Cannabis findings in drivers suspected of driving under the influence of drugs in Finland from 2006 to 2008.

The authors examined driving under the influence of drugs (DUID) cases which were found to be positive in whole blood for cannabis in Finland from 2006 to 2008. Factors studied were the number of cases positive for any combination of Δ(9)-tetrahydrocannabinol (THC) and the metabolites 11-hydroxy-Δ(9)-tetrahydrocannabinol (THC-OH) and 11-nor-9-carboxy-Δ(9)-tetrahydrocannabinol (THC-COOH). Concurrent use of amphetamines, benzodiazepines and/or alcohol was also recorded, as well as the drivers' age and gender. Altogether 2957 cannabis positive cases were retrieved from the database of the Alcohol and Drug Analytics Unit, National Institute for Health and Welfare. Drug findings were examined in relation to the zero-tolerance policy operated towards DUID in Finland. The number of cannabis positive cases in each year was approximately 1000 and the main demographic of cases was males aged 20-30 years. In the majority of cases (51.6%) the inactive metabolite THC-COOH was the only indication of cannabis use, however, associated use of amphetamines (58.8% of all cases) and/or benzodiazepines (63.9%) in cannabis positive drivers was very common. Detections for amphetamines and/or benzodiazepines were especially common in drivers with THC-COOH only (92.8% of these cases). Combined use of alcohol (25.7%) was also prevalent. Suspect DUID cases generally arise from suspicion on behalf of the police and the zero-tolerance policy offers an expedient means to deal with the challenges presented in DUID, particularly in view of the high incidence of multiple drug use - the legislation is not unduly punitive when enforced in this manner.

An evaluation of on-site oral fluid drug screening devices DrugWipe 5+ and Rapid STAT using oral fluid for confirmation analysis.

In this study, the performance of two on-site oral fluid drug-testing devices, DrugWipe 5(+) (Securetec) and Rapid STAT (Mavand), was assessed. The results obtained by the devices were compared with gas chromatography-mass spectrometry confirmation analysis results in oral fluid. Sensitivity, specificity, and accuracy of the tests, as well as positive and negative predictive values, were calculated based on the classified results of the comparison. Both of the devices were evaluated for their ability to meet toxicological cutoffs as set in the DRUID project (www.druid-project.eu) as well as those reported by the manufacturers. The evaluation was performed for relevant drug groups of both devices: amphetamines, cannabis, cocaine, and opiates. Additionally, Rapid STAT has a test for benzodiazepines included in the same device. Both tests seemed to perform quite well for amphetamines although they also gave negative results for cases with high concentrations. Also, the benzodiazepine test of Rapid STAT was at a relatively good level although only half of the positive test results were true positives using the test cutoffs. The same phenomenon was detected for the cannabis tests of both devices. The proper evaluation of cocaine and opiates tests was not applicable because of the very low number of positive cases.

An analytical evaluation of eight on-site oral fluid drug screening devices using laboratory confirmation results from oral fluid.

The performance of eight on-site oral fluid drug screening devices was studied in Belgium, Finland and the Netherlands as a part of the EU-project DRUID. The main objective of the study was to evaluate the reliability of the devices for testing drivers suspected of driving under the influence of drugs (DUID). The performance of the devices was assessed by their ability to detect substances using cut-offs which were set at sufficiently low levels to allow optimal detection of positive DUID cases. The devices were evaluated for the detection of amphetamine(s), cannabis, cocaine, opiates and benzodiazepines when the relevant test was incorporated. Methamphetamine, MDMA and PCP tests that were included in some devices were not evaluated since there were too few positive samples. The device results were compared with confirmation analysis results in oral fluid. The opiates tests appeared to perform relatively well with sensitivity results between 69 and 90%. Amphetamines and benzodiazepines tests had lower sensitivity, although the DrugWipe test evaluated was promising for amphetamine. In particular, it is evident that the cannabis and cocaine tests of the devices still lack sensitivity, although further testing of the cocaine tests is desirable due to the low prevalence and low concentrations encountered in this study.

Performance evaluation of the DrugWipe® 5/5+ on-site oral fluid screening device.

This study presents a retrospective performance evaluation of an on-site oral fluid drug screening device DrugWipe® 5/5+ (Securetec). The results obtained by the device were compared with gas chromatography-mass spectrometry confirmation analysis results in whole blood. Data used in the comparison were based on 1,807 real cases in which the Finnish police had conducted an on-site drug test on persons suspected of driving under the influence of drugs. The present data cover only cases wherein the DrugWipe device has shown a positive result for at least one substance. The data were compiled from the databases of Alcohol and Drug Analytics Unit at the National Institute for Health and Welfare. The performance of the DrugWipe was evaluated for its relevant drug groups: amphetamines, cannabis, opiates, and cocaine. The evaluation was carried out by calculating the sensitivity, specificity, and accuracy as well as the positive and negative predictive values. These calculations were based on the classification of the results as true positives, false positives, true negatives, and false negatives. Additionally, the demographics of the cases and analytical findings in whole blood are discussed. According to this study, the DrugWipe device performed quite well in detecting amphetamines, the most frequently encountered group of illicit drugs in Finnish traffic. The performance of the cannabis, opiate, and cocaine tests was not at the same level.

Drug testing in oral fluid-evaluation of sample collection devices.

Nine different oral fluid (OF) collection devices were studied to evaluate their suitability for collecting samples for drug analysis. The devices were Greiner Bio-One, Orasure Intercept, Immunalysis Quantisal, StatSure Saliva.Sampler, Cozart, Sarstedt Salivette, Malvern Medical OraCol, Acro Biotech Salicule, and Varian OraTube. For comparison, OF was also collected into plastic tubes. The volume of collected OF was quantified for samples collected both in vitro and from volunteers. Drug recovery was studied by collecting OF fortified at 1000 ng/mL with amphetamine, 3,4-methylenedioxymethamphetamine, cocaine, Delta(9)-tetrahydrocannabinol, morphine, codeine, diazepam, and alprazolam with the devices in vitro and analyzing the samples with gas chromatography-mass spectrometry. Recovery of ethanol was measured from 0.2% in OF by headspace gas chromatography-flame-ionization detection. The stability of drugs in the samples was studied by analyzing the samples after 0, 14, and 28 days storage. The study shows that there are substantial differences between the OF collection devices on the market. Some are well suited for collecting samples for toxicological analysis, but some give quite poor results.

Roadside oral fluid testing: comparison of the results of drugwipe 5 and drugwipe benzodiazepines on-site tests with laboratory confirmation results of oral fluid and whole blood.

Drugged drivers pose a serious threat to other people in traffic as well as to themselves. Reliable oral fluid screening devices for on-site screening of drugged drivers would be both a useful and convenient means for traffic control. In this study we evaluated the appropriateness of Drugwipe 5 and Drugwipe Benzodiazepines oral fluid on-site tests for roadside drug screening. Drivers suspected of driving under the influence of drugs were screened with the Drugwipe tests. Oral fluid and whole blood samples were collected from the drivers and tested for amphetamine-type stimulant drugs, cannabis, opiates, cocaine and benzodiazepines by immunological methods, GC and GC-MS. The performance evaluations of the tests were made by comparing the results of the Drugwipe tests with laboratory GC-MS confirmation results of oral fluid or whole blood. In addition to the performance evaluations of the Drugwipe tests based on laboratory results, a questionnaire on the practical aspects of the tests was written for the police officers who performed the tests. The aim of the questionnaire was to obtain user comments on the practicality of the tests as well as the advantages and weak points of the tests. The results of the performance evaluations were: for oral fluid (sensitivity; specificity; accuracy) amphetamines (95.5%; 92.9%; 95.3%), cannabis (52.2%; 91.2%; 85.1%), cocaine (50.0%; 99.3%; 98.6%), opiates (100%; 95.8%; 95.9%), benzodiazepines (74.4%; 84.2%; 79.2%) and for whole blood accordingly, amphetamines (97.7%; 86.7%; 95.9%), cannabis (68.3%; 87.9%; 84.9%), cocaine (50.0%; 98.5%; 97.7%), opiates (87.5%; 96.9%; 96.6%) and benzodiazepines (66.7%; 87.0%; 74.4%). Although the Drugwipe 5 successfully detected amphetamine-type stimulant drugs and the police officers were quite pleased with the current features of the Drugwipe tests, improvements must still be made regarding the detection of cannabis and benzodiazepines.