Benzodiazepine whole blood concentrations in cases with positive oral fluid on-site screening test results using the DrugWipe(®) single for benzodiazepines.

Reliable on-site oral fluid screening devices are a useful and convenient means of policing traffic. In Finland, benzodiazepines represent a particular challenge to traffic safety. This study presents a retrospective examination of toxicological analysis results from whole blood in cases which gave a positive screening result for benzodiazepines in oral fluid using the DrugWipe Single device (Securetec). Use of oral fluid on-site screening tests and blood confirmation analyses reflects the real situation in many countries. The data were compiled from the databases of Alcohol and Drug Analytics Unit at the National Institute for Health and Welfare. Confirmation analysis results in whole blood were obtained using gas chromatography-mass spectrometry. Data were from 224 real cases in which the Finnish police had conducted a DrugWipe Single benzodiazepines test on drivers suspected of driving under the influence of drugs (DUID). The benzodiazepine concentrations encountered in positive oral fluid screening cases in this study indicate that the device is able to detect these substances even at relatively low levels. However, the DrugWipe device does not enable any distinction between therapeutic use and harmful use of benzodiazepines at higher doses.

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.