The relationship between observed signs of impairment and THC concentration in oral fluid

Fierro, Inmaculada; Luque, Juan Carlos González; Álvarez, F. Javier

doi:10.1016/j.drugalcdep.2014.09.770

Cited by 14 publications

(11 citation statements)

References 28 publications

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“…However, in this sample, OF THC >1600μg/L indicated intake within the last 1.4h, and >600μg/L indicated intake within the last 2.3h. In a roadside study, the percentage of people displaying observable cannabis-related impairment increased with increasing OF concentrations when aggregated into wide ranges (≤3μg/L, 3–25μg/L, 25–100μg/L, >100μg/L) (Fierro et al, 2014). …”

Section: Discussionmentioning

confidence: 99%

Cannabis effects on driving lateral control with and without alcohol

Hartman

Brown

Milavetz

et al. 2015

Drug and Alcohol Dependence

202

173

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Background Effects of cannabis, the most commonly encountered non-alcohol drug in driving under the influence cases, are heavily debated. We aimed to determine how blood Δ9-tetrahydrocannabinol (THC) concentrations relate to driving impairment, with and without alcohol. Methods Current occasional (≥1×/last 3months, ≤3days/week) cannabis smokers drank placebo or low-dose alcohol, and inhaled 500mg placebo, low (2.9%)-THC, or high (6.7%)-THC vaporized cannabis over 10min ad libitum in separate sessions (within-subject design, 6 conditions). Participants drove (National Advanced Driving Simulator, University of Iowa) simulated drives (~0.8h duration). Blood, oral fluid (OF) and breath alcohol samples were collected before (0.17h, 0.42h) and after (1.4h, 2.3h) driving that occurred 0.5–1.3h after inhalation. We evaluated standard deviations of lateral position (lane weave, SDLP) and steering angle, lane departures/min, and maximum lateral acceleration. Results In N=18 completers (13 men, ages 21–37years), cannabis and alcohol increased SDLP. Blood THC concentrations of 8.2 and 13.1μg/L during driving increased SDLP similar to 0.05 and 0.08g/210L breath alcohol concentrations, the most common legal alcohol limits. Cannabis-alcohol SDLP effects were additive rather than synergistic, with 5μg/L THC+0.05g/210L alcohol showing similar SDLP to 0.08g/210L alcohol alone. Only alcohol increased lateral acceleration and the less-sensitive lane departures/min parameters. OF effectively documented cannabis exposure, although with greater THC concentration variability than paired blood samples. Conclusions SDLP was a sensitive cannabis-related lateral control impairment measure. During-drive blood THC ≥8.2μg/L increased SDLP similar to notably-impairing alcohol concentrations. Despite OF’s screening value, OF variability poses challenges in concentration-based effects interpretation. KEYWORDS: Cannabis, Alcohol, Driving, Lateral Control, THC, Oral Fluid

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Section: Discussionmentioning

confidence: 99%

Cannabis effects on driving lateral control with and without alcohol

Hartman

Brown

Milavetz

et al. 2015

Drug and Alcohol Dependence

202

173

View full text Add to dashboard Cite

show abstract

“…The database used here is unique because the presence of drugs was determined in all drivers, whether or not they had tested positive in the roadside screening process, and because it included a representative sample of the Spanish driver population [10, 13]. However, the extent to which these figures and conclusions could be applied to other countries should be viewed with caution.…”

Section: Discussionmentioning

confidence: 99%

“…Drivers were selected at random from the total population of drivers using a sampling scheme stratified by country areas, time period, population size, and road type, following the DRUID criteria as previously described [10, 11, 13]. A total of 128 police roadside checkpoints were selected.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Roadside opioid testing of drivers using oral fluid: the case of a country with a zero tolerance law, Spain

Fierro

Colás

Luque

et al. 2017

Subst Abuse Treat Prev Policy

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BackgroundOpioids can impair psychomotor performance, and driving under the influence of opioids is associated with an increased risk of accidents. The goals of this study were i) to determine the prevalence of opioids (heroin, morphine, codeine, methadone and tramadol) in Spanish drivers and ii) to explore the presence of opioids, more specifically whether they are used alone or in combination with other drugs.MethodsThe 2008/9 DRUID database regarding Spain was used, which provided information on 3302 drivers. All drivers included in the study provided a saliva sample and mass-chromatographic analyses were carried out in all cases. To determine the prevalence, the sample was weighted according to traffic intensity. In the case of opioid use combinations, the sample was not weighted. The detection limit for each substance was considered a positive result.ResultsThe prevalence of opioids in Spanish drivers was 1.8% (95% CI, 1.4–2.3). Polydrug detection was common (56.2%): of these, in two out of three cases, two opioids were detected and cocaine was also detected in 86% of the cases. The concentration (median [Q1-Q3] ng/ml) of the substances was low: methadone 1.71 [0.10–15.30], codeine 40.55 [2.10–120.77], 6-acetylmorphine 5.71 [1.53–84.05], and morphine 37.40 [2.84–200.00]. Morphine was always detected with 6-acetylmorphine (heroin use).ConclusionsDriving under the influence of opioids is relatively infrequent, but polydrug use is common. Our study shows that 6 out of 10 drivers with methadone in their OF (likely in methadone maintenance programs) are using other substances. This should be taken into account by health professionals in order to properly inform patients about the added risks of mixing substances when driving.

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“…There is an increasing amount of literature that is addressing and comparing the performance of on‐site instrumental‐based platforms with law enforcement observations, oral fluid, urine, and blood toxicology . A report following the National Roadside Survey in 2007 showed a 97% correlation between drugs detected in simultaneously collected blood and oral fluid samples while a recent publication comparing the DDS®2 with laboratory‐based testing concluded that oral fluid testing is a viable option both at the roadside and in a laboratory setting .…”

Section: Introductionmentioning

confidence: 99%

Roadside drug testing: An evaluation of the Alere DDS^®2 mobile test system

Rohrig¹,

Moore

Stephens³

et al. 2017

Drug Testing and Analysis

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The number of drivers using drugs has increased over the last few years, and is likely to continue its upward trend. Testing drivers for alcohol use is routine and standardized, but the same is not true for the identification of driving under the influence of drugs (DUID). The Drug Evaluation and Classification Program (DECP) was developed to train police officers to recognize the signs and symptoms of recent drug use and remains an invaluable program; however, there are insufficient numbers of these highly trained drug recognition experts (DREs) available to attend every potential drug involved traffic incident. While blood and urine samples are used to test for drugs in a driver, both have disadvantages, particularly as they pertain to the length of time required after a traffic stop to sample collection. Therefore, the development of oral fluid testing devices which can be operated at the roadside and have the potential to assist officers in the identification of drug use is a major advancement in DUID cases. This project evaluated the performance of one instrumental oral fluid roadside testing device (Alere DDS®2) compared to DRE opinion, oral fluid laboratory-based analysis, and routine blood testing. The results showed that there was a good correlation with DRE observations and the device performance was >80% in all drug categories compared to laboratory-based analytical testing, both in oral fluid and blood, with few exceptions. The instrument can be considered a useful tool to assist law enforcement in identifying a drugged driver. Because the device does not test for all potentially impairing drugs, the opinion of the police officer regarding the condition of the driver should still be considered the most important aspect for arrest and further action.

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The relationship between observed signs of impairment and THC concentration in oral fluid

Cited by 14 publications

References 28 publications

Cannabis effects on driving lateral control with and without alcohol

Cannabis effects on driving lateral control with and without alcohol

Roadside opioid testing of drivers using oral fluid: the case of a country with a zero tolerance law, Spain

Roadside drug testing: An evaluation of the Alere DDS^®2 mobile test system

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The relationship between observed signs of impairment and THC concentration in oral fluid

Cited by 14 publications

References 28 publications

Cannabis effects on driving lateral control with and without alcohol

Cannabis effects on driving lateral control with and without alcohol

Roadside opioid testing of drivers using oral fluid: the case of a country with a zero tolerance law, Spain

Roadside drug testing: An evaluation of the Alere DDS®2 mobile test system

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Product

Resources

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Roadside drug testing: An evaluation of the Alere DDS^®2 mobile test system