In toxicological testing, drug stability is important when providing quantitative results and interpretation of findings, as well as when collecting correlation data. The goal of this study was to expand on previous stability studies and to evaluate other cannabinoids encountered in forensic toxicology. In this 6-month study, the stability of Δ-9-tetrahydrocannabinol (THC), 11-hydroxy-THC, 11-nor-9-carboxy-THC, Cannabinol and Cannabidiol in antemortem and postmortem blood was evaluated in refrigerated (4°C) and frozen (−4°C) storage conditions. Pooled antemortem and postmortem bloods were fortified at low and high concentrations and stored in untreated glassware. Over 6 months, samples were analyzed by automated extraction and liquid chromatography-mass spectrometry/mass spectrometry to evaluate the change in concentration over time. Samples in each storage condition were analyzed in triplicate 12 times over the 6-month period. Cannabinoids in antemortem blood were more stable in the refrigerated condition than in the frozen condition, with 11-hydroxy-THC, 11-nor-9-carboxy-THC and Cannabinol having more than 80% of the original concentration remaining at the end of the study. Cannabinoids in postmortem blood had improved stability in the frozen storage condition with THC, 11-hydroxy-THC, 11-nor-9-carboxy-THC and Cannabinol in the low concentration pool with more than 80% of the original concentration remaining. These data demonstrated that cannabinoids may decrease in concentration over time when stored in untreated glass vials. To ensure the most accurate determination of drug concentration, samples containing cannabinoids should be analyzed as soon as possible.

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Starting in early 2017 flualprazolam was detected in toxicology and seized drug cases across the United States of America. Due to the addition of fluorine to alprazolam, flualprazolam’s chemistry was enough to bypass targeted toxicology confirmations and it has become increasingly available for purchase both on the dark web and in counterfeit pills. Flualprazolam was added to the exact mass screening regiment of the Orange County forensic laboratory in December of 2018. Through data mining of previously analyzed cases, data were evaluated beginning from August of 2018. Flualprazolam was subsequently added to the laboratory’s validated quantitative liquid chromatography dual mass spectrometry method in the summer of 2020 and all driving cases from August of 2018 to June of 2020 were re-analyzed to obtain concentrations. The police and drug recognition evaluation (if available) reports were collected and reviewed for all cases where flualprazolam was detected. Of the 203 cases containing quantifiable drug, the average flualprazolam concentration (median, range) was 22.8 ng/mL (15.4 ng/mL, 4.0 to 133.3 ng/mL). Only two cases had flualprazolam detected with no other drugs. The most common other drugs detected were THC (62%), ethanol (20%) and cocaine and/or methamphetamine (32%). The most common reason for the police investigation was an accident/collision (50%) and the most common time of officer contact was evening (1800 to 2359). The field sobriety test (FST) results were evaluated and showed a higher frequency of impaired performance in cases of flualprazolam in combination with other drugs. No conclusion could be made regarding the effect of flualprazolam alone on FST performance.

Over the last 25 years, marijuana laws have been changing throughout the United States of America. California started legalizing medicinal marijuana in 1996 and has since continued to relax laws. Compared to Washington and Colorado, there is little data on how the changing laws have affected the cannabinoid detection rate in California. This paper looks at the prevalence of five cannabinoids (Δ9-tetrahydrocannabinol (THC), 11-hydroxy-tetrahydrocannabinol (Hydroxy-THC), 11-nor-9-carboxy-tetrahydrocannabinol (Carboxy-THC), cannabinol, and cannabidiol) in Orange County, CA for 2016 through 2019. From 2016 – 2017, after legalizing recreational marijuana, there was an increase in the presence of THC, Carboxy-THC and Hydroxy-THC in postmortem and major crime cases, consisting mostly of sexual assaults. However, driving under the influence of drugs (DUID) saw a slight decrease. In 2018, when shops could be licensed to sell marijuana to anyone over 21 years old, there was an increase seen in all five cannabinoids for DUID and postmortem cases. The age group from 21 – 30 years old had the most prevalent cannabinoid use in all case types for all years except in major crime cases in 2019 where < 21 years old was the most prevalent. Surprisingly, the > 50 years old group in death investigation cases was a close second in prevalence in all years which differs from DUID and major crime cases.