Suspicion of driving under the influence of alcohol or drugs: Cross sectional analysis of drug prevalence in the context of the Swiss legislation

Maurer, Jonathan; Vergalito, Emeline; Prior, Anne-Flore; Donzé, Nicolas; Thomas, Aurélien; Augsburger, Marc

doi:10.1016/j.forsciint.2021.111081

Cited by 9 publications

(8 citation statements)

References 19 publications

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“…Recently, Willeman et al presented trends in drivers for drugs of abuse from more than 3000 analyses of oral fluid samples over a period of 4 years in France 33 . Cannabis was the drug most frequently detected as previously observed in the last few years in other European countries such as Hungary, 34 Denmark, 35 and Switzerland 36 . As observed, cannabis consumption is more frequent and particularly in young people (under 22 years old).…”

Section: Resultssupporting

confidence: 63%

“…33 Cannabis was the drug most frequently detected as previously observed in the last few years in other European countries such as Hungary, 34 Denmark, 35 and Switzerland. 36 As observed, cannabis consumption is more frequent and particularly in young people (under 22 years old). As previously noted, HHC gained popularity in a very short time as a legal alternative to THC.…”

Section: Oral Fluid Analysismentioning

confidence: 90%

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Identification and quantification of both isomers of hexahydrocannabinol, (9R)‐hexahydrocannabinol and (9S)‐hexahydrocannabinol, in three different matrices by mass spectrometry

Bottinelli,

Baradian,

Poly

et al. 2024

Rapid Comm Mass Spectrometry

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ContextHexahydrocannabinol (HHC), a compound derived from synthetic production using cannabidiol (CBD) or delta‐9‐tetrahydrocannabinol (Δ9‐THC), has gained recent attention due to its presence in seized materials across Europe. Sold legally in various forms, HHC poses potential health risks, particularly as a legal alternative to THC in some countries. Despite its historical description in the 1940s, limited toxicology data, pharmacological understanding, and analytical methods for HHC exist.MethodThis study proposes analytical techniques using mass spectrometry to detect, identify, and quantify (9R)‐HHC and (9S)‐HHC, concurrently with THC and CBD in various matrices, including oral fluid, whole blood, and seized material. Three distinct methods were employed for different matrices: GC/MS for seized material, GC/MS/MS for whole blood, and UHPLC/MS/MS for oral fluid. Methods were validated qualitatively for oral fluid with a FLOQSwab® device and quantitatively in whole blood and seized material according to Peters et al's recommendations and ICH guidelines.ResultsValidated methods were considered reliable in detecting and quantifying HHC isomers in terms of repeatability, reproducibility, and linearity with r2 systematically >0.992. These methods were applied to authentic cases, including seized materials and biological samples from traffic control (whole blood and oral fluid). In seized materials, (9R)‐HHC levels ranged from 2.09% to 8.85% and (9R)‐HHC/(9S)‐HHC ratios varied from 1.36 to 2.68. In whole blood sample, (9R)‐HHC and (9S)‐HHC concentrations were, respectively, 2.38 and 1.39 ng/mL. For all analyzed samples, cannabinoids such as THC and CBD were also detected.ConclusionThis research contributes analytical insights into differentiating and simultaneously analyzing (9R)‐HHC and (9S)‐HHC, using widely applicable mass spectrometric methods. The study emphasizes the need for vigilance among toxicologists, as new semisynthetic cannabinoids continue to emerge in Europe, with potential health implications. The findings underscore the importance of reliable analytical methods for monitoring these compounds in forensic and clinical settings.

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Section: Resultssupporting

confidence: 63%

Section: Oral Fluid Analysismentioning

confidence: 90%

Identification and quantification of both isomers of hexahydrocannabinol, (9R)‐hexahydrocannabinol and (9S)‐hexahydrocannabinol, in three different matrices by mass spectrometry

Bottinelli,

Baradian,

Poly

et al. 2024

Rapid Comm Mass Spectrometry

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“…In previous studies of drugged drivers, median cocaine concentrations in blood ranged between 0.05 and 0.07 mg/L, and the maximum concentration reported was 1.5 mg/L ( 21 , 22 , 26 , 27 ). The median and maximum concentrations of cocaine found in our study are relatively comparable to the concentrations previously reported by others.…”

Section: Discussionmentioning

confidence: 86%

Driving under the influence of cocaine and MDMA: Relationship between blood concentrations and results from clinical test of impairment

Heide,

Jamt,

Fainberg-Sandbu

et al. 2024

Journal of Analytical Toxicology

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The general use of cocaine is increasing in recent years, while the trend for 3,4-methylenedioxymethamphetamine (MDMA) is less clear. The relationship between blood concentrations and impairment is poorly understood, which complicates interpretation. The aims of this study were to report prevalence and blood concentrations of cocaine and MDMA in drugged drivers, and to investigate the relationship between blood concentrations and impairment. Samples of whole blood were collected from apprehended drivers in the period 2000–2022, and a clinical test of impairment (CTI) was simultaneously performed. The samples were initially analyzed for cocaine and MDMA using gas chromatography mass spectrometry (until 2009 and 2012, respectively), and later using ultra-high-performance liquid chromatography–tandem mass spectrometry. Overall, cocaine was detected in 2,331 cases and MDMA in 2,569 cases. There were 377 and 85 mono cases of cocaine and MDMA, respectively. In the mono cases, the median cocaine concentration was 0.09 mg/L (range: 0.02–1.15 mg/L), and 54% of the drivers were clinically impaired. The median MDMA concentration was 0.19 mg/L (range: 0.04–1.36 mg/L), and 38% were clinically impaired. There was a statistically significant difference in the median cocaine concentration between drivers assessed as not impaired (0.07 mg/L) and drivers assessed as impaired (0.10 mg/L) (P = 0.009). There was also a significant effect of the blood concentration of cocaine (adjusted odds ratio [aOR] = 6.42, 95% confidence interval [CI] = 1.13–36.53, P = 0.036) and driving during the evening/night-time (aOR = 2.17, 95% CI = 1.34–3.51, P = 0.002) on the probability of being assessed as impaired on the CTI. No significant differences were found for MDMA. Many drivers are not assessed as impaired on a CTI following cocaine or especially MDMA use. For cocaine, a relationship between blood concentrations and impairment was demonstrated, but this could not be shown for MDMA.

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“…Malgré les possibles mises en garde du médecin, de la phar macie et de l'information destinée au patient, il arrive que ce dernier prenne néanmoins le volant. 2 En Suisse, de nombreuses personnes consomment des benzodiazépines, des antidépres seurs, des psychostimulants ou encore des antidouleurs. 3 Probablement, une majorité d'entre elles conduisent.…”

Section: Risques Pour La Personne En Traitementunclassified

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Junod¹,

Baud²,

Broers³

et al. 2022

Revue Médicale Suisse

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Prescrire des médicaments contenant des substances soumises à contrôle (SSC : stupéfiants et substances psychotropes) peut avoir des conséquences en matière de circulation routière. Nous présentons ici les devoirs du médecin et les risques encourus par la personne en traitement, avant de plaider pour une clarification s'agissant de médicaments pouvant influer sur la capacité ou l'aptitude à la conduite. Driving under the influence…Prescribing medicines containing controlled substances (SSC : narco tics and psychotropic substances) can have legal consequences as per the Road Traffic Act. We set forth the physician's duties as well as the risks incurred by the patient. We recommend that rules regarding SSC, which can influence the capacity or the ability to drive, be clarified. VIGNETTE CLINIQUE : DISCUSSIONDans le cas de la vignette, si le médecin a informé la personne traitée du risque spécifique lié à la prise de chacun des médica-

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Suspicion of driving under the influence of alcohol or drugs: Cross sectional analysis of drug prevalence in the context of the Swiss legislation

Cited by 9 publications

References 19 publications

Identification and quantification of both isomers of hexahydrocannabinol, (9R)‐hexahydrocannabinol and (9S)‐hexahydrocannabinol, in three different matrices by mass spectrometry

Identification and quantification of both isomers of hexahydrocannabinol, (9R)‐hexahydrocannabinol and (9S)‐hexahydrocannabinol, in three different matrices by mass spectrometry

Driving under the influence of cocaine and MDMA: Relationship between blood concentrations and results from clinical test of impairment

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