- Email: [email protected]
Comparison of point-of-collection screening of drugs of abuse in oral fluid with a laboratory-based urine screen
Forensic Science International 122 (2001) 163±166
Comparison of point-of-collection screening of drugs of abuse in oral ¯uid with a laboratory-based urine screen Cindy Barretta,*, Carl Gooda, Christine Mooreb b
a Avitar Research and Development, Avitar, 65 Dan Road, Canton, MA 02021, USA U.S. Drug Testing Laboratories, 1700 S. Mount Prospect Road, Des Plaines, IL 60018, USA
Received 9 February 2001; received in revised form 14 March 2001; accepted 8 April 2001
Abstract Oral ¯uid is becoming increasingly useful for the detection of drugs, since it is a non-invasive specimen to collect and, because collection is directly observed, it is dif®cult to adulterate. A point-of-collection (POCT) oral ¯uid drug analysis kit has been developed for use in many drug testing situations. This paper summarizes the results of ®eld evaluations of the ORALscreen System for screening of drugs in oral ¯uid. The ORALscreen System consists of an oral ¯uid collection device and a test device containing a lateral ¯ow membrane immunoassay system. Paired samples (oral ¯uid and urine) were collected from drug users and the results from the ORALscreenTM POCT system were compared to urine screening results conducted in a licensed laboratory. The results demonstrate that the ORALscreen System has excellent percent agreement with the laboratory-based urine screening test results for the detection of cocaine and opiates through 2.5±3 days following drug use, respectively. Tetrahydrocannabinol (THC) was detected by ORALscreen on the day of use and 1 day after use. Good correlation between urine and oral ¯uid screening results was observed for the methamphetamine positive samples, however, the number of days following drug use was not determined. # 2001 Elsevier Science Ireland Ltd. All rights reserved. Keywords: Oral ¯uid; Point-of-collection test; Drug testing
1. Introduction In the US, drug testing is being carried out increasingly in abuse/rehabilitation clinics, law enforcement agencies, and employer screening programs. Testing for drugs of abuse is usually performed using a urine sample, which can be tested using a point-of-collection test or sent to a laboratory for analysis. The use of urine as a specimen for drug testing has certain disadvantages, including ease of dilution, substitution and/or adulteration which can easily occur when specimen collection is not directly observed. By enabling direct observation of the sample collection, oral ¯uid circumvents these problems. Oral ¯uid is a complex mixture, which is predominantly made up of saliva secretions from various oral glands. For drug testing purposes, the terms ``oral ¯uid'', ``saliva'' and ``mixed saliva'' are often interchanged. In order to enter oral ¯uid through passive diffusion from the * Corresponding author. Tel.: 1-800-255-0511; fax: 1-781-821-4458. E-mail address: [email protected] (C. Barrett).
blood, drugs must be non-ionized, in the ``free'' form and lipid soluble. Numerous drugs of abuse have been detected in oral ¯uid including cocaine and opiates [1,2], amphetamines [3], and cannabinoids [4], although the presence of tetrahydrocannabinol (THC) in oral ¯uid may be from its presence in the oral cavity rather than diffusion from the blood. The utility of oral ¯uid in determining drug use has been widely reviewed [5,6]. The ORALscreen System provides a drug screening result at the point-of-collection within 15 min, using an observed sample collection protocol. Advantages of using ORALscreen include direct observation without embarrassment, minimized possibility of sample adulteration, rapid re-test if necessary and no requirement for special collection facilities. ORALscreenTM four drug panel is an immunoassay system intended for use in the highly sensitive detection of cannabinoids (code THC), cocaine and metabolites (code COC), opiates (code OPI), and D-methamphetamine (code MET). Methylenedioxymethamphetamine (MDMA, ecstasy) is also detected by the methamphetamine assay. The ORALscreen System is based on a patented lateral ¯ow
0379-0738/01/$ ± see front matter # 2001 Elsevier Science Ireland Ltd. All rights reserved. PII: S 0 3 7 9 - 0 7 3 8 ( 0 1 ) 0 0 4 9 2 - 3
164
C. Barrett et al. / Forensic Science International 122 (2001) 163±166
membrane immunoassay technique and contains an internal procedural control for quality control purposes [7]. This study was designed to determine the correlation between urine and oral ¯uid specimens taken from drug users at different time intervals after self reported drug use. 2. Methods 2.1. Collection sites ORALscreen THC/COC/OPI/MET was evaluated in ®eld trials at inpatient substance abuse clinics in Massachusetts and Florida and by a probation department in California. 2.2. Self report Volunteers who participated in the study signed a consent form. They then completed an interview, in which they were asked what they had eaten or drunk in the last 30 min, what prescription and/or over-the-counter drugs they had taken in the last 2 days, and what drugs of abuse they had taken recently, when taken, and the mode of use. The volunteers from the California site did not self report use of drugs of abuse. 2.3. Protocol The study protocol involved the collection of a urine sample and the observed collection of an oral ¯uid sample using the ORALscreen Oral Fluid Collector. The oral ¯uid sample was tested at the point-of-collection by ORALscreen. The urine was analyzed by a urine screening test at a licensed laboratory using standard industry cutoff concentrations: benzoylecgonine (cocaine metabolite) 300 ng/ml, opiates 300 ng/ml, amphetamines 1000 ng/ml and cannabinoids 50 ng/ml. Urine specimens found to be positive by the urine screening test were analyzed by gas chromatography±mass spectrometry (GC±MS). 3. Results and discussion 3.1. Correlation studies The urine samples from the Massachusetts and Florida sites were analyzed by two laboratory-based screening methods: EMIT for THC, cocaine metabolite, and opiates and by CEDIA DAU amphetamines for methamphetamine. The urine samples from the California site were analyzed by a laboratory-based EIA method. Urine screen positives were further analyzed by GC±MS con®rmation assays. There was excellent correlation between the urine screening results and the urine con®rmation results as 95% or greater of the screening positives were con®rmed by GC±MS.
Donors from the Florida site self reported THC use the day before samples were collected and the day of collection; opiate use the day before samples were collected and the day of collection; and cocaine use up to 2.5 days before samples were collected and through the day that samples were collected. No donors from either the Florida or Massachusetts sites self reported use of methamphetamine. The self reports correlated well with drugs detected in oral ¯uid and urine. Donors from the California site did not self report use of drugs of abuse. Percent agreement between results for the different test methods and matrices was determined as de®ned below: PP 100 PP PN NN percent agreement for negative samples 100 NN NP percent agreement for positive samples
Test method
Reference method
PP PN
NP NN
The reference method is the laboratory-based screening assay for urine. The test method is ORALscreen, point-ofcollection screening system for oral ¯uid. Here PP denotes positive by both the reference method and the test method, PN is positive by the reference method and negative by the test method, NN is negative by both the reference method and the test method and NP denotes negative by the reference method and positive by the test method. The percent agreement of the ORALscreen results compared to the laboratory-based urine screening results for both urine positives and negatives are shown in Table 1. Suf®cient numbers of THC and COC positives were not obtained from either the Massachusetts or California sites to be included in the calculations. No methamphetamine users participated in the studies in Florida or Massachusetts. The percent agreement values were very good for both the positive set and the negative set, averaging 84 and 89%, respectively, across all four drug groups. Results from this study demonstrate that the ORALscreen System has a very good correlation with laboratory-based screening assays for urine. The lower correlation for THC positives may be related to the shorter detection window of THC and metabolites in oral ¯uid versus the longer detection window typically displayed in urine. 3.2. ORALscreen detection window compared to urine results for opiates To allow for an estimation of the detection window of ORALscreen compared to urine screening results, the Massachusetts site data was sorted according to days following
C. Barrett et al. / Forensic Science International 122 (2001) 163±166
165
Table 1 Percent agreement of ORALscreen results with laboratory-based urine screening resultsa Drug group
Site
Agreement with positive urine specimens (%)
Agreement with negative urine specimens (%)
COC OPI OPI MET THC
FL FL MA CA FL
96 100 94 86 43
92 99 86 94 76
Overall a
(n (n (n (n (n
26) 23) 47) 7) 37)
84 (n 140)
(n (n (n (n (n
65) 68) 14) 50) 54)
89 (n 251)
FL: Florida; MA: Massachusetts; CA: California.
self reported drug use. The percent agreement of the ORALscreen results compared to the laboratory-based urine screening results for both urine positives and negatives are shown in Table 2. Day 0 indicates that self reported use occurred on the same day that the samples were collected, day 1 indicates that self reported use occurred the day before samples were collected, etc. The data shows very good correlation between the ORALscreen and laboratory-based urine screening results for opiate use up to 3 days before the samples are collected. Suf®cient numbers of samples were not collected beyond 3 days following use to determine percent agreement values. 3.2.1. Interferences Numerous compounds were selected to determine the degree of interference which may be caused by over-thecounter or prescription drugs. Additionally, common food and drink which could easily have been present in the oral cavity before testing were studied. 1. Unrelated drugs and medications: Compounds were dissolved in an arti®cial oral ¯uid solution which contained no drugs or contained drugs at the concentrations listed: morphine at 60 ng/ml, benzoylecgonine at 75 ng/ml, carboxy THC (11-nor-9-carboxy-D9-THC) at 600 ng/ml, and D-methamphetamine at 90 ng/ml. At a concentration of 50 mg/ml, the following compounds did not affect the expected results for either Table 2 Agreement of ORALscreen results with laboratory-based urine screening results for opiatesa Days following drug use
Agreement with urine positive samples (%)
Agreement with urine negative samples (%)
0 1 2 3
100 96 88 80
Not 100 100 50
(n (n (n (n
5) 26) 8) 5)
determined (n 1) (n 4) (n 2)
a The number of negative samples is low because these specimens originated from individuals enrolled in a methadone treatment program.
the drug positive or drug negative specimens: acetaminophen; acetylsalicylic acid; aminopyrine; amobarbital; aspartame; buprenorphine; butabarbital; caffeine; carbamazepine; chloroquine; chlorpromazine; desipramine; dextromethorphan; diazepam; 10,11-dihydrocarbamazepine; 5,5-diphenylhydantoin; L-ephedrine; ibuprofen; imipramine; lidocaine; LSD; mephentermine; methadone; methaqualone; PEMA; pentobarbital; phencyclidine; phenobarbital; D,L-phenylpropanolamine; primidone; propoxyphene; D,L-pseudoephedrine; quinine; secobarbital; tetracycline; tetrahydrozoline. 2. Structurally similar drugs and medications: Potentially cross-reactive drugs were tested in the laboratory by preparing pure standards at known concentrations in an arti®cial oral ¯uid solution. For the methamphetamine test, the antibody was directed towards D-methamphetamine (100% cross-reactive) and MDMA (135% crossreactive). The cross-reactivity with L-methamphetamine (Vicks inhaler) was only 5% cross-reactive. Table 3 lists the lowest concentration tested that yielded a drug positive test result. 3. Food and drink: Controlled laboratory studies conducted to determine the effect of consumption of certain foods and drinks showed that the items listed did not interfere with the ORALscreen test result. Foods/drinks were selected because of low pH, high alcohol content, or common ingestion. Consumed food and drink that did not interfere with ORALscreen result: coffee with skim milk; hot tea with skim milk; toothpaste; orange soda; diet cola; cranberry juice; apple juice; lemonade; pickles; sour fruit candy; bubble gum; beer; Listerine1 mouthwash (26.9% alcohol); poppy seed salad dressing. Consumption of lemon-poppy seed quick bread rendered a positive opiate test result. A second test was performed 1 h later, and the opiate was negative. Therefore, it is recommended that if a positive opiate result is obtained for a donor who claims ingestion of poppy seeds, that another ORALscreen test be run approximately 1 h after the initial test. Under this scenario, poppy seeds should not interfere with the test result 1 h after consumption.
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C. Barrett et al. / Forensic Science International 122 (2001) 163±166
Table 3 Cross-reactive compoundsa Compound
Cross-reactive class
Lowest concentration yielding a positive result
Hydrocodone Hydromorphone Codeine 6-Acetylmorphine Oxycodone Oxymorphone Naloxone Meperidine Procaine Atropine Benzoylecgonine Carboxy THC MDMA MDA MDEA D-Amphetamine D-Ephedrine
OPI OPI OPI OPI OPI OPI OPI OPI OPI OPI COC THC MET MET MET MET MET
5 ng/ml 5 ng/ml 5 ng/ml 5 ng/ml 10 ng/ml 10 ng/ml 400 ng/ml 12.5 mg/ml 12.5 mg/ml 25 mg/ml 15 ng/ml 350 ng/ml 50 ng/ml 2000 ng/ml >60 mg/ml 53 mg/ml 25 mg/ml
a
MDMA: methylenedioxymethamphetamine (ecstasy); MDA: methylenedioxyamphetamine; MDEA: methylenedioxyethylamphetamine.
4. Conclusion The ORALscreenTM System is an easy to use collection and immunoassay system intended for use in the sensitive, qualitative analysis of cannabinoids, cocaine and metabolites, opiates, and methamphetamines (including MDMA) in human oral ¯uid. The results show excellent performance compared to a laboratory-based urine screening test for the detection of cocaine and opiates through 2.5±3 days
following drug use, respectively. THC was detected by ORALscreen on the day of use and 1 day after use. Good correlation between urine and oral ¯uid screening results was observed for the methamphetamine positive samples, however, the number of days following drug use could not be determined. Advantages of the ORALscreen System over a laboratory-based urine screening test include: results obtained at the point-of-collection in minutes, no need for special collection facilities, observed sample collection and no requirement for special laboratory equipment or reagents. References [1] K. Kato, M. Hillsgrove, L. Weinhold, D.A. Gorelick, W.D. Darwin, E.J. Cone, Cocaine and metabolite excretion in saliva under stimulated and nonstimulated conditions, J. Anal. Toxicol. 17 (1993) 338±341. [2] A.J. Jenkins, J.M. Oyler, E.J. Cone, Comparison of heroin and cocaine concentrations in saliva with concentrations in blood and plasma, J. Anal. Toxicol. 19 (1995) 359±374. [3] R.J.F. Scheper, J.M. Oyler, R.E. Evans, R.E. Joseph, E.T. Moolchan, M. Huestis, Disposition of methamphetamine and amphetamine in saliva and plasma following controlled oral drug administration to human volunteers, in: Proceedings of the Society of Forensic Toxicologists Annual Meeting, Abstract #22, Milwaukee, WI, 2000. [4] H.W. Peel, B.J. Perrigo, N.Z. Mikhael, Detection of drugs in saliva of impaired drivers, J. Forensic Sci. 29 (1984) 185. [5] D.A. Kidwell, J.C. Holland, S. Athanaselis, Testing for drugs of abuse in saliva and sweat, J. Chromatogr. (Biomed. Appl.) 713 (1998) 111±135. [6] W. Schramm, R.H. Smith, P.A. Craig, Drugs of abuse in saliva: a review, J. Anal. Toxicol. 16 (1992) 1±9. [7] M. Sun, F.R. Pfeiffer, Analytical test devices for competition assay for drugs of non-protein antigens using immunochromatographic techniques, US Patent 5,238,652 (1993).
Comparison of point-of-collection screening of drugs of abuse in oral ¯uid with a laboratory-based urine screen Cindy Barretta,*, Carl Gooda, Christine Mooreb b
a Avitar Research and Development, Avitar, 65 Dan Road, Canton, MA 02021, USA U.S. Drug Testing Laboratories, 1700 S. Mount Prospect Road, Des Plaines, IL 60018, USA
Received 9 February 2001; received in revised form 14 March 2001; accepted 8 April 2001
Abstract Oral ¯uid is becoming increasingly useful for the detection of drugs, since it is a non-invasive specimen to collect and, because collection is directly observed, it is dif®cult to adulterate. A point-of-collection (POCT) oral ¯uid drug analysis kit has been developed for use in many drug testing situations. This paper summarizes the results of ®eld evaluations of the ORALscreen System for screening of drugs in oral ¯uid. The ORALscreen System consists of an oral ¯uid collection device and a test device containing a lateral ¯ow membrane immunoassay system. Paired samples (oral ¯uid and urine) were collected from drug users and the results from the ORALscreenTM POCT system were compared to urine screening results conducted in a licensed laboratory. The results demonstrate that the ORALscreen System has excellent percent agreement with the laboratory-based urine screening test results for the detection of cocaine and opiates through 2.5±3 days following drug use, respectively. Tetrahydrocannabinol (THC) was detected by ORALscreen on the day of use and 1 day after use. Good correlation between urine and oral ¯uid screening results was observed for the methamphetamine positive samples, however, the number of days following drug use was not determined. # 2001 Elsevier Science Ireland Ltd. All rights reserved. Keywords: Oral ¯uid; Point-of-collection test; Drug testing
1. Introduction In the US, drug testing is being carried out increasingly in abuse/rehabilitation clinics, law enforcement agencies, and employer screening programs. Testing for drugs of abuse is usually performed using a urine sample, which can be tested using a point-of-collection test or sent to a laboratory for analysis. The use of urine as a specimen for drug testing has certain disadvantages, including ease of dilution, substitution and/or adulteration which can easily occur when specimen collection is not directly observed. By enabling direct observation of the sample collection, oral ¯uid circumvents these problems. Oral ¯uid is a complex mixture, which is predominantly made up of saliva secretions from various oral glands. For drug testing purposes, the terms ``oral ¯uid'', ``saliva'' and ``mixed saliva'' are often interchanged. In order to enter oral ¯uid through passive diffusion from the * Corresponding author. Tel.: 1-800-255-0511; fax: 1-781-821-4458. E-mail address: [email protected] (C. Barrett).
blood, drugs must be non-ionized, in the ``free'' form and lipid soluble. Numerous drugs of abuse have been detected in oral ¯uid including cocaine and opiates [1,2], amphetamines [3], and cannabinoids [4], although the presence of tetrahydrocannabinol (THC) in oral ¯uid may be from its presence in the oral cavity rather than diffusion from the blood. The utility of oral ¯uid in determining drug use has been widely reviewed [5,6]. The ORALscreen System provides a drug screening result at the point-of-collection within 15 min, using an observed sample collection protocol. Advantages of using ORALscreen include direct observation without embarrassment, minimized possibility of sample adulteration, rapid re-test if necessary and no requirement for special collection facilities. ORALscreenTM four drug panel is an immunoassay system intended for use in the highly sensitive detection of cannabinoids (code THC), cocaine and metabolites (code COC), opiates (code OPI), and D-methamphetamine (code MET). Methylenedioxymethamphetamine (MDMA, ecstasy) is also detected by the methamphetamine assay. The ORALscreen System is based on a patented lateral ¯ow
0379-0738/01/$ ± see front matter # 2001 Elsevier Science Ireland Ltd. All rights reserved. PII: S 0 3 7 9 - 0 7 3 8 ( 0 1 ) 0 0 4 9 2 - 3
164
C. Barrett et al. / Forensic Science International 122 (2001) 163±166
membrane immunoassay technique and contains an internal procedural control for quality control purposes [7]. This study was designed to determine the correlation between urine and oral ¯uid specimens taken from drug users at different time intervals after self reported drug use. 2. Methods 2.1. Collection sites ORALscreen THC/COC/OPI/MET was evaluated in ®eld trials at inpatient substance abuse clinics in Massachusetts and Florida and by a probation department in California. 2.2. Self report Volunteers who participated in the study signed a consent form. They then completed an interview, in which they were asked what they had eaten or drunk in the last 30 min, what prescription and/or over-the-counter drugs they had taken in the last 2 days, and what drugs of abuse they had taken recently, when taken, and the mode of use. The volunteers from the California site did not self report use of drugs of abuse. 2.3. Protocol The study protocol involved the collection of a urine sample and the observed collection of an oral ¯uid sample using the ORALscreen Oral Fluid Collector. The oral ¯uid sample was tested at the point-of-collection by ORALscreen. The urine was analyzed by a urine screening test at a licensed laboratory using standard industry cutoff concentrations: benzoylecgonine (cocaine metabolite) 300 ng/ml, opiates 300 ng/ml, amphetamines 1000 ng/ml and cannabinoids 50 ng/ml. Urine specimens found to be positive by the urine screening test were analyzed by gas chromatography±mass spectrometry (GC±MS). 3. Results and discussion 3.1. Correlation studies The urine samples from the Massachusetts and Florida sites were analyzed by two laboratory-based screening methods: EMIT for THC, cocaine metabolite, and opiates and by CEDIA DAU amphetamines for methamphetamine. The urine samples from the California site were analyzed by a laboratory-based EIA method. Urine screen positives were further analyzed by GC±MS con®rmation assays. There was excellent correlation between the urine screening results and the urine con®rmation results as 95% or greater of the screening positives were con®rmed by GC±MS.
Donors from the Florida site self reported THC use the day before samples were collected and the day of collection; opiate use the day before samples were collected and the day of collection; and cocaine use up to 2.5 days before samples were collected and through the day that samples were collected. No donors from either the Florida or Massachusetts sites self reported use of methamphetamine. The self reports correlated well with drugs detected in oral ¯uid and urine. Donors from the California site did not self report use of drugs of abuse. Percent agreement between results for the different test methods and matrices was determined as de®ned below: PP 100 PP PN NN percent agreement for negative samples 100 NN NP percent agreement for positive samples
Test method
Reference method
PP PN
NP NN
The reference method is the laboratory-based screening assay for urine. The test method is ORALscreen, point-ofcollection screening system for oral ¯uid. Here PP denotes positive by both the reference method and the test method, PN is positive by the reference method and negative by the test method, NN is negative by both the reference method and the test method and NP denotes negative by the reference method and positive by the test method. The percent agreement of the ORALscreen results compared to the laboratory-based urine screening results for both urine positives and negatives are shown in Table 1. Suf®cient numbers of THC and COC positives were not obtained from either the Massachusetts or California sites to be included in the calculations. No methamphetamine users participated in the studies in Florida or Massachusetts. The percent agreement values were very good for both the positive set and the negative set, averaging 84 and 89%, respectively, across all four drug groups. Results from this study demonstrate that the ORALscreen System has a very good correlation with laboratory-based screening assays for urine. The lower correlation for THC positives may be related to the shorter detection window of THC and metabolites in oral ¯uid versus the longer detection window typically displayed in urine. 3.2. ORALscreen detection window compared to urine results for opiates To allow for an estimation of the detection window of ORALscreen compared to urine screening results, the Massachusetts site data was sorted according to days following
C. Barrett et al. / Forensic Science International 122 (2001) 163±166
165
Table 1 Percent agreement of ORALscreen results with laboratory-based urine screening resultsa Drug group
Site
Agreement with positive urine specimens (%)
Agreement with negative urine specimens (%)
COC OPI OPI MET THC
FL FL MA CA FL
96 100 94 86 43
92 99 86 94 76
Overall a
(n (n (n (n (n
26) 23) 47) 7) 37)
84 (n 140)
(n (n (n (n (n
65) 68) 14) 50) 54)
89 (n 251)
FL: Florida; MA: Massachusetts; CA: California.
self reported drug use. The percent agreement of the ORALscreen results compared to the laboratory-based urine screening results for both urine positives and negatives are shown in Table 2. Day 0 indicates that self reported use occurred on the same day that the samples were collected, day 1 indicates that self reported use occurred the day before samples were collected, etc. The data shows very good correlation between the ORALscreen and laboratory-based urine screening results for opiate use up to 3 days before the samples are collected. Suf®cient numbers of samples were not collected beyond 3 days following use to determine percent agreement values. 3.2.1. Interferences Numerous compounds were selected to determine the degree of interference which may be caused by over-thecounter or prescription drugs. Additionally, common food and drink which could easily have been present in the oral cavity before testing were studied. 1. Unrelated drugs and medications: Compounds were dissolved in an arti®cial oral ¯uid solution which contained no drugs or contained drugs at the concentrations listed: morphine at 60 ng/ml, benzoylecgonine at 75 ng/ml, carboxy THC (11-nor-9-carboxy-D9-THC) at 600 ng/ml, and D-methamphetamine at 90 ng/ml. At a concentration of 50 mg/ml, the following compounds did not affect the expected results for either Table 2 Agreement of ORALscreen results with laboratory-based urine screening results for opiatesa Days following drug use
Agreement with urine positive samples (%)
Agreement with urine negative samples (%)
0 1 2 3
100 96 88 80
Not 100 100 50
(n (n (n (n
5) 26) 8) 5)
determined (n 1) (n 4) (n 2)
a The number of negative samples is low because these specimens originated from individuals enrolled in a methadone treatment program.
the drug positive or drug negative specimens: acetaminophen; acetylsalicylic acid; aminopyrine; amobarbital; aspartame; buprenorphine; butabarbital; caffeine; carbamazepine; chloroquine; chlorpromazine; desipramine; dextromethorphan; diazepam; 10,11-dihydrocarbamazepine; 5,5-diphenylhydantoin; L-ephedrine; ibuprofen; imipramine; lidocaine; LSD; mephentermine; methadone; methaqualone; PEMA; pentobarbital; phencyclidine; phenobarbital; D,L-phenylpropanolamine; primidone; propoxyphene; D,L-pseudoephedrine; quinine; secobarbital; tetracycline; tetrahydrozoline. 2. Structurally similar drugs and medications: Potentially cross-reactive drugs were tested in the laboratory by preparing pure standards at known concentrations in an arti®cial oral ¯uid solution. For the methamphetamine test, the antibody was directed towards D-methamphetamine (100% cross-reactive) and MDMA (135% crossreactive). The cross-reactivity with L-methamphetamine (Vicks inhaler) was only 5% cross-reactive. Table 3 lists the lowest concentration tested that yielded a drug positive test result. 3. Food and drink: Controlled laboratory studies conducted to determine the effect of consumption of certain foods and drinks showed that the items listed did not interfere with the ORALscreen test result. Foods/drinks were selected because of low pH, high alcohol content, or common ingestion. Consumed food and drink that did not interfere with ORALscreen result: coffee with skim milk; hot tea with skim milk; toothpaste; orange soda; diet cola; cranberry juice; apple juice; lemonade; pickles; sour fruit candy; bubble gum; beer; Listerine1 mouthwash (26.9% alcohol); poppy seed salad dressing. Consumption of lemon-poppy seed quick bread rendered a positive opiate test result. A second test was performed 1 h later, and the opiate was negative. Therefore, it is recommended that if a positive opiate result is obtained for a donor who claims ingestion of poppy seeds, that another ORALscreen test be run approximately 1 h after the initial test. Under this scenario, poppy seeds should not interfere with the test result 1 h after consumption.
166
C. Barrett et al. / Forensic Science International 122 (2001) 163±166
Table 3 Cross-reactive compoundsa Compound
Cross-reactive class
Lowest concentration yielding a positive result
Hydrocodone Hydromorphone Codeine 6-Acetylmorphine Oxycodone Oxymorphone Naloxone Meperidine Procaine Atropine Benzoylecgonine Carboxy THC MDMA MDA MDEA D-Amphetamine D-Ephedrine
OPI OPI OPI OPI OPI OPI OPI OPI OPI OPI COC THC MET MET MET MET MET
5 ng/ml 5 ng/ml 5 ng/ml 5 ng/ml 10 ng/ml 10 ng/ml 400 ng/ml 12.5 mg/ml 12.5 mg/ml 25 mg/ml 15 ng/ml 350 ng/ml 50 ng/ml 2000 ng/ml >60 mg/ml 53 mg/ml 25 mg/ml
a
MDMA: methylenedioxymethamphetamine (ecstasy); MDA: methylenedioxyamphetamine; MDEA: methylenedioxyethylamphetamine.
4. Conclusion The ORALscreenTM System is an easy to use collection and immunoassay system intended for use in the sensitive, qualitative analysis of cannabinoids, cocaine and metabolites, opiates, and methamphetamines (including MDMA) in human oral ¯uid. The results show excellent performance compared to a laboratory-based urine screening test for the detection of cocaine and opiates through 2.5±3 days
following drug use, respectively. THC was detected by ORALscreen on the day of use and 1 day after use. Good correlation between urine and oral ¯uid screening results was observed for the methamphetamine positive samples, however, the number of days following drug use could not be determined. Advantages of the ORALscreen System over a laboratory-based urine screening test include: results obtained at the point-of-collection in minutes, no need for special collection facilities, observed sample collection and no requirement for special laboratory equipment or reagents. References [1] K. Kato, M. Hillsgrove, L. Weinhold, D.A. Gorelick, W.D. Darwin, E.J. Cone, Cocaine and metabolite excretion in saliva under stimulated and nonstimulated conditions, J. Anal. Toxicol. 17 (1993) 338±341. [2] A.J. Jenkins, J.M. Oyler, E.J. Cone, Comparison of heroin and cocaine concentrations in saliva with concentrations in blood and plasma, J. Anal. Toxicol. 19 (1995) 359±374. [3] R.J.F. Scheper, J.M. Oyler, R.E. Evans, R.E. Joseph, E.T. Moolchan, M. Huestis, Disposition of methamphetamine and amphetamine in saliva and plasma following controlled oral drug administration to human volunteers, in: Proceedings of the Society of Forensic Toxicologists Annual Meeting, Abstract #22, Milwaukee, WI, 2000. [4] H.W. Peel, B.J. Perrigo, N.Z. Mikhael, Detection of drugs in saliva of impaired drivers, J. Forensic Sci. 29 (1984) 185. [5] D.A. Kidwell, J.C. Holland, S. Athanaselis, Testing for drugs of abuse in saliva and sweat, J. Chromatogr. (Biomed. Appl.) 713 (1998) 111±135. [6] W. Schramm, R.H. Smith, P.A. Craig, Drugs of abuse in saliva: a review, J. Anal. Toxicol. 16 (1992) 1±9. [7] M. Sun, F.R. Pfeiffer, Analytical test devices for competition assay for drugs of non-protein antigens using immunochromatographic techniques, US Patent 5,238,652 (1993).