A feasibility study of short message service text messaging as a surveillance tool for alcohol consumption and vehicle for interventions in university students.

BACKGROUND: Practitioners who come into contact with the intoxicated, such as those in unscheduled care, often have limited resources to provide structured interventions. There is therefore a need for cost-effective alcohol interventions requiring minimal input. This study assesses the barriers, acceptability and validity of text messaging to collect daily alcohol consumption data and explores the feasibility of a text-delivered intervention in an exploratory randomised controlled trial. METHODS: Study I. Participants (n = 82) completed the initial online screening survey and those eligible were asked each day, for 157 days via text message, to reply with the number of alcohol units consumed the previous day. Analyses compared standard measures of hazardous consumption with self-report alcohol use. Attrition and sampling biases were examined. Study I included secondary exploratory analyses using data from 70 participants to determine associations between events (including Christmas and other celebratory occasions) and consumption. Study I further included the thematic analysis of semi-structured interview data and assessed the feasibility of and barriers to surveillance and interventions delivered through text messaging. Developing findings from Study I, Study II developed an exploratory randomised control trial that delivered a single message on monthly alcohol expenditure in order to assess effect size and test generalisability. RESULTS: Self-report alcohol consumption data was significantly associated with FAST and AUDIT scores. Attrition from the study was not associated with greater alcohol use. Greater alcohol use was observed on Fridays, Saturdays and Wednesdays as were notable celebratory events. Interview data indicated that text messaging was acceptable to participants and preferred over email and web-based methods. The exploratory randomised controlled trial suggested that a simple text delivered intervention might be effective in eliciting a reduction in alcohol consumption in a future trial. CONCLUSIONS: The ubiquity of mobile telephones and the acceptability of text messaging suggests that this approach can be developed as a surveillance tool to collect high frequency consumption data to identify periods of vulnerability and that it can offer a platform through which targeted interventions can be delivered.

Tetrahydrocannabinol and two of its metabolites in whole blood using liquid chromatography-tandem mass spectrometry.

An analytical procedure for the determination of Delta9-tetrahydrocannabinol (THC), 11-nor-9-carboxy-Delta9-tetrahydrocannabinol (THCA), and 11-hydroxy-Delta9-tetrahydrocannabinol (11-OH-THC) in whole blood has been developed and validated using liquid chromatography with tandem mass spectral detection (MS). Cannabinoids present in the blood samples were quantified using solid-phase extraction followed by MS detection in positive electrospray ionization mode. For confirmation, two transitions were monitored and one ratio determined. Samples being reported as positive were required to have both transitions present, the ratio of quantifying transition to qualifying transition being within 20% of that determined from known calibration standards. The monitoring of the qualifying transition and requirement for its presence within a specific ratio to the primary ion has the potential of limiting the sensitivity of the assay, however, the additional confidence in the final result as well as forensic defensibility were considered to be of greater importance. The limit of quantitation was 0.5 ng/mL for THC, 5 ng/mL for THCA, and 2 ng/mL for 11-OH-THC. The limit of detection was 0.5 ng/mL for THC, 4 ng/mL for THCA, and 1 ng/mL for 11-OH-THC. The percentage recovery of the cannabinoids from whole blood at a concentration of 5 ng/mL was 71.5% for THC, 64.5% for 11-OH-THC, and 61.2% for THCA (n = 3).

Detection of phencyclidine in human oral fluid using solid-phase extraction and liquid chromatography with tandem mass spectrometric detection.

An analytical procedure for the determination of phencyclidine in oral fluid has been developed and validated using liquid chromatography with tandem mass spectral detection, following initial screening with enzyme linked immunosorbent assay. The oral fluid samples were collected using the Quantisal device, and any drugs present were quantified using mixed mode solid-phase extraction followed by mass spectrometric detection in positive atmospheric pressure chemical ionization mode. For confirmation, two transitions were monitored and one ratio determined, which had to be within 20% of that of the known calibration standard. The monitoring of the qualifying transition and requirement for its presence within a specific ratio to the primary ion has the potential of limiting the sensitivity of the assay, however, the additional confidence in the final result as well as forensic defensibility were considered to be of greater importance. The limit of quantitation was 5ng/mL; the intra-day precision of the assay (n=5) was 3.04%; inter-day precision 3.35% (n=5) at a concentration of 10ng/mL. The accuracy was determined at four concentrations (5, 10, 20 and 40ng/mL) within the linear range of the assay. The percentage recovery of phencyclidine from the oral fluid collection pad was 81.7% (n=6). The methods were applied to both proficiency specimens and to samples obtained during research studies in the USA.

Determination of benzodiazepines in oral fluid using LC-MS-MS.

A rapid, simple, highly sensitive procedure for the simultaneous analysis of bromazepam, alprazolam, clonazepam, lorazepam, oxazepam, diazepam, midazolam, flurazepam, flunitrazepam, nordiazepam, triazolam, temazepam, nitrazepam, and chlordiazepoxide in oral fluid is described, using liquid chromatography coupled to a triple quadrupole mass spectrometer in positive electrospray mode. Benzodiazepines in oral fluid samples (1 mL) were analyzed using the Quantisal collection device, quantified using solid-phase extraction, and detected using liquid chromatography with tandem mass spectrometric detection. For confirmation, two transitions were monitored and one ion ratio determined, which was within 20% of the ratio for known calibration standards. The limits of quantitation ranged from 0.5-5 ng/mL of neat oral fluid; the intraday precision of the assays (n=5) ranged from 2.8-7.29%; and the interday precision ranged from 1.42-6.8% (n=5). The percentage recovery of the drugs from the collection pads ranged from a low of 81.4% for midazolam to the highest of 90.17% for nitrazepam. The procedure can be applied to authentic oral fluid specimens.

Achieving proposed federal concentrations using reduced specimen volume for the extraction of amphetamines from oral fluid.

This article details the rapid extraction of amphetamines from oral fluid using low specimen volume, low sorbent bed mass, and fast gas chromatography with mass selective detection. The collection of a known amount of sample volume coupled with high percentage recovery of drug from the collection pad has allowed oral fluid to be increasingly employed as the specimen of choice for the detection of drug use in various applications. Additionally, low specimen volume for confirmation is required, so that adequate test volume remains for second analysis in case of batch failure or for testing at a different laboratory facility. The extracts were prepared using low bed mass sorbent, so less conditioning, washing, and elution solvent further reduced the overall cost of sample preparation. The limits of quantitation for the assay were 25 ng/mL; the intraday precision of the assays (n = 5) ranged from 0.3 to 3.99%; interday precision ranged from 0.72 to 4.6% for the amphetamine class. The percentage recovery of the drugs from the collection pads ranged from 85.4 to 89.1% (n = 6). The process lends itself to widely available automated processing instrumentation and significantly increases the efficiency of laboratories providing high-volume oral fluid analysis for drugs of abuse.

Determination of cocaine, benzoylecgonine, cocaethylene and norcocaine in human hair using solid-phase extraction and liquid chromatography with tandem mass spectrometric detection.

A quantitative analytical procedure for the determination of cocaine, benzoylecgonine and cocaethylene and norcocaine in hair has been developed and validated. The hair samples were washed, incubated, and any drugs present were quantified using mixed mode solid-phase extraction and liquid chromatography with tandem mass spectrometric detection in positive atmospheric pressure chemical ionization mode. For confirmation, two transitions were monitored and one ion ratio was determined, which was within 20% of that of the known calibration standards. The monitoring of the qualifying transition and requirement for its presence within a specific ratio to the primary ion limited the sensitivity of the assay, particularly for benzoylecgonine, however, the additional confidence in the final result as well as forensic defensibility were considered to be of greater importance. Even with simultaneous monitoring, the concentrations proposed by the United States Federal guidelines for hair analysis were achieved. The limits of quantitation were 50 pg/mg; the limit of detection was 25 pg/mg. The intra-day precision of the assays at 100 pg/mg (n=5) was 1.3%, 8.1%, 0.8% and 0.4%; inter-day precision 4.8%, 9.2%, 15.7% and 12.6% (n=10) for cocaine, benzoylecgonine, cocaethylene and norcocaine, respectively. The methods were applied to both proficiency specimens and to samples obtained during research studies in the USA.