Is oral fluid analysis as accurate as urinalysis in detecting drug use in a treatment setting?
BACKGROUND
Technology for testing oral fluid (OF) for the presence of drugs is available for treatment services and is more attractive than urinalysis: its validity is not well established.


OBJECTIVE
Compare the accuracy of methods of on-site testing of OF and urine.


METHODS
Comparison of the sensitivity and specificity of on-site testing of samples of OF and urine collected on the same occasion, using subsequent blind laboratory analysis of the same urine samples as the standard.


METHODS
British addiction treatment service.


METHODS
157 drug dependent persons, 89% with evidence of opiates, 73% male, and 85% aged between 20 and 35 years.


METHODS
Assessment of presence of four drugs using SYVA ETS urinalysis and Cozart Rapiscan OF Drug Test systems. Laboratory urinalysis using microplate enzyme-immunoassay technique.


RESULTS
The sensitivity of OF tests and urinalysis were, respectively, for opiates 91 and 91%, methadone 91 and 94%, and benzodiazepines 6 and 72%. The specificity of OF tests and urinalysis were, respectively, for opiates 78 and 67%, methadone 90 and 95%, and benzodiazepines 95 and 96%. Amphetamine usage was rare.


CONCLUSIONS
OF testing is as accurate as urinalysis in detecting the presence of opiates and methadone, and the absence of methadone and benzodiazepines.
Bennett
Gerald A
GA
Addictions Service, Sedman Unit, Dorset HealthCare NHS Trust, 16-18 Tower Road, Bournemouth BH1 4LP, UK. gerals.bennett@dorsethc-tr.swest.nhs.uk
Davies
Eleanor
E
Thomas
Peter
P
D000328:Adult; D001569:Benzodiazepines / Q000032:analysis; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods*; D008297:Male; D009294:Narcotics / Q000032:analysis; D012463:Saliva / Q000737:chemistry*; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000379:methods*; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000652:urine*
D009294:Narcotics; D001569:Benzodiazepines