The prevalence of gamma-hydroxybutyrate (GHB) in motor vehicle drivers and its co-administration with amphetamine type substances (ATS) in Queensland, Australia (2011-2018).

The routine analysis of driver specimens for gamma-hydroxybutyrate (GHB) is rarely performed by toxicology laboratories as the physical and chemical properties of GHB make it unamenable to the screening methods usually employed. The prevalence of the drug in driver populations has therefore only rarely been reported. This study outlines the results of the routine analysis for GHB in the blood of motor vehicle drivers in Queensland, Australia, over an eight-year period (2011-2018). The methodology for GHB analysis was updated over the course of the study; screening for GHB was conducted using GC/FID or GC/MS between 2011 and 2016 and by LC/MS/MS from 2017 onwards. Due to the endogenous nature of GHB, any specimens containing greater than 5mg/kg GHB were subjected to quantitative analysis by either; GC/MS after liquid-liquid extraction and derivatisation with BSTFA+1%TMCS (2011-2016), or by LC/MS/MS analysis after solvent precipitation from 2017 onwards. Of the 15,061 specimens analysed, 160 were positive for GHB (1.1% of all cases, range 0.4-1.8%). GHB positive drivers were 66.9% male (33.1% female) and had an average age of 32 years. The mean GHB concentration identified was 89mg/kg (range 6-354mg/kg). GHB was found to be closely associated with amphetamine type substances (ATS), particularly methylamphetamine. Though GHB was present in only 2.2% of all ATS positive specimens submitted to the laboratory, 91.2% of all GHB positive cases contained an ATS. Other drugs commonly co-administered with GHB were THC, cocaine, benzodiazepines and erectile dysfunction drugs. GHB was found to be more commonly identified in drivers from city areas and a geographical localisation of the use of the drug was identified in the Gold Coast region of Queensland.

Smoke on the water-Oral fluid analysis at sea.

This study outlines the operational challenges and findings of an illicit drug oral fluid testing program carried out on the skippers (those in charge) of water vessels in Queensland, Australia. Between 2010 and 2016, 953 tests of skippers were conducted on water (waterside) for three proscribed illicit drugs; delta-9-tetrahydrocannabinol (THC), methylamphetamine (MA) and 3,4-methylendioxymethylamphetamine (MDMA). 126 (13%) of the skippers tested returned an on-site positive during waterside testing, 125 were confirmed positive for one or more illicit drug by subsequent laboratory analysis, whilst one skipper did not provide an oral fluid sample for confirmatory analysis. The skippers were entirely male (100%) with an average age of 39 years (range 17-59). THC was by far the most common drug detected (91%); MA was detected in 22% of skippers and a combination or THC and MA in 14% of specimens. MDMA was identified only once during the study, this being in combination with THC. As a single waterside operation can take more than a week, operational pre-planning becomes essential. Aspects of the operation such as, weather, shift times, food, testing consumables, sleeping quarters, hygiene, liaison between different agencies and multiple other factors need to be taken into account prior to commencement. A waterside operation must be mobile and, in Queensland at least, able to cover a large area of water. There is also a much lower volume of vessels likely to be encountered at sea compared to a roadside operation targeting motor vehicles.