Drug abuse screening with exhaled breath and oral fluid in adults with substance use disorder

Abstract

In the treatment of substance use disorder, regular laboratory-based testing has the dual purpose of monitoring compliance with the prescribed medication and abstention from medically non-motivated substances (ie, drug abuse screening). The principal specimen for testing is urine, but collection of urine has some disadvantages, for example being more time-consuming and more intrusive compared to other matrices. There is also the risk of adulteration. This project compared exhaled breath and oral fluid as alternative matrices for drug abuse screening in patients with substance use disorder. All 51 subjects included in the study were enrolled at the Drug Addiction Emergency Unit in Stockholm. Exhaled breath, oral fluid, and urine samples were collected together with a self-report. Of all 117 self-reported drug intakes during the previous week, 72% were confirmed in urine, 73% in oral fluid and 39% in exhaled breath. In 31% of the subjects, additional substances other than those self-reported were detected analytically. For substance abuse screening, urine had the highest detection rate for buprenorphine, cannabis, and benzodiazepines, while oral fluid had the highest detection rate for amphetamines and methadone. Exhaled breath showed the highest detection rate of all matrices for cocaine. To identify significant differences in detection rates between the matrices future studies with larger sampling sizes are needed. Both oral fluid and exhaled breath are viable alternative specimens to urine, depending on the circumstances and purpose of the testing.

Validation and Optimization of Ultrasound-Assisted Dispersive LiquidLiquid Microextraction as a Preparation Method for Detection of Methadone in Saliva with Gas Chromatography-Mass Spectrometry Technique

“…4 Rate of methadone consimption in Iran is high and rapid detection of this drug in biological samples is a requirement in forensic medicine and toxicology. 5 In our forensic laboratories, DLLME/GC-MS is the routine method for methadone detection which is typically conducted on urine samples. 2 Oral fluid (saliva) can be a good substitute for urine sample because of its easy collection, low probability of adultration and high accuracy for methadon detection.…”

“…2 Oral fluid (saliva) can be a good substitute for urine sample because of its easy collection, low probability of adultration and high accuracy for methadon detection. 5 Limited resources in our forensic laboratories and increasing demand for methadone testing in Iran made us to seek for a more efficient, rapid and cost-effective technique of methadone analysis in biological samples as an alternative to current methods. Hence, we conducted qualitative validation of ultrasound assisted DLLME combined with GC-MS technique (UADLLME/GC-MS) for methadone detection in saliva samples and compared the efficiency of this method with conventional DLLME/ GC-MS.…”

Pharmacokinetics of methylphenidate and ritalinic acid in plasma correlations with exhaled breath and oral fluid in healthy volunteers

“…Therapeutic drug monitoring (TDM) is an established concept of quantification and interpretation of drug concentrations in biological fluids (most often in whole blood, plasma, or serum) to guide individualized dosing and for monitoring medication adherence [18,19]. Over the last decade, there has been a growing interest in alternatives to the traditional sampling matrices, blood, and urine, and significant methodological advances have been made [20,21]. Oral fluid specimens are easy-to-collect and can be used when there is a risk of adulteration of urine.…”

A Comprehensive Breath Test that Confirms Recent Use of Inhaled Cannabis within the Impairment Window

“…The same testing strategy we employed for cannabis in the present study may also prove to be useful for detecting recent use of other impairing drugs such as methamphetamine, phencyclidine, and cocaine that can be administered through vaporization. Exhaled breath testing has already been proven useful for detecting multiple drug types [15,16], and this test allows the simultaneous testing for cannabis as well as other potentially impairing drugs in both breath and blood. Potential applications include sports medicine, enforcement of workplace drug policy, and law enforcement.…”