Cannabinoids and metabolites in expectorated oral fluid following controlled smoked cannabis

Milman, Garry; Schwope, David M.; Gorelick, David A.; Huestis, Marilyn A.

doi:10.1016/j.cca.2012.01.011

Cited by 50 publications

(89 citation statements)

References 27 publications

(45 reference statements)

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“…THC, THC-A, and CBN Cmax happened concurrently a short time after inhalation of the cannabis joint (T max=0.3-0.4 h). A similar observation has been already reported in several other studies [11,23,38,39]. For instance, the Cmax determined by Kauert et al [23] for THC was already measured in the first OF sample taken just 0.25 h after starting inhalation.…”

Section: μG/l)supporting

confidence: 71%

“…The median (range) OF THCCOOH Tmax occurred 0.6 (0.3-2.0 h) after inhalation. These values correspond to those of Milman et al [39]. They determined cannabinoids in oral fluid and obtained a median Tmax for THCCOOH of 1 h (range was between 0.25 and 2.0 h).…”

Section: μG/l)mentioning

confidence: 71%

“…Broad variations in the THC concentrations measured in OF were observed between studies. For example, Milman et al [39] reported a median THC highest concentration of 2,629 μg/L at 0.25 h after smoking. Huestis and Cone [11] indicated an OF THC Cmax of 5,800 μg/L 0.2 h after inhalation.…”

Section: μG/l)mentioning

confidence: 99%

“…First, the devices used for collecting OF differ and may influence the THC levels recovered from the saliva. The expectoration [39] provided undiluted OF. However, it presents some limitations, such as low specimen volume, high viscosity, and decreased drug stability.…”

Section: μG/l)mentioning

confidence: 99%

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Comparison of cannabinoid concentrations in oral fluid and whole blood between occasional and regular cannabis smokers prior to and after smoking a cannabis joint

et al. 2013

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A cross-over controlled administration study of smoked cannabis was carried out on occasional and heavy smokers. The participants smoked a joint (11 % Δ9-tetrahydrocannabinol (THC)) or a matching placebo on two different occasions. Whole blood (WB) and oral fluid (OF) samples were collected before and up to 3.5 h after smoking the joints. Pharmacokinetic analyses were obtained from these data. Questionnaires assessing the subjective effects were administered to the subjects during each session before and after the smoking time period. THC, 11-hydroxy-THC (11-OH-THC) and 11-nor-9-carboxy-THC (THCCOOH) were analyzed in the blood by gas chromatography or liquid chromatography (LC)-tandem mass spectrometry (MS/MS). The determination of THC, THCCOOH, cannabinol (CBN), and Δ9-tetrahydrocannabinolic acid A (THC-A) was carried out on OF only using LC-MS/MS. In line with the widely accepted assumption that cannabis smoking results in a strong contamination of the oral cavity, we found that THC, and also THC-A, shows a sharp, high concentration peak just after smoking, with a rapid decrease in these levels within 3 h. No obvious differences were found between both groups concerning THC median maximum concentrations measured either in blood or in OF; these levels were equal to 1,338 and 1,041 μg/L in OF and to 82 and 94 μg/L in WB for occasional and heavy smokers, respectively. The initial WB THCCOOH concentration was much higher in regular smokers than in occasional users. Compared with the occasional smokers, the sensation of confusion felt by the regular smokers was much less while the feeling of intoxication remained almost unchanged.

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Section: μG/l)supporting

confidence: 71%

Section: μG/l)mentioning

confidence: 71%

Section: μG/l)mentioning

confidence: 99%

Section: μG/l)mentioning

confidence: 99%

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Comparison of cannabinoid concentrations in oral fluid and whole blood between occasional and regular cannabis smokers prior to and after smoking a cannabis joint

et al. 2013

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“…In addition, there is concern that exposure to secondhand cannabis smoke might produce a positive drug test in oral fluid, similar to concerns expressed for urine (6), in nonsmokers. Cannabinoid-related analytes that have been identified in oral fluid after cannabis use include THC, 9-carboxy-11-nor-D 9 tetrahydrocannabinol (THCCOOH) and its conjugate, cannabidiol (CBD) and cannabinol (CBN) (7)(8)(9)(10)(11)(12)(13)(14). The 2004 US Department of Health and Human Services (DHHS) proposed revisions to mandatory guidelines for federal workplace drug testing programs (Mandatory Guidelines) with oral fluid called for initial testing for THC parent drug and a metabolite at a 4-ng/mL cutoff concentration (oral fluid) and a confirmatory test at 2 ng/mL for THC (15).…”

mentioning

confidence: 99%

Nonsmoker Exposure to Secondhand Cannabis Smoke. III. Oral Fluid and Blood Drug Concentrations and Corresponding Subjective Effects

et al. 2015

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The increasing use of highly potent strains of cannabis prompted this new evaluation of human toxicology and subjective effects following passive exposure to cannabis smoke. The study was designed to produce extreme cannabis smoke exposure conditions tolerable to drugfree nonsmokers. Six experienced cannabis users smoked cannabis cigarettes [5.3% D 9 -tetrahydrocannabinol (THC) in Session 1 and 11.3% THC in Sessions 2 and 3] in a closed chamber. Six nonsmokers were seated alternately with smokers during exposure sessions of 1 h duration. Sessions 1 and 2 were conducted with no ventilation and ventilation was employed in Session 3. Oral fluid, whole blood and subjective effect measures were obtained before and at multiple time points after each session. Oral fluid was analyzed by ELISA (4 ng/mL cutoff concentration) and by LC-MS-MS (limit of quantitation) for THC (1 ng/mL) and total THCCOOH (0.02 ng/mL). Blood was analyzed by LC -MS-MS (0.5 ng/mL) for THC, 11-OH-THC and free THCCOOH. Positive tests for THC in oral fluid and blood were obtained for nonsmokers up to 3 h following exposure. Ratings of subjective effects correlated with the degree of exposure. Subjective effect measures and amounts of THC absorbed by nonsmokers (relative to smokers) indicated that extreme secondhand cannabis smoke exposure mimicked, though to a lesser extent, active cannabis smoking.

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Current knowledge on cannabinoids in oral fluid

Lee

Huestis

2013

Drug Testing and Analysis

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Oral fluid (OF) is a new biological matrix for clinical and forensic drug testing, offering non-invasive and directly observable sample collection reducing adulteration potential, ease of multiple sample collections, lower biohazard risk during collection, recent exposure identification, and stronger correlation with blood than urine concentrations. Because cannabinoids are usually the most prevalent analytes in illicit drug testing, application of OF drug testing requires sufficient scientific data to support sensitive and specific OF cannabinoid detection. This review presents current knowledge on OF cannabinoids, evaluating pharmacokinetic properties, detection windows, and correlation with other biological matrices and impairment from field applications and controlled drug administration studies. In addition, on-site screening technologies, confirmatory analytical methods, drug stability, and effects of sample collection procedure, adulterants, and passive environmental exposure are reviewed. Delta-9-tetrahydrocannabinol OF concentrations could be > 1000 μg/L shortly after smoking, whereas minor cannabinoids are detected at 10-fold and metabolites at 1000-fold lower concentrations. OF research over the past decade demonstrated that appropriate interpretation of test results requires a comprehensive understanding of distinct elimination profiles and detection windows for different cannabinoids, which are influenced by administration route, dose, and drug use history. Thus, each drug testing program should establish cutoff criteria, collection/analysis procedures, and storage conditions tailored to its purposes. Building a scientific basis for OF testing is on-going, with continuing OF cannabinoids research on passive environmental exposure, drug use history, donor physiological conditions, and oral cavity metabolism needed to better understand mechanisms of cannabinoid OF disposition and expand OF drug testing applicability.

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Cannabinoids and metabolites in expectorated oral fluid following controlled smoked cannabis

Cited by 50 publications

References 27 publications

Comparison of cannabinoid concentrations in oral fluid and whole blood between occasional and regular cannabis smokers prior to and after smoking a cannabis joint

Comparison of cannabinoid concentrations in oral fluid and whole blood between occasional and regular cannabis smokers prior to and after smoking a cannabis joint

Nonsmoker Exposure to Secondhand Cannabis Smoke. III. Oral Fluid and Blood Drug Concentrations and Corresponding Subjective Effects

Current knowledge on cannabinoids in oral fluid

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