Oral fluid drug tests: Effects of adulterants and foodstuffs

Wong, Raphael C.; Tran, Minhchau; Tung, James K.

doi:10.1016/j.forsciint.2005.02.023

Cited by 37 publications

(22 citation statements)

References 2 publications

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“…The risk of test falsification requires initial characterization and continuous surveillance of potential interfering substances and adulterants. Specified foods, drinks, mouthwash, and cigarettes did not interfere with the Cozart RapiScan and the Cozart Microplate ELISA assays for opiates (22), cocaine (23), and amphetamines (24), nor with the Branan Oratect ® collection device (25). Alcohol and hemoglobin did not affect the Cozart assays and the RapiScan collection device (22–24).…”

Section: Poctmentioning

confidence: 99%

Oral Fluid Testing for Drugs of Abuse

2009

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BACKGROUND Oral fluid (OF) is an exciting alternative matrix for monitoring drugs of abuse in workplace, clinical toxicology, criminal justice, and driving under the influence of drugs (DUID) programs. During the last 5 years, scientific and technological advances in OF collection, point-of-collection testing devices, and screening and confirmation methods were achieved. Guidelines were proposed for workplace OF testing by the Substance Abuse and Mental Health Services Administration, DUID testing by the European Union’s Driving under the Influence of Drugs, Alcohol and Medicines (DRUID) program, and standardization of DUID research. Although OF testing is now commonplace in many monitoring programs, the greatest current limitation is the scarcity of controlled drug administration studies available to guide interpretation. CONTENT This review outlines OF testing advantages and limitations, and the progress in OF that has occurred during the last 5 years in collection, screening, confirmation, and interpretation of cannabinoids, opioids, amphetamines, cocaine, and benzodiazepines. We examine controlled drug administration studies, immunoassay and chromatographic methods, collection devices, point-of-collection testing device performance, and recent applications of OF testing. SUMMARY Substance Abuse and Mental Health Services Administration approval of OF testing was delayed because questions about drug OF disposition were not yet resolved, and collection device performance and testing assays required improvement. Here, we document the many advances achieved in the use of OF. Additional research is needed to identify new bio-markers, determine drug detection windows, characterize OF adulteration techniques, and evaluate analyte stability. Nevertheless, there is no doubt that OF offers multiple advantages as an alternative matrix for drug monitoring and has an important role in DUID, treatment, workplace, and criminal justice programs.

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Section: Poctmentioning

confidence: 99%

Oral Fluid Testing for Drugs of Abuse

2009

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“…In addition, the parent drug is usually present in high concentrations, making oral fluid testing great for identifying drugs. However, as with other tests, drug concentration levels found in saliva may fluctuate based on the individuals physiology, the type of technique used to collect the fluid, and other external/environmental factors [33][34][35]. Due to the high concentrations of the parent drug in oral samples, the cut off values are larger in oral devices compared to GC/MS and vary from substance to substance, for example, cocaine metabolites: 4 ng/mL (GC/MS) v. 20 ng/mL (oral); THC metabolites: 0.2 ng/mL (GC/MS) v. 40 ng/mL (oral) [35].…”

Section: Oralmentioning

confidence: 99%

“…However, as discussed, there are still factors that can affect the drug concentrations in saliva and need to be considered. A study conducted using one specific device, Oratect, showed that drug concentrations were not affected by foods, toothpaste, and beverages 30 min after exposure [35].…”

Section: Advantages and Disadvantagesmentioning

confidence: 99%

Review and Recommendations for Drug Testing in Substance Use Treatment Contexts

Jaffe¹,

Molnar²,

Williams³

et al. 2016

J Reward Defic Syndr Addict Sci

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“…However, there were no false-positive results with mass spectrometry confirmation of presumptive positive OF screening test results. A third study demonstrated that mouthwash decreased 2- or 3-fold the concentrations of opiates in OF collected with an Oratect ® or Intercept device 30 min after rinsing of the mouth, which was 30 min after administration of 10 mg codeine or 1 h after eating a 180-g poppy seed muffin (76). Finally, the OF elution buffer that stabilizes analytes and improves drug recovery from the collection pad can require frequent changes of GC-MS septa, liners, columns, and sources.…”

Section: General Limitations and Advantages Of Drug Testingmentioning

confidence: 99%

The Potential Role of Oral Fluid in Antidoping Testing

Anizan

Huestis

2014

Clinical Chemistry

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BACKGROUND Currently, urine and blood are the only matrices authorized for antidoping testing by the World Anti-Doping Agency (WADA). Although the usefulness of urine and blood is proven, issues remain for monitoring some drug classes and for drugs prohibited only in competition. The alternative matrix oral fluid (OF) may offer solutions to some of these issues. OF collection is easy, noninvasive, and sex neutral and is directly observed, limiting potential adulteration, a major problem for urine testing. OF is used to monitor drug intake in workplace, clinical toxicology, criminal justice, and driving under the influence of drugs programs and potentially could complement urine and blood for antidoping testing in sports. CONTENT This review outlines the present state of knowledge and the advantages and limitations of OF testing for each of the WADA drug classes and the research needed to advance OF testing as a viable alternative for antidoping testing. SUMMARY Doping agents are either prohibited at all times or prohibited in competition only. Few OF data from controlled drug administration studies are available for substances banned at all times, whereas for some agents prohibited only in competition, sufficient data may be available to suggest appropriate analytes and cutoffs (analytical threshold concentrations) to identify recent drug use. Additional research is needed to characterize the disposition of many banned substances into OF; OF collection methods and doping agent stability in OF also require investigation to allow the accurate interpretation of OF tests for antidoping monitoring.

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Oral fluid drug tests: Effects of adulterants and foodstuffs

Cited by 37 publications

References 2 publications

Oral Fluid Testing for Drugs of Abuse

Oral Fluid Testing for Drugs of Abuse

Review and Recommendations for Drug Testing in Substance Use Treatment Contexts

The Potential Role of Oral Fluid in Antidoping Testing

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