δ9 -tetrahydrocannabinol (THC). This proof-of-concept assay uses a fluorescent-based immunoassay detection of polymeric beads, conjugated to antibodies against native THC. The fluorescent technique allows for significantly lower limits of detection and higher precision determination of recent marijuana use without the use of urine or blood sampling-thus allowing for roadside identification. Detection levels of 0.01 ng/mL were distinguished from background and the lower limit of quantification was determined to approach 1 ng/mL.
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Affiliation(s)
- Brian D Plouffe
- Department of STEM, Regis College, Weston, MA, USA.,Department of Chemical Engineering and Barnett Institute of Chemical and Biological Analysis, Northeastern University, Boston, MA, USA
| | - Shashi K Murthy
- Department of Chemical Engineering and Barnett Institute of Chemical and Biological Analysis, Northeastern University, Boston, MA, USA
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44
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Swortwood MJ, Newmeyer MN, Abulseoud OA, Andersson M, Barnes AJ, Scheidweiler KB, Huestis MA. On-site oral fluid Δ9-tetrahydrocannabinol (THC) screening after controlled smoked, vaporized, and oral cannabis administration. Forensic Toxicol 2016. [DOI: 10.1007/s11419-016-0348-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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45
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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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46
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Techniques and technologies for the bioanalysis of Sativex®, metabolites and related compounds. Bioanalysis 2016; 8:829-45. [DOI: 10.4155/bio-2015-0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Sativex® is an oromucosal spray indicated for the treatment of moderate-to-severe spasticity in multiple sclerosis and is also an effective analgesic for advanced cancer patients. Sativex contains Δ9-tetrahydrocannabinol (THC) and cannabidiol in an approximately 1:1 ratio. The increasing prevalence of medicinal cannabis products highlights the importance of reliable bioanalysis and re-evaluation of the interpretation of positive test results for THC, as legal implications may arise in workplace, roadside and sports drug testing situations. This article summarizes published research on the bioanalysis of THC and cannabidiol, with particular focus on Sativex. Common screening and confirmatory testing of blood, urine, oral fluid and hair samples are outlined. Correlations between matrices and current analytical pitfalls are also addressed.
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47
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Abstract
Oral fluid has become an important matrix for drugs of abuse analysis. These days the applicability is challenged by the fact that an increasing number of new psychoactive drugs are coming on the market. Synthetic cannabinoids and synthetic cathinones have been the main drug classes, but the diversity is increasing and other drugs like piperazines, phenethylamines, tryptamines, designer opioids and designer benzodiazepines are becoming more prevalent. Many of the substances are very potent, and low doses ingested will lead to low concentrations in biological media, including oral fluid. This review will highlight the phenomenon of new psychoactive substances and review methods for oral fluid drug testing analysis using on-site tests, immunoassays and chromatographic methods.
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48
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Ellefsen KN, Concheiro M, Pirard S, Gorelick DA, Huestis MA. Cocaine and benzoylecgonine oral fluid on-site screening and confirmation. Drug Test Anal 2016; 8:296-303. [PMID: 26968560 DOI: 10.1002/dta.1966] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 01/31/2016] [Accepted: 02/01/2016] [Indexed: 11/10/2022]
Abstract
Accurate on-site devices to screen for drug intake are critical for establishing whether an individual is driving under the influence of drugs (DUID); however, on-site oral fluid (OF) cocaine device performance is variable. We evaluated the performance of a newly developed benzoylecgonine (BE) test-strip for the Draeger® DrugTest 5000 device (20 µg/L cut-off) with equivalent cross reactivity for cocaine and BE. Ten cocaine users provided OF, collected with the Draeger cassette and Oral-Eze® and StatSure Saliva Sampler(TM) devices, up to 69 h following 25 mg intravenous cocaine administration. All screening results were confirmed by a validated two-dimensional-gas chromatography-mass spectrometry (2D-GC-MS) method for cocaine and/or BE. Cocaine test-strip median Tlast for screening only results was 6.5 h, and 6.5 h with Oral-Eze® and 4 h for StatSure OF confirmation for cocaine and/or BE at 1, 8, and 10 µg/L; sensitivity, specificity, and efficiency ranged from 85.5 to 100% and 83.3 to 100% for cocaine only confirmation at 8 and 10 µg/L. For the BE test-strip, median Tlast was 12.5 h for screening only and confirmation for cocaine and/or BE at all three cut-offs; sensitivity, specificity, and efficiency ranged from 85.5 to 97.5% and 78.4 to 97.4% with cocaine and/or BE confirmation at 8 and 10 µg/L cut-offs, respectively. The Draeger cocaine test-strip with cocaine only confirmation offers a useful option for monitoring the acute intoxication phase of DUID; additionally the BE test-strip with cocaine and/or BE confirmation increases the length of detection of cocaine intake for workplace drug testing, drug court, parole, pain management, drug treatment programs and both the acute cocaine intoxication and cocaine crash/fatigue phase of DUID. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Kayla N Ellefsen
- Chemistry and Drug Metabolism Section, IRP, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA.,Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, USA
| | - Marta Concheiro
- Department of Sciences, John Jay College of Criminal Justice, City University of New York, New York, NY, USA
| | - Sandrine Pirard
- Chemistry and Drug Metabolism Section, IRP, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - David A Gorelick
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marilyn A Huestis
- Chemistry and Drug Metabolism Section, IRP, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
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49
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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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50
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Newmeyer MN, Concheiro M, da Costa JL, Flegel R, Gorelick DA, Huestis MA. Oral fluid with three modes of collection and plasma methamphetamine and amphetamine enantiomer concentrations after controlled intranasal l-methamphetamine administration. Drug Test Anal 2015; 7:877-83. [PMID: 25786659 DOI: 10.1002/dta.1784] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/25/2015] [Accepted: 02/09/2015] [Indexed: 11/08/2022]
Abstract
Methamphetamine is included in drug testing programmes due to its high abuse potential. d-Methamphetamine is a scheduled potent central nervous system stimulant, while l-methamphetamine is the unscheduled active ingredient in the over-the-counter nasal decongestant Vicks® VapoInhaler™. No data are available in oral fluid (OF) and few in plasma after controlled Vicks® VapoInhaler™ administration. We quantified methamphetamine and amphetamine enantiomers in OF collected with two different devices and plasma via a fully validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Additionally, OF were analyzed with an on-site screening device. Sixteen participants received 7 Vicks® VapoInhaler™ doses according to manufacturer's recommendations. Specimens were collected before and up to 32 h after the first dose. No d-methamphetamine or d-amphetamine was detected in any sample. All participants had measurable OF l-methamphetamine with median maximum concentrations 14.8 and 16.1 μg/L in Quantisal™ and Oral-Eze® devices, respectively, after a median of 5 doses. One participant had measurable OF l-amphetamine with maximum concentrations 3.7 and 5.5 μg/L after 6 doses with the Quantisal™ and Oral-Eze® devices, respectively. There were no positive DrugTest® 5000 results. In the cutoff range 20-50 μg/L methamphetamine with amphetamine ≥limit of detection, 3.1-10.1% of specimens were positive; first positive results were observed after 1-4 doses. Two participants had detectable plasma l-methamphetamine, with maximum observed concentrations 6.3 and 10.0 μg/L after 2 and 5 doses, respectively. Positive OF and plasma methamphetamine results are possible after Vicks® VapoInhaler™ administration. Chiral confirmatory analyses are necessary to rule out VapoInhaler™ intake. Implementing a selective d-methamphetamine screening assay can help eliminate false-positive OF results.
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Affiliation(s)
- Matthew N Newmeyer
- Chemistry and Drug Metabolism Section, IRP, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA.,Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, USA
| | - Marta Concheiro
- Chemistry and Drug Metabolism Section, IRP, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA.,Currently at Department of Sciences, John Jay College of Criminal Justice, City University of New York, New York, NY, USA
| | - Jose Luiz da Costa
- Chemistry and Drug Metabolism Section, IRP, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA.,Currently at Forensic Toxicology and Chemistry Laboratory, Criminalistics Institute of São Paulo, São Paulo, SP, Brazil
| | - Ronald Flegel
- Division of Workplace Programs, Substance Abuse Mental Health Services Administration, Department of Health and Human Services, Rockville, MD, USA
| | - David A Gorelick
- Chemistry and Drug Metabolism Section, IRP, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA.,Currently at Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marilyn A Huestis
- Chemistry and Drug Metabolism Section, IRP, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
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