Oral Fluid vs. Urine Analysis to Monitor Synthetic Cannabinoids and Classic Drugs Recent Exposure

Abstract

Background Urine is a common biological sample to monitor recent drug exposure, and oral fluid is an alternative matrix of increasing interest in clinical and forensic toxicology. Limited data are available about oral fluid vs. urine drug disposition, especially for synthetic cannabinoids. Objective To compare urine and oral fluid as biological matrices to monitor recent drug exposure among HIV-infected homeless individuals. Methods Seventy matched urine and oral fluid samples were collected from 13 participants. Cannabis, amphetamines, benzodiazepines, cocaine and opiates were analyzed in urine by the enzyme-multiplied-immunoassay-technique and in oral fluid by liquid chromatography tandem mass spectrometry (LC-MSMS). Eleven synthetic cannabinoids were analyzed in urine and in oral fluid by LC-MSMS. Results Five oral fluid samples were positive for AB-FUBINACA. In urine, 4 samples tested positive for synthetic cannabinoids PB-22, 5-Fluoro-PB-22, AB-FUBINACA, and metabolites UR-144 5-pentanoic acid and UR-144 4-hydroxypentyl. In only one case, oral fluid and urine results matched, both specimens being AB-FUBINACA positive. For cannabis, 40 samples tested positive in urine and 30 in oral fluid (85.7% match). For cocaine, 37 urine and 52 oral fluid samples were positive (75.7% match). Twenty-four urine samples were positive for opiates, and 25 in oral fluid (81.4% match). For benzodiazepines, 23 samples were positive in urine and 25 in oral fluid (85.7% match). Conclusion/Discussion These results offer new information about drugs disposition between urine and oral fluid. Oral fluid is a good alternative matrix to urine for monitoring cannabis, cocaine, opiates and benzodiazepines recent use; however, synthetic cannabinoids showed mixed results.

In Vitro Interaction of AB-FUBINACA with Human Cytochrome P450, UDP-Glucuronosyltransferase Enzymes and Drug Transporters

“…A few reports on AB-FUBINACA concentrations in blood, urine, and oral fluids of drug abusers have appeared; the serum AB-FUBINACA concentration was 15 nM in a healthy 24-year-old man after ingestion of two drops of e-cigarette fluid containing AB-FUBINACA [ 35 ] and the post-mortem level of AB-FUBINACA in the femoral blood of a 35-year-old man who engaged in polysubstance abuse was 5.4 nM [ 36 ]. The concentrations of AB-FUBINACA in 5 of 70 oral fluid samples collected from 13 subjects were 2.2–106 nM [ 37 ]. The extent of AB-FUBINACA (10 μM) binding to plasma proteins was 99.7 ± 0.03% in our laboratory.…”

Oral fluid analysis to monitor recent exposure to synthetic cannabinoids in a high‐risk subpopulation

“…Recently, epidemiological studies evaluating exposure to xenobiotics took the advantages of non-conventional matrices such as oral fluid [7][8][9][10] or hair [11,12], being more attractive to volunteers due to low invasiveness. On this frame, oral fluid has become increasingly popular as alternative biological specimen for the detection of parent drugs and metabolites [13].…”

CNR2 rs2229579 and COMT Val158Met variants, but not CNR2 rs2501432, IL-17 rs763780 and UCP2 rs659366, contribute to susceptibility to substance use disorder in the Turkish population

“…This case-control study included 136 subjects with SUD (female/male: 4/132) and 100 age-matched healthy controls (female/male:52/48). The subjects with SUD were selected from among the individuals with a positive urine test in the Department of Psychiatry, Bakirkoy Research and Training Hospital for Psychiatry Hospital, Istanbul Turkey and Department of Psychiatry, Sakarya University Training and Research Hospital, Sakarya Turkey [8]. The healthy control group was similar in terms of age and sex distribution; with 100 healthy individuals who did not have a personal history of any psychiatric disorder and chronic use of any drugs.…”