title: Selection of an immunoassay screening cutoff concentration for opioids in oral fluid.
abstract: A retrospective analysis of data from oral fluid specimens was conducted in order to identify a relevant cutoff concentration for opiates and/or synthetic opiates in oral fluid. Previously proposed regulations from the Substance Abuse and Mental Health Services Administration (SAMHSA) have recommended 40 μg/L as a cutoff concentration. In this study, data from oral fluid specimens collected using the Quantisal™ device and screened with enzyme linked immunosorbent assays (ELISA) for both opiates and oxycodone were retrospectively assessed for screen positives > 20 μg/L and those between negative and 20 μg/L. Specimens identified at these concentrations were then analyzed using liquid chromatography with tandem mass spectral detection using a fully validated procedure. Overall, 156 positive specimens were identified using 40 μg/L; 191 specimens using 20 μg/L; and 241 specimens between negative and 20 μg/L. Specifically, the number of 6-acetylmorphine (6-AM) positives increased from 10 to 16; morphine 4 to 9; codeine from 11 to 19; oxycodone from 56 to 74; hydrocodone from 73 to 119; and hydromorphone from 2 to 4 when specimens with enzyme inhibition between negative and 20 μg/L were analyzed. For workplace testing where only codeine, morphine, and 6-AM are considered, the use of a lowered cutoff concentration produced significant increases in the positive rate.
authors: Immunalysis Corporation, Pomona, California 91767, USA.
authors: Margaux
authors: M
authors: Garnier
authors: Cynthia
authors: C
authors: Coulter
authors: Christine
authors: C
authors: Moore
mesh_terms: D000701:Analgesics, Opioid / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis; D057230:Limit of Detection; D012189:Retrospective Studies; D012463:Saliva / Q000737:chemistry*; D015813:Substance Abuse Detection
chemical_list: D000701:Analgesics, Opioid; D013287:Illicit Drugs