Drugs of Abuse in Saliva: A Review

Abstract

There has been substantial interest in the use of saliva as a diagnostic medium for drugs of abuse because it can be obtained noninvasively. Although drugs of abuse have been investigated in saliva for more than a decade, the role of saliva remains uncertain. A clear picture is difficult to obtain because of variations in (1) the analytical methods used; (2) the dose regimen of subjects, which was either unknown or differed between studies; and (3) the elapsed time between drug intake and sample collection. This communication summarizes the studies on the quantitative determination of different drugs of abuse in saliva to elucidate the current status in this area. Marijuana, cocaine, phencyclidine, opiates, barbiturates, amphetamines, and diazepines (or their metabolites) have all been detected in saliva by various analytical methods, including immunoassay, gas chromatography/mass spectrometry, and thin layer chromatography. Initial studies with cocaine and phencyclidine suggest a correlation between saliva and plasma concentrations of these drugs, indicating a dynamic equilibrium between saliva and blood. Tetrahydrocannabinol, the active component in marijuana, on the other hand, does not appear to be transferred from plasma to saliva. However, tetrahydrocannabinol is sequestered in the buccal cavity during smoking and can be detected in saliva. These findings point to the potential role of saliva in the analysis of many illicit drugs. To clearly identify the role of saliva as a diagnostic medium for drugs of abuse, research efforts should be directed towards (1) performing systematic studies on correlations between saliva, blood, and urine and (2) determining the concentrations of drugs and their metabolites in saliva as a function of dose and time after intake.

Oral fluid as an alternative matrix to monitor opiate and cocaine use in substance-abuse treatment patients

“…In recent years, interest in other biological matrices as alternative drug-testing tools has grown, with oral fluid as one of the most promising new matrices (Choo and Huestis, 2004;Kidwell et al, 1998;Rivier, 2000;Schramm et al, 1992). This colorless, highly aqueous liquid is a natural ultrafiltrate of plasma (Haeckel and Hanecke, 1996).…”

“…A number of illicit drugs have been detected in oral fluid including cocaine, amphetamine and derivatives, opioids, phencyclidine (PCP) and cannabinoids (Clauwaert et al, 2004;Cone, 1993;Cooper et al, ;Drummer, 2005;Idowu and Caddy, 1982;Schramm et al, 1992). Controlled drug administration studies have investigated the presence and pharmacokinetic characteristics of a number of these drugs in oral fluid (Cone, 1993;Cone et al, 1997;Jenkins et al, 1995;Jufer et al, 2000;Kacinko et al, 2004;Kato et al, 1993;Kim et al, 2002;Kintz et al, 1998;Kopecky et al, 1997;Moolchan et al, 2000;Navarro et al, 2001;O'Neal et al, 1999;Schepers et al, 2003;Skopp et al, 2001;Wang et al, 1994) Furthermore, oral fluid has been successfully applied in criminal justice programs (Yacoubian et al, 2001), workplace (Cone, 2001) and roadside drug testing (DUI) (Peel et al, 1984;Samyn and van Haeren, 2000), but little is known of the usefulness of oral fluid drug monitoring in a population of substance-abuse treatment patients.…”

Salivary Diagnosis: A Single Drop Can Diagnose Many

“…But, the salivary drug measurement is made difficult due to the unwanted materials in the whole saliva like bacterial products and epithelia cells which make the collected samples unstable, and these can be dealt with with the use of salivary sample preservatives and advanced/improved saliva collection methods and devices. 21,22,23,24,25,26 …”

Microextraction Techniques for Forensic Drug Analysis in Saliva

“…In recent times, saliva has emerged as an alternative biological matrix for screening and determination of drugs of abuse. Main advantages of saliva drug testing are, a) Sampling of saliva is simple, quick and non-invasive and can be performed on-site, b) In case of sampling supervision, unlike sampling of urine, saliva sampling can be done without violating any privacy, and c) Concentration of drugs in saliva can be correlated to freedrug concentration in plasma [2,3].…”