Driving under the influence of drugs -- evaluation of analytical data of drugs in oral fluid, serum and urine, and correlation with impairment symptoms.
A study was performed to acquire urine, serum and oral fluid samples in cases of suspected driving under the influence of drugs of abuse. Oral fluid was collected using a novel sampling/testing device (Dräger DrugTest System). The aim of the study was to evaluate oral fluid and urine as a predictor of blood samples positive for drugs and impairment symptoms. Analysis for cannabinoids, amphetamine and its derivatives, opiates and cocaine was performed in urine using the Mahsan Kombi/DOA4-test, in serum using immunoassay and gas chromatography-mass spectrometry (GC-MS) confirmation and in oral fluid by GC-MS. Police and medical officer observations of impairment symptoms were rated and evaluated using a threshold value for the classification of driving inability. Accuracy in correlating drug detection in oral fluid and serum were >90% for all substances and also >90% in urine and serum except for THC (71.0%). Of the cases with oral fluid positive for any drug 97.1% of corresponding serum samples were also positive for at least one drug; of drug-positive urine samples this were only 82.4%. In 119 of 146 cases, impairment symptoms above threshold were observed (81.5%). Of the cases with drugs detected in serum, 19.1% appeared not impaired which were the same with drug-positive oral fluid while more persons with drug-positive urine samples appeared uninfluenced (32.7%). The data demonstrate that oral fluid is superior to urine in correlating with serum analytical data and impairment symptoms of drivers under the influence of drugs of abuse.
Toennes
Stefan W
SW
Institute of Forensic Toxicology, Center of Legal Medicine, Kennedyallee 104, D-60596 Frankfurt/Main, Germany. toennes@em.uni-frankfurt.de
Kauert
Gerold F
GF
Steinmeyer
Stefan
S
Moeller
Manfred R
MR
D000662:Amphetamines / Q000032:analysis; D001334:Automobile Driving; D002186:Cannabinoids / Q000032:analysis; D002492:Central Nervous System Depressants / Q000097:blood; D003042:Cocaine / Q000032:analysis; D018765:Dopamine Uptake Inhibitors / Q000032:analysis; D000431:Ethanol / Q000097:blood; D005410:Flame Ionization; D005554:Forensic Medicine; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D009294:Narcotics / Q000032:analysis; D010865:Pilot Projects; D012463:Saliva / Q000737:chemistry; D015813:Substance Abuse Detection / Q000379:methods*
D000662:Amphetamines; D002186:Cannabinoids; D002492:Central Nervous System Depressants; D018765:Dopamine Uptake Inhibitors; D009294:Narcotics; D000431:Ethanol; D003042:Cocaine