Immunochromatography screening devices for cannabinoids in oral fluid sample

Authors

  • Jonathaline Apollo Duarte LabToxico - Laboratório de Análises e Pesquisas em Toxicologia, Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Brazil http://orcid.org/0000-0001-5979-9652
  • Roberta Petry Gorziza LabToxico - Laboratório de Análises e Pesquisas em Toxicologia, Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Brazil
  • Marina González LabToxico - Laboratório de Análises e Pesquisas em Toxicologia, Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Brazil
  • João Marcelo Astolfi Picanço LabToxico - Laboratório de Análises e Pesquisas em Toxicologia, Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Brazil
  • Renata Pereira Limberger LabToxico - Laboratório de Análises e Pesquisas em Toxicologia, Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Brazil

DOI:

https://doi.org/10.1590/s2175-97902023e20555

Keywords:

Screening devices, Drug test, Traffic accidents, Oral fluid, Cannabinoids, THC

Abstract

Cannabis sativa L. is one of the most consumed drugs in the world and recent studies have associated its use with an increase in the number of traffic accidents in different countries. In many countries, like Brazil, simple and reliable methodologies are still needed for the detection of drugs on site, mainly cannabinoids, considering its prevalence of use and oral fluid (OF) has been proved as an appropriate biological matrix for this purpose. Considering that, this work aims to review previous studies on immunochromatographic devices for on-site detection of cannabinoids in OF, discussing their sensitivity, specificity, cut-offs values and confirmatory methods. This data shows the importance of choosing a screening device and it reinforces the need for its implementation in Brazil. The research was conducted on 5 databases and all original articles, published in the last 10 years, were selected. A total of 32 articles were found, providing data for 17 screening devices of distinct brands. Only 2 screening devices showed satisfactory sensitivity and specificity in the evaluated studies (≥80% and ≥90% respectively). However, it should be considered that the screening devices still have some limitations, such as a higher cut-off than those recommended by international guidelines (cut-off > 2 ng/mL), therefore demonstrating the need for more studies in the area and the importance of confirmatory analysis usually fulfilled by LC-MS/MS, GC-MS/MS or GC-MS. Thus, the screening analyzes should not be evaluated by itself, but in association with confirmatory results and observational traits (behavioral changes), for a better understanding of the traffic scenario.

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References

Anizan S, Bergamaschi MM, Barnes AJ, Milman G, Desrosiers N, Lee D, et al. Impact of oral fluid collection device on cannabinoid stability following smoked cannabis. Drug Test Anal. 2015;7(2):114-20.

ANVISA. Agência Nacional de Vigilância Sanitária. Resolução da Diretoria Colegiada RDC No 325, de 3 de dezembro de 2019. Diário Oficial da União 04 abr; 2019 p. 85.

Anzillotti L, Castrignanò E, Rossi SS, Chiarotti M. Cannabinoids determination in oral fluid by SPME-GC/ MS and UHPLC-MS/MS and its application on suspected drivers. Sci Justice. 2014;54(6):421-6.

Arroyo A, Sanchez M, Barberia E, Barbal M, Marrón MT, Mora A. Comparison of the Cozart DDS 801 on-site drug test device and gas chromatography/mass spectrometry (GC/ MS) confirmation results of cannabis and cocaine in oral fluid specimens. Aust J Forensic Sci. 2014;46(3):272-81.

Baggio EV. Monitoramento do uso de canábis por condutores de veículo automotor: desenvolvimento de método bioanalítico compatível com a rotina laboratorial da perícia no Brasil. Universidade Federal do Rio Grande do Sul; 2017.

Beirness DJ, Smith DR. An assessment of oral fluid drug screening devices. J Can Soc Forensic Sci. 2017;50(2):55-63.

Berning A, Compton R, Wochinger K. Results of the 2013-2014 national roadside survey of alcohol and drug use by drivers. Drug-Impaired Driv Data Reduct Strateg. 2015;(February):63-74.

Blencowe T, Pehrsson A, Lillsunde P, Bernhoft IM, Engblom C, Langel K, et al. Analytical evaluation of oral fluid screening devices and preceding selection procedures. Alcohol Drug Anal. Unit Natl Inst Heal Welf Helsinki, FIN. 2010.

Blencowe T, Pehrsson A, Lillsunde P, Vimpari K, Houwing S, Smink B, et al. An analytical evaluation of eight on-site oral fluid drug screening devices using laboratory confirmation results from oral fluid. Forensic Sci Int. 2011;208(1-3):173-9.

Brasil. Ministério da Casa Civil. Lei No 9.503, de 23 de setembro de 1997. Diário Oficial da União 25 set; 1997.

Brasil. Secretaria Geral da Presidência da República. Lei No 11.343, de 23 de agosto de 2006. Diário Oficial da União 24 ago; 2006.

Callaghan RC, Gatley JM, Veldhuizen S, Lev-Ran S, Mann R, Asbridge M. AlcoholOr drug-use disorders and motor vehicle accident mortality: A retrospective cohort study. Accid Anal Prev. 2013;53:149-55.

Canada. Criminal Code. Approved Drug Screening Equipment Order. Attorney General’s Office; 2019 p. R.S.C., 1985, c. C-46.

Canadian Centre on Substance Use and Addiction. Oral Fluid Drug Screening [Internet]. 2018. Available from: https://ccsa.ca/sites/default/files/2019-04/CCSA-Oral-FluidDrug-Screening-Policy-Brief-2018-en.pdf

» https://ccsa.ca/sites/default/files/2019-04/CCSA-Oral-FluidDrug-Screening-Policy-Brief-2018-en.pdf

CEE FIOCRUZ. Centro de Estudos Estratégicos da FIOCRUZ. Descriminalizar a maconha reduziria o tráfico de drogas? [Internet]. FIOCRUZ. 2016. Available from: https://cee.fiocruz.br/?q=node/377

» https://cee.fiocruz.br/?q=node/377

Davey J, Armstrong K, Martin P. Results of the Queensland 2007-2012 roadside drug testing program: The prevalence of three illicit drugs. Accid Anal Prev . 2014;65:11-7.

DeBoni RB, Bastos FI, De Vasconcellos M, Oliveira F, Limberger RP, Pechansky F. Drug use among drivers who drank on alcohol outlets from Porto Alegre, Brazil. Accid Anal Prev . 2014;62:137-42.

Department of Health and Human Services. Mandatory Guidelines for Federal Workplace Drug Testing Programs - Oral/Fluid. Subst Abus Ment Heal Serv Adm. 2019 p. 57554-600.

Desrosiers NA, Lee D, Schwope DM, Milman G, Barnes AJ, Gorelick DA, et al. On-site test for cannabinoids in oral fluid. Clin Chem. 2012;58(10):1418-25.

Domingo-Salvany A, Herrero MJ, Fernandez B, Perez J, del Real P, González-Luque JC, et al. Prevalence of psychoactive substances, alcohol and illicit drugs, in Spanish drivers: A roadside study in 2015. Forensic Sci Int . 2017;278:253-9.

EMCDDA. European Monitoring Centre for Drugs and Drug Addiction. Driving Under the Influence of Drugs, Alcohol and Medicines in Europe findings from the DRUID project. Luxembourg: Publications Office of the European Union; 2012.

Fierro I, González-Luque JC, Álvarez FJ. The relationship between observed signs of impairment and THC concentration in oral fluid. Drug Alcohol Depend. 2014;144:231-8.

FIOCRUZ. Agência Fiocruz de Notícias. Drogas e saúde pública [Internet]. FIOCRUZ. 2013 [cited 2020 Mar 20]. Available from: Available from: https://agencia.fiocruz.br/drogas-e-saudepublica

» https://agencia.fiocruz.br/drogas-e-saudepublica

Fiorentin TR, D’Avila FB, Comiran E, Zamboni A, Scherer JN, Pechansky F, et al. Simultaneous determination of cocaine/crack and its metabolites in oral fluid, urine and plasma by liquid chromatography-mass spectrometry and its application in drug users. J Pharmacol Toxicol Methods. 2017;86:60-6.

Gentili S, Solimini R, Tittarelli R, Mannocchi G, Busardò FP. A Study on the Reliability of an On-Site Oral Fluid Drug Test in a Recreational Context. J Anal Methods Chem. 2016;2016:1-10.

Gjerde H, Clausen GB, Andreassen E, Furuhaugen H. Evaluation of dräger drugtest 5000 in a naturalistic setting. J Anal Toxicol. 2018;42(4):248-54.

Goessaert AS, Pil K, Veramme J, Verstraete A. Analytical evaluation of a rapid on-site oral fluid drug test. Anal Bioanal Chem. 2010;396(7):2461-8.

Griffiths A, Leonars R, Hadley L, Stephenson M, Teale R. Smoke on the water - Oral fluid analysis at sea. Forensic Sci Int . 2017;278:361-6.

Hartman RL, Brown TL, Milavetz G, Spurgin A, Pierce RS, Gorelick DA, et al. Cannabis effects on driving lateral control with and without alcohol. Drug Alcohol Depend . 2015 Sep;154:25-37.

Hartman RL, Huestis MA. Cannabis effects on driving skills. Clin Chem . 2013;59(3):478-92.

HealthNewsReview.org. Understanding medical tests: sensitivity, specificity and positive predictive value [Internet]. [cited 2020 Jun 18]. Available from: Available from: https://www.healthnewsreview.org/toolkit/tips-for-understandingstudies/understanding-medical-tests-sensitivity-specificityandpositive-predictive-value/

» https://www.healthnewsreview.org/toolkit/tips-for-understandingstudies/understanding-medical-tests-sensitivity-specificityandpositive-predictive-value/

Herrera-Gómez F, García-Mingo M, Colás M, González-Luque JC, Álvarez FJ. Opioids in oral fluid of Spanish drivers. Drug Alcohol Depend . 2018;187:35-9.

Huestis MA, Verstraete A, Kwong TC, Morland J, Vincent MJ, de la Torre R. Oral fluid testing: Promises and pitfalls. Clin Chem . 2011;57(6):805-10.

Krotulski AJ, Mohr ALA, Friscia M, Logan BK. Field detection of drugs of abuse in oral fluid using the AlereTM DDS®2 mobile test system with confirmation by liquid chromatography tandem mass spectrometry (LC-MS/MS). J Anal Toxicol . 2017;42(3):170-6.

Lee D, Huestis MA. Current knowledge on cannabinoids in oral fluid. Drug Test Anal . 2014;6(0):88-111.

Lee D, Milman G, Schwope DM, Barnes AJ, Gorelick DA, Huestis MA. Cannabinoid stability in authentic oral fluid after controlled cannabis smoking. Clin Chem . 2012;58(7):1101-9.

Lema-Atán JÁ, de Castro A, Lendoiro E, López-Rivadulla M, Cruz A. Toxicological oral fluid results among Spanish drivers testing positive on on-site drug controls from 2013 to 2015. Drug Alcohol Depend . 2019;195:106-13.

Lendoiro E, De Castro A, Fernández-Vega H, CelaPérez MC, López-Vilariño JM, González-Rodríguez MV, et al. Molecularly imprinted polymer for selective determination of Δ9-tetrahydrocannabinol and 11-nor-Δ9tetrahydrocannabinol carboxylic acid using LC-MS/MS in urine and oral fluid Forensic Toxicology. Anal Bioanal Chem . 2014;406(15):3589-97.

Leyton V, Sinagawa DM, Oliveira KCBG, Schmitz W, Andreuccetti G, De Martinis BS, et al. Amphetamine, cocaine and cannabinoids use among truck drivers on the roads in the State of Sao Paulo, Brazil. Forensic Sci Int . 2012;215(1-3):25-7.

Logan BK, Mohr ALA, Talpins SK. Detection and prevalence of drug use in arrested drivers using the dräger drug test 5000 and affiniton DrugWipe oral fluid drug screening devices. J Anal Toxicol . 2014;38(7):444-50.

Lund HME, Øiestad EL, Gjerde H, Christophersen AS. Drugs of abuse in oral fluid collected by two different sample kits Stability testing and validation using ultra performance tandem mass spectrometry analysis. J. Chromatogr B Anal Technol Biomed Life Sci. 2011;879(30):3367-77.

Matzopoulos R, Lasarow A, Bowman B. A field test of substance use screening devices as part of routine drunkdriving spot detection operating procedures in South Africa. Accid Anal Prev . 2013;59:118-24.

Mazina J, Spiljova A, Vaher M, Kaljurand M, Kulp M. A rapid capillary electrophoresis method with LED-induced native fluorescence detection for the analysis of cannabinoids in oral fluid. Anal Methods. 2015;7(18):7741-7.

MJSP. Ministério da Justiça e Segurança Pública. MJSP cria Grupo de Trabalho para implantar aparelho que flagra uso de drogas por motoristas [Internet]. 2020 [cited 2020 Oct 15]. Available from: Available from: https://www.justica.gov.br/news/collectivenitf-content-1555076113.46

» https://www.justica.gov.br/news/collectivenitf-content-1555076113.46

Molnar A, Fu S, Lewis J, Allsop DJ, Copeland J. The detection of THC, CBD and CBN in the oral fluid of Sativex® patients using two on-site screening tests and LC-MS/MS. Forensic Sci Int . 2014;238:113-9.

Molnar A, Lewis J, Fu S. Recovery of spiked Δ9tetrahydrocannabinol in oral fluid from polypropylene containers. Forensic Sci Int . 2013;227(1-3):69-73.

Moore C, Kelley-Baker T, Lacey J. Field testing of the Alere DDS2 mobile test system for drugs in oral fluid. J Anal Toxicol . 2013;37(5):305-7.

Moreira MR, Carvalho AI de, Ribeiro JM, Fernandes FMB. Agendas democráticas para o século XXI: percepções dos(as) brasileiros(as) sobre descriminalização e legalização da maconha. Saúde em Debate. 2016;40(spe):163-75.

Musshoff F, Hokamp EG, Bott U, Madea B. Performance evaluation of on-site oral fluid drug screening devices in normal police procedure in Germany. Forensic Sci Int . 2014;238:120-4.

Newmeyer MN, Desrosiers NA, Lee D, Mendu DR, Barnes AJ, Gorelick DA, et al. Cannabinoid disposition in oral fluid after controlled cannabis smoking in frequent and occasional smokers. Drug Test Anal . 2014;6(10):1002-10.

Newmeyer MN, Swortwood MJ, Andersson M, Abulseoud OA, Scheidweiler KB, Huestis MA. Cannabis edibles: Blood and oral fluid cannabinoid pharmacokinetics and evaluation of oral fluid screening devices for predicting Δ9-tetrahydrocannabinol in blood and oral fluid following cannabis brownie administration. Clin Chem . 2017;63(3):647-62.

ONU. Organização das Nações Unidas. Brasil, México e Uruguai mostram como segurança no trânsito pode ser melhorada [Internet]. 2019a [cited 2020 Mar 17]. Available from: Available from: https://nacoesunidas.org/brasil-mexico-e-uruguaimostram-como-seguranca-no-transito-pode-ser-melhorada/

» https://nacoesunidas.org/brasil-mexico-e-uruguaimostram-como-seguranca-no-transito-pode-ser-melhorada/

ONU. Organização das Nações Unidas. Região das Américas registra quase 155 mil mortes no trânsito por ano, diz agência da ONU [Internet]. 2019b [cited 2020 Mar 17]. Available from: Available from: https://nacoesunidas.org/regiao-dasamericas-registra-quase-155-mil-mortes-no-transito-porano-diz-agencia-da-onu/

» https://nacoesunidas.org/regiao-dasamericas-registra-quase-155-mil-mortes-no-transito-porano-diz-agencia-da-onu/

Pechansky F, Scherer JN, Schuch JB, Roglio V, Telles YM, Silvestrin R, et al. User experience and operational feasibility of four point-of-collection oral fluid drug-testing devices according to Brazilian traffic agents. Traffic Inj Prev. 2019;20(1):30-6.

Pehrsson A, Blencowe T, Vimpari K, Impinen A, Gunnar T, Lillsunde P. Performance evaluation of the DrugWipe® 5/5+ on-site oral fluid screening device. Int J Legal Med. 2011a;125(5):675-83.

Pehrsson A, Blencowe T, Vimpari K, Langel K, Engblom C, Lillsunde P. An evaluation of on-site oral fluid drug screening devices drugwipe® 5+ and rapid STAT® using oral fluid for confirmation analysis. J Anal Toxicol . 2011b;35(4):211-8.

Pelição FS, Peres MD, Pissinate JF, de Paula DML, de Faria M das GC, Nakamura-Palacios EM, et al. Predominance of alcohol and illicit drugs among traffic accidents fatalities in an urban area of Brazil. Traffic Inj Prev . 2016;17(7):663-7.

Perna EB de SF, Theunissen EL, Kuypers KPC, Toennes SW, Ramaekers JG. Subjective aggression during alcohol and cannabis intoxication before and after aggression exposure. Psychopharmacology (Berl). 2016;233(18):3331-40.

Röhrich J, Zörntlein S, Becker J, Urban R. Detection of Δ9tetrahydrocannabinol and amphetamine-type stimulants in oral fluid using the rapid statTM point-of-collection drugtesting device. J Anal Toxicol . 2010;34(3):155-61.

Rohrig TP, Moore CM, Stephens K, Cooper K, Coulter C, Baird T, et al. Roadside drug testing: An evaluation of the Alere DDS ® 2 mobile test system. Drug Test Anal . 2018;10(4):663-70.

Saldanha RF, Pechansky F, Benzano D, de Barros CASM, De Boni RB. Diferenças entre homens e mulheres vítimas de acidente de trânsito atendidos em emergências de Porto Alegre, RS, Brasil. Cienc Saude Coletiva. 2014;19(9):3925-30.

Scheidweiler KB, Andersson M, Swortwood MJ, Sempio C, Huestis MA. Long-term stability of cannabinoids in oral fluid after controlled cannabis administration. Drug Test Anal . 2017;9(1):143-7.

Scherer JN. Substâncias Psicoativas no Trânsito: Estudo sobre Fatores de Risco e Tecnologias de Detecção in loco. Universidade Federal do Rio Grande do Sul (UFRGS); 2017.

SENAD. Secretaria Nacional de Política sobre Drogas. Aperfeiçoamento em técnicas para fiscalização do uso de álcool e outras drogas no trânsito brasileiro. 2ed ed. SENAD. Brasília, DF: SENAD; 2014.

SOFT. Society of Forensic Toxicology. Oral Fluid as a Test Specimen for Roadside Studies: Guidelines for Implementing a Data Collection Program. Driving Under the Influence of Drugs (DUID); 2014.

Souza DZ, Boehl PO, Comiran E, Prusch DS, Zancanaro I, Fuentefria AM, et al. Which amphetamine-type stimulants can be detected by oral fluid immunoassays? Ther Drug Monit. 2012;34(1):98-109.

Strano-Rossi S, Castrignanò E, Anzillotti L, Serpelloni G, Mollica R, Tagliaro F, et al. Evaluation of four oral fluid devices (DDS®, Drugtest 5000®, Drugwipe 5+® and RapidSTAT®) for on-site monitoring drugged driving in comparison with UHPLC-MS/MS analysis. Forensic Sci Int . 2012;221(1-3):70-6.

Swortwood MJ, Newmeyer MN, Andersson M, Abulseoud OA, Scheidweiler KB, Huestis MA. Cannabinoid disposition in oral fluid after controlled smoked, vaporized, and oral cannabis administration. Drug Test Anal . 2017;9(6):905-15.

Tang MHY, Ching CK, Poon S, Chan SSS, Ng WY, Lam M, et al. Evaluation of three rapid oral fluid test devices on the screening of multiple drugs of abuse including ketamine. Forensic Sci Int . 2018;286:113-20.

VanderLinden T, Wille SMR, Ramírez-Fernandez M, Verstraete AG, Samyn N. Roadside drug testing: Comparison of two legal approaches in Belgium. Forensic Sci Int . 2015;249:148-55.

Veitenheimer AM, Wagner JR. Evaluation of oral fluid as a specimen for DUID. J Anal Toxicol . 2017;41(6):517-22.

Vindenes V, Yttredal B, Øiestad EL, Waal H, Bernard JP, Mørland JG, et al. Oral fluid is aviable alternative for monitoring drug abuse: Detection of drugs in oral fluid by liquid chromatography-tandem mass spectrometry and comparison to the results from urine samples from patients treated with methadone or buprenorphine. J Anal Toxicol . 2011;35(1):32-9.

Volkow ND, Baler RD, Compton WM, Weiss SRB. Adverse health effects of marijuana use. N Engl J Med. 2014;370(23):2219-27.

Walsh JM, Verstraete AG, Huestis MA, Mørland J. Guidelines for research on drugged driving. Addiction. 2008;103(8):1258-68.

WHO. World Health Organization. Global Status Report on Road Safety. Geneva: Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention (NVI); 2018.

WHO. World Health Organization. Road Traffic Injuries [Internet]. 2020 [cited 2020 Mar 17]. Available from: Available from: https://www.who.int/news-room/fact-sheets/detail/road-trafficinjuries

» https://www.who.int/news-room/fact-sheets/detail/road-trafficinjuries

Wille SMR, Samyn N, Ramírez-Fernández M del M, De Boeck G. Evaluation of on-site oral fluid screening using Drugwipe-5+®, RapidSTAT® and Drug Test 5000® for the detection of drugs of abuse in drivers. Forensic Sci Int 2010;198(1-3):2-6.

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Published

2023-04-14

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Review

How to Cite

Immunochromatography screening devices for cannabinoids in oral fluid sample. (2023). Brazilian Journal of Pharmaceutical Sciences, 59, e20555. https://doi.org/10.1590/s2175-97902023e20555