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If you smoke cannabis and drive, you could be in for a THC saliva test.  Here is how it works in detail.  Studies done by the ma

SALIVA THC TEST BY "THE MAN"

If you smoke cannabis and drive, you could be in for a THC saliva test.  Here is how it works in detail.  

 

PREAMBLE

The campaign for DUI testing for cannabis is run by the same folks that brought you Reefer Madness, which are the same folks that ran the war on drugs.  They are up to the same old tricks, quoting studies that "show" the grave danger of the evil weed, which now focus on stoned drivers.  

Make no mistake, if you're high as a kite, you should never drive.  Then again, people that are way high don't tend to drive in the first place, as opposed to booze, where the instinct can be the opposite.

 

This is a technical review of a popular law enforcement saliva test for for THC and other cannabinoids from marijuana consumption.  This detailed article explains the details your lawyer needs to know if you need to defend yourself against a cannabis DUI.  While the research articles and statistics cited are seen to be "cherry picked" and represents not a scientific inquiry, but to make a case for need of roadside testing of THC.  With that said, this is the kind of approach and mentality that people will have to deal with in the event of a cannabis DUI.

 

Right now, there is a massive propaganda campaign to against cannabis and driving, which is ruthlessly aimed at convincing a gullible public, yet one more time about the dangers of smoking cannabis.  In actuality, veteran police officers nearly unanimously find that it is alcohol that is the real concern and that cannabis is a not a major issue.   

 

THE DRAEGER ORAL CANNABIS TEST

 

The Draeger DrugTest 5000 is an easy to use mobile drug screening system that uses oral fluid to test for seven types of the most commonly abused drugs. This quick drug test provides a non-invasive alternative to the hassle of collecting urine or blood samples, for the testing of the occasional and chronic frequent smokers of marijuana.


420 EVALUATION NOTES - Having a medical marijuana card won't protect you from being arrested for a cannabis DUI, however, if your saliva test shows marginal amounts of THC and the officer sees your medical card, he may be inclined to give you the benefit of doubt and let you on your way.  So too may a judge that is looking upon your case..  If you tested positive for marginal amounts of THCsubsequently testify that you used marijuana previously - some hours previously in a responsible way  to treat something like chronic pain, there is a good chance that you'll receive the minimum sentence or even get a nod of not guilty verdict.  

Medical marijuana patients in California are exempt from state tax and pay up to $75 per ounce compared to recreational users.   A medical recommendation for cannabis can be acquired online in minutes here.  Your medical cannabis card allows for the tax exempt purchase at dispensaries, delivery services, cannabis clubs and other licensed vendors in the State of California.

 

THE MAN AND HIS MACHINE

Marijuana is the most commonly reported illicit drug in drugged driving cases. Achievingaccurate oral liquid phytocannabinoid onsite test results are challenging and essential.to fair enforcement of the law or regulations.  These test data document that a sensitive and specific onsite screening test for phytocannabinoids in oral liquid is available for use in DUID- workplace and drug treatment programs. The instrument is easy to use and produces reliable screening test results. These test data should advance the possibility of oral liquid testing for roadside testing- providing a deterrent for drugged driving- and a means of improving public health and safety.

 

SALIVA TEST FOR THC

 

Analysis of phytocannabinoids has been the major challenge to onsite oral liquid tests due primarily to poor sensitivity- although many other instruments also had frequent false positive screening test results. We previously reported sensitivity- specificity and efficiency of the DrugTest 5000 monitoring instrument.

 

  • The system is designed for rapid, accurate drug screening.

  • Evaluate an unknown substance on the spot with the Surface Sampling Kit transfer it onto the collection tip of the test kit, then analyze the sample for immediate results.

  • Quick and simple to operate.

  • The device controls analysis time and internal temperature for accurate results.

  • Positive results can be confirmed with a second oral fluid sample via an independent, third-party laboratory analysis.

  • Results are available online in a matter of days.

  • Built-in sample collector and volume adequacy indicator.

  • Rechargeable, fully automated onsite analyzer
    The analyzer stores 500 test results with the date and time. Data can be downloaded to a PC or printed.

  • To protect both tester and the donor, sample collection is non-invasive.

  • No contact with the donor’s oral fluid.

     

The DrugTest 5000 consists of an analyzer- a test cassette- and buffer cartridge to determine if cocaine- opiates- benzodiazepines- phytocannabinoids- amphetamines- or methamphetamine are present in oral liquid above specified cutoffs. After the buffer cartridge and test cassette are inserted into the instrument- the analysis is automated and the cartridge is pushed onto the tip of the test cassette for the lateral flow immunoassay.

 

Test cassettes were calibrated during production with fortified native oral liquid and the threshold for a positive result encoded on the test cassette. Objective test results are displayed on a screen as “Positive”- “Negative,” or “Invalid”. An invalid result occurs if the instrument detects problematic lateral flow. THC test results are acquired in 8.5 minutes while other drugs are achieved in 5 minutes

 

The DrugTest 5000 test cassette was equipped with a polymeric non-compressible pad for oral liquid collection. Oral liquid was collected by swiping the test cassette on the tongue and side of the cheeks.  Test cassettes were analyzed immediately and compared to 2D-GCMS phytocannabinoid test results from simultaneously collected Oral-Eze oral liquid.
 

 

Draeger DrugTest 5000 at a 5 ng/mL screening cutoff and 1 ng/mL DRUID {87.7 percent - 77.8 percent  and 86.4 percent }- and 2 ng/mL SAMHSA {90.7 percent - 75.0 percent - and 87.9 percent } 2D-GCMS analysis of oral liquid collected with the Quantisal oral liquid instrument in chronic frequent marijuana smokers. For the first time- we present performance test data for the DrugTest 5000 5 ng/mL cutoff with the same confirmation cutoffs in oral liquid collected with the Oral-Eze collection instrument.

 

Sensitivity of the DrugTest 5000 5 ng/mL cutoff was lower for occasional as compared to chronic frequent smokers over the extended 30 hours monitoring window with the 1 and 2 ng/mL confirmation cutoffs; however- these authentic test data after controlled smoked marijuana document the best performance to date for onsite phytocannabinoid tests. Sensitivity within 6 and 8 hours time frames- highly relevant for DUI testing and representing recent marijuana smoking- were 85.6 and 84.7 percent  and 84.0 and 82.5 percent  at the proposed SAMHSA and DRUID confirmation cutoffs- respectively.   instrument performance and OF phytocannabinoid detection windows 30h post-smoking were evaluated in occasional {<2x/week} and frequent {≥4x/week} marijuana smokers.
 

Methods

10 occasional and 14 frequent smokers {18-45 years} provided written informed consent for this Institutional Review Board-approved study- and smoked ad libitum one 6.8 percent  THC marijuana joint. OF was collected with the DrugTest 5000 test cassette and Oral-Eze® collector {Quest Diagnostics} before and frequently up to 30h post-dose. Test cassettes were analyzed immediately and compared to two-dimensional gas chromatography mass spectrometry {2D-GCMS} phytocannabinoid test results from simultaneously collected Oral-Eze OF.
 

Test Results


404 paired OF were collected; 9 samples {2.2 percent } were invalid- yielding 395 OF pairs for comparison. Sensitivity- specificity and efficiency were 75.3- 94.1- and 81.8 percent  and 66.4- 98.9, and 73.9 percent  with 2 ng/mL THC proposed SAMHSA and 1 ng/mL DRUID confirmation cutoffs- respectively. Sensitivity was 6-11 percent  higher in chronic frequent as compared to occasional marijuana smokers due to longer detection windows and higher true positive rates.  Median {range} last detection times with the DrugTest 5000 were 12h {4-24} and 21h {1->30} for occasional and frequent smokers- respectively {p=0.12- >30 assigned as 30h}. Three frequent smokers were still positive at 30 hours but had up to 5 negative specimens prior to 30h.
 

Discussion and conclusions


Sensitivity of the DrugTest 5000 5 ng/mL cutoff was lower for occasional as compared to chronic frequent smokers over the extended 30h monitoring window with the 2 and 1 ng/mL confirmation cutoffs; however- these authentic test data after controlled smoking document the best performance to date for onsite phytocannabinoid tests. Sensitivity within 6 and 8h time frames- representing recent smoking- were 85.6 and 84.7 percent ; and 84.0 and 82.5 percent  at the proposed SAMHSA and DRUID confirmation cutoffs- respectively.  Supported by the Intramural Research Program- NIH- National Institute on Drug Abuse

 

Introduction


Marijuana sativa {marijuana} has been smoked for its medicinal and psychoactive properties for thousands of years and is the most widely consumed illicit drug in the world.   Evaluation the onsite Draeger DrugTest 5000 in occasional and chronic frequent smokers following controlled marijuana smoking 2002}. Worldwide- 119-224 million people {2.6-5.0 percent } aged 15-64 consumed marijuana at least once in 2010 {World Drug Report 2012}. In 2011 in the United States- 18.1 million Americans 12 years and older {7.0 percent } reported past-month use and 4.3 million Americans {1.6 percent } reported past-year marijuana dependence or abuse {test results from the 2011 National Survey on Drug Use and Health: Summary of National Findings. 2012}.

In addition- 872,000 Americans received treatment for marijuana dependence or abuse- second only to alcohol. marijuana is also common in driving under the influence of drugs {DUI} cases. Δ9 tetrahydrocannabinol {THC} was the most prevalent illicit drug detected in injured drivers {9.8 percent } in Victoria- Australia {Drummer- Kourtis- Beyer- Tayler- Boorman- Gerostamoulos, 2012}. Similarly- in the first US Roadside Survey in 2007- phytocannabinoids were identified in oral liquid and/or blood in 8.6 percent  of nighttime drivers {Lacey et al.- 2009}. Nearly two-thirds of U.S. trauma center admissions were due to motor vehicle accidents- with almost 60 percent  positive for drugs or alcohol {Walsh et al.- 2004}.

 

Acute marijuana intoxication produces dose-related impairment in cognitive and psychomotor functioning- as well as risk-taking behavior {McDonald- Schleifer- Richards- de Wit H.- 2003}; Ramaekers et al.- 2006}. Reaction time {RT}- perception- short-term memory and attention- motor skills- tracking- and skilled activities are altered. Driving within one hour of smoking marijuana increased crash risk - even after adjustment for demographic characteristics. In France- drivers in fatal crashes with detectable THC in blood had a 3.17 OR for crash responsibility {Laumon- Gadegbeku- Martin- Biecheler; SAM Group- 2005}. Driving under the influence of marijuana or synthetic phytocannabinoids prior to or during driving increases the risk of death or injury and is an important public safety concern.
 

Oral liquid drug testing in workplace- pain management- drug treatment and DUID programs is increasing due to advantages in drug monitoring, including easy- less invasive specimen collection- lack of the need for a same-sex collector- and less opportunity for adulteration.  Elucidating phytocannabinoid oral liquid pharmacokinetics after controlled smoked marijuana is essential for determining drug detection windows- markers of recent smoking- and minimizing potential for passive environmental smoke contamination.

 

The ideal drug detection window varies depending upon the goals and design of drug testing programs. For workplace- pain management- and drug treatment research follow-up visits- a long drug detection window is ideal- as testing opportunities are widely separated. However- drug testing during accident investigations or “for cause” testing is focused on recent use and potential impairment. Controlled marijuana administration and sequestration of participants on closed research units to eliminate self-administered drugs provide test data for rigorously determining windows of drug detection in oral liquid and improving result interpretation.

 

Oral liquid testing offers non-invasive sample collection for onsite drug testing; however- until recently {Desrosiers et al.- 2012}- test performance for THC detection had unacceptable diagnostic sensitivity. onsite tests must accurately identify marijuana exposure since this drug accounts for the highest prevalence in workplace drug testing and DUID programs. The DrugTest 5000 onsite instrument provided high diagnostic sensitivity and specificity for detection of phytocannabinoid exposure.
 

We conducted a controlled smoked marijuana administration study are to characterize and contrast the disposition of THC and its metabolites in blood- plasma- urine- oral liquid- and breath in occasional and chronic frequent marijuana smokers. In addition- we evaluated the sensitivity- specificity- accuracy- and predictive values of the Draeger DrugTest 5000® for identifying phytocannabinoids in oral liquid as compared to phytocannabinoid test results.  Evaluation the onsite Draeger DrugTest 5000 in occasional and chronic frequent smokers following controlled marijuana smoking collected with the Oral-Eze collector before and frequently up to 30 hours after smoking a 6.8 percent THC joint.
 


Study Design
This clinical study- approved by the National Institute on Drug Abuse Institutional Review Board- recruited chronic frequent marijuana and occasional smokers. The study consisted of a three day- two-night stay on a closed clinical research unit. Baseline measures and biological samples were collected before drug administration. Participants smoked ad-libitum {10 min maximum} one 6.8±0.2 percent  {54 milligrams} THC- 0.25±0.08 cannabidiol {CBD}- and 0.21±0.02 percent cannabinol {CBN} marijuana joint the morning of Day 2 and provided oral liquid samples up to 30 hours after smoking.

 

Participants
Occasional and frequent marijuana smokers {age 18-45 years} were recruited from the community by advertising and word-of-mouth. Occasional smokers self-reported an average smoking frequency <2 times per week in the past 3 months. Chronic frequent smokers self reported an average smoking frequency ≥4 times per week in the past 3 months and had a positive urine phytocannabinoid test.

 

Additional inclusion criteria included peripheral veins suitable for venipuncture- blood pressure ≤140 mm Hg systolic and 90 mm Hg diastolic- heart rate ≤90 bpm- and an electrocardiogram and 3-minute rhythm strip without clinically significant abnormalities.

 

Exclusion criteria included history of any clinically significant sickness- based on medical history- physical examination- and clinical laboratory tests- history of a clinically significant adverse event associated with marijuana intoxication- donation of more than 450 mL blood in previous 30 days- pregnancy or nursing- or interest or participation in drug abuse treatment within the past 60 days.

 

Pregnancy tests were administered at screening and on the morning of drug administration to women with reproductive potential. The National Institute on Drug Abuse Institutional Review Board approved the study. All participants provided written informed consent and were compensated for their study participation.
 

Sample collection and analysis
The Oral Eze® instrument was utilized for oral liquid collection at admission {16 to 19 h before drug administration}- 1 hour before- and 0.5- 1- 2- 3- 4- 5- 6- 8- 10.5- 13.5- 21- 24- 26- 28- and 30 hours after smoked marijuana. Oral intake- including smoking- was prohibited 10 min before oral liquid collection. The collection instrument consists of an absorptive cotton pad- a volume adequacy indicator that turns blue upon collection of 1 mL oral liquid- and a plastic tube containing 2 mL stabilizing buffer- yielding a 1:3 oral liquid dilution. Following manufacturer recommendations- parameters were eluted from the pad at room temperature for at least 12 hours. Oral liquid analysis generally occurred within 24 h of collection. THC- 11-OH THC,

 

THCacid- CBN- and CBD were quantified by two-dimensional gas chromatography mass spectrometry {2D-GCMS} according to a previously published method {Milman, Barnes- Lowe- Huestis- 2005} with minor modifications: calibrators and quality controls were prepared with 0.25 mL blank oral liquid and 0.5 mL Oral-Eze® buffer- identical with the 1:3 dilution of authentic samples. Intra-assay imprecision was 1.0 percent -4.7 percent - inter-assay imprecision was <7.6 percent - and bias was 88.2 percent -110.1 percent .

 

Evaluation the onsite Draeger DrugTest 5000 in occasional and chronic smokers following controlled marijuana smoking observed:

 

  • THC- 42.5-48.8 percent  

  • 11-OH-THC- 43.5-54.5 percent  

  • THCacid- 68.1-86.2 percent

  • CBN- 35.6-58.7 percent

  • CBD- 33.5-47.7 percent
     

 

Test data analysis
Qualitative oral liquid DrugTest 5000 phytocannabinoid test results were evaluated against a preprogrammed 5 μg/L THC cutoff. True positive {TP- DrugTest 5000 and GC-MS positive}, true negative {TN- DrugTest 5000 and GC-MS negative}- false positive {FP- positive DrugTest 5000, however,  less than GC-MS specified cutoff} and false negative {FN- negative. DrugTest 5000, however,  positive GC-MS at specified cutoff} test results were calculated at 5 μg/L

 

THC DrugTest 5000 screening cutoff and 1 {Driving Under the Influence of Drugs- Alcohol and Medicines- DRUID}- and 2 {Substance Abuse and Mental Health Services Administration- SAMHSA} GC-MS THC confirmation cutoffs. Diagnostic sensitivity ,diagnostic specificity and efficiency.  {100×{[TP+TN]/[TP+TN+FP+FN]}} were calculated at one screening and multiple confirmation cutoffs. Rates of detection and windows of detection were evaluated with the DrugTest 5000 screen and different confirmation parameters and cutoffs.
 

Results
Fourteen chronic- frequent and 10 occasional marijuana smokers spent the night before smoking on the clinical unit to ensure that participants were not intoxicated at the time of smoking. Chronic- frequent users reported smoking a median {range} of 28 marijuana joints per week {21-147}- while occasional smokers reported 0.75 marijuana joints per week {0.06-2.5}. Four hundred and four paired oral liquid specimens were collected; 9 samples {2.2 percent } were invalid- yielding 395 oral liquid pairs for comparison.

 

Sensitivity- specificity and efficiency were 66.4- 98.9- and 73.9 percent  with the 1 ng/mL DRUID- and 75.3- 94.1- and 81.8 percent  with the 2 ng/mL THC proposed SAMHSA confirmation cutoffs- respectively. Sensitivity was 6-11 percent  higher in chronic frequent as compared to occasional marijuana smokers due to longer detection windows and higher true positive rates. Median {range} last detection times with the DrugTest 5000 were 12 hours {4-24} and 21 hours {1->30} for occasional and frequent smokers- respectively {p=0.12- >30 assigned as 30 hours}.

 

Evaluation of the onsite Draeger DrugTest 5000 in occasional and chronic frequent smokers following controlled marijuana smoking oral liquid specimens were still positive at 30 hours, however, had up to 5 negative oral liquid specimens prior to 30 hours.
 

Discussion and conclusions
The DrugTest 5000 was easy to operate and provided reliable test results and operation. The instrument was designed to be operated by non-medical personnel in the field under diverse weather and lighting conditions. The oral liquid collection instrument has a volume indicator to tell the operator when sufficient oral liquid is collected. The instrument may only be inserted into the instrument in one way- and the reading of the reaction line is performed by the instrument- a major advantage over many other onsite tests that require the operator to read the presence or absence of a line to indicate a qualitative positive or negative test result. This is especially difficult under poor on-the-road lighting conditions.

 

 

References


Vega- W.A.- Aguilar-Gaxiola- S.- Andrade- L.- Bijl- R.- Borges- G.- Caraveo-Anduaga- J.J,  Wittchen- H.U. {2002}. Prevalence and age of onset for drug use in seven international sites: test results from the international consortium of psychiatric epidemiology. Drug and Alcohol Dependence 68{3}:285-297.
 

World Drug Report 2012. United Nations Office of Drugs and Crime {2012} Vienna.
 

Test results from the 2011 National Survey on Drug Use and Health: Summary of National
 

Substance Abuse and Mental Health Services Administration {2012}, Findings.
 

NSDUH Series H-44. U.S. Department of Health and Human Services- Rockville.Drummer- O.H.- Kourtis- I.- Beyer- J.- Tayler- P.- Boorman. M.- Gerostamoulos. D. {2012}.
 

The prevalence of drugs in injured drivers. Forensic Science International 215{1–
3}:14-17. Lacey- J.H.- Kelley-Baker- T.- Furr-Holden- D.- Voas- R.B.- Romano- E.- Ramirez- A.- …Berning- A. {2009}. 2007 National Roadside Survey of Alcohol and Drug Use

 

Evaluation the onsite Draeger DrugTest 5000 in occasional and chronic frequent smokers following controlled marijuana smoking
 

Drivers: Drug findings. National Highway Traffic Safety Administration Office of Behavioral Safety Research- Washington- DC.
Walsh- J.M.- Flegel- R.- Cangianelli- L.A.- Atkins- R.- Soderstrom- C.A. Kerns- T. J. {2004}

 

Epidemiology of alcohol and other drug use among motor vehicle crash victims admitted to a trauma center. Traffic Injury Prevention 5:254-260. Lane- S.D.- Cherek- D.R.- Tcheremissine- O.F.- Living- L.M.- Pietras- C.J. {2005}

 

Acute Marijuana effects on human risk taking. Neuropsychopharmacology 30:800-809. McDonald- J.- Schleifer- L.- Richards- J.B.- de Wit H. {2003} Effects of THC on behavioral measures of impulsivity in humans. Neuropsychopharmacology 28:1356-1365. Ramaekers- J.G.- Kauert- G.- van Ruitenbeek- P.- Theunissen- E.L.- Schneider- E.- Moeller, M.R. {2006}

 

High-potency marijuana impairs executive function and inhibitory motor control. Neuropsychopharmacology 31:2296-2303. Ramaekers- J.G.- Berghaus- G.- van Laar- M.- Drummer O.H. {2004}

 

Dose related risk of motor vehicle crashes after marijuana use. Drug and Alcohol Dependence 73:109-119. Riedel- G. and Davies- S.N. {2005} Phytocannabinoid Function in Learning- Memory and Plasticity. edited by R. G. Pertwee {Verlag- Springer- NY}- Vol. 168- pp. 446-470.Asbridge- M.- Poulin- C.- and Donato- A. {2005}

 

Motor vehicle collision risk and driving under the influence of marijuana: evidence from adolescents in Atlantic Canada. Accident- Analysis and Prevention 37:1025-1034. Mann- R.E.- Adlaf- E.- Zhao- J.- Stoduto- G.- Ialomiteanu- A.- Smart- R.G.- Asbridge- M.
{2007}

Marijuana use and self-reported collisions in a representative sample of adult drivers. Journal of Safety Research 38:669-674. Laumon- B.- Gadegbeku- B.- Martin- J.L.- Biecheler MB; SAM Group. {2005} marijuana intoxication and fatal road crashes in France: population based case-control study.British Medical Journal 331:1371-1374. Desrosiers- N.A.- Lee- D.- Schwope- D.M.- Milman- G.- Barnes- A.J.- Gorelick- D.A.- Huestis, M.A.

2012 onsite Test for Phytocannabinoids in Oral liquid. Clinical Chemistry. 58{10}:1418-25. Milman- G.- Barnes- A.J.- Lowe- R.H.- Huestis- M.A. {2010} Simultaneous quantification of phytocannabinoids and metabolites in oral liquid by two-dimensional gas chromatography mass spectrometry. Journal of Chromatography A 1217;1513–21.

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