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On-site oral fluid Δ9-tetrahydrocannabinol (THC) screening after controlled smoked, vaporized, and oral cannabis administration

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Abstract

Increasing driving under the influence of cannabis cases is an important short-term consequence of cannabis legalization. On-site oral fluid (OF) testing devices provide advantages for roadside drug screening, because OF Δ9-tetrahydrocannabinol (THC) indicates more recent cannabis intake than urine, and it can be collected non-invasively by law enforcement personnel. THC presence in OF primarily results from oromucosal contamination during cannabis inhalation. To date, on-site OF devices were not investigated following edible cannabis. We evaluated sensitivity, specificity, and efficiency of the Dräger DrugTest® 5000 [DT5000] and Alere™ DDS®2 [DDS2] at various OF THC confirmatory cutoffs following controlled smoked, vaporized, and edible cannabis in frequent and occasional smokers. Times of last positive (t last) were evaluated for each device, cutoff, and smoking group. At a 5 µg/L OF THC confirmation cutoff, overall performance criteria exceeded the recommended 80% for both devices. At lower THC confirmation cutoffs (1–2 µg/L), true positive results were maximized but sensitivity was <80%. When confirmation cutoffs were below manufacturers’ screening cutoffs (5 µg/L DT5000, 25 µg/L DDS2), false negative results increased. No differences in t last were observed for DT5000 between the three administration routes, but later t last times were observed after smoking compared to vaporization with DDS2. Frequent smokers had significantly later median t last (5 h) compared to occasional smokers (1.5–3.5 h) for all conditions. There were no true positive results at 44 and 50 h with the DT5000 and DDS2, respectively. OF screening followed by confirmatory OF analysis is an important strategy for investigations of driving under the influence of drugs, with these data improving interpretation of cannabinoid OF results.

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Acknowledgements

The authors would like to thank Dr. Sandrine Pirard for her contribution to study design and the contributions of the clinical staffs of the Intramural Research Program, National Institute on Drug Abuse, and the Clinical Research Unit, Johns Hopkins Bayview Medical Center. This study was registered on clinicaltrials.gov (NCT02177513). Quantisal devices, Dräger DrugTest 5000, and Alere DDS2 were provided by the manufacturers to NIH via Materials Transfer Agreements. This research was funded by the Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health. MNN acknowledges the Graduate Partnership Program, NIH.

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    Authors and Affiliations

    1. Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse National Institutes of Health, Baltimore, MD, USA

      Madeleine J. Swortwood, Matthew N. Newmeyer, Osama A. Abulseoud, Maria Andersson, Allan J. Barnes, Karl B. Scheidweiler & Marilyn A. Huestis

    2. Department of Forensic Science, College of Criminal Justice, Sam Houston State University, Huntsville, TX, USA

      Madeleine J. Swortwood

    3. Program in Toxicology, University of Maryland Baltimore, Baltimore, MD, USA

      Matthew N. Newmeyer

    4. University of Maryland School of Medicine, 683 Shore Road, Severna Park, MD, 21146, USA

      Marilyn A. Huestis

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    1. Madeleine J. Swortwood
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    4. Maria Andersson
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    Correspondence to Marilyn A. Huestis.

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    The authors have no personal or financial conflicts of interest to disclose.

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    All procedures performed in this study were in accordance with the ethical standards of the Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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    M. J. Swortwood and M. N. Newmeyer contributed equally.

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    Swortwood, M.J., Newmeyer, M.N., Abulseoud, O.A. et al. On-site oral fluid Δ9-tetrahydrocannabinol (THC) screening after controlled smoked, vaporized, and oral cannabis administration. Forensic Toxicol 35, 133–145 (2017). https://doi.org/10.1007/s11419-016-0348-3

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