title: Oral fluid testing for illicit substance use in preanaesthetic care.
abstract: OBJECTIVE
  Due to specific risks associated with illicit drug use, the preanaesthetic detection of illicit substances is essential. This prospective observational study evaluated oral fluid testing and self reporting of illicit drug use compared with confirmatory blood testing.
  
  
  METHODS
  Consecutively enrolled preanaesthetic and emergency room patients (n=939) completed a paper-based lifestyle questionnaire. An oral fluid sample was obtained and analysed for illicit substance use by a point-of-care testing device (Dräger Drugtest® 5000). Patients who tested positive by self reporting or oral fluid testing underwent confirmatory blood testing (n=117).
  
  
  RESULTS
  Self reporting revealed more overall illicit substance use and more users of cannabinoids, amphetamines, opioids, cocaine and benzodiazepines than oral fluid testing. Self reporting was more sensitive than blood testing for the detection of overall illicit substance use, and for use of cannabinoids and benzodiazepines.
  
  
  CONCLUSIONS
  Self reporting revealed higher rates of illicit substance use than oral fluid testing in preanaesthetic patients, and may lead to more interventions and more appropriately tailored treatment and anaesthesia compared with oral fluid testing.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Campus Virchow Clinic and Campus Charité Mitte, Charité-University Medicine Berlin, Berlin, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Kork
authors.forename: R
authors.initials: R
authors.lastname: Kleinwächter
authors.forename: E
authors.initials: E
authors.lastname: Weiss-Gerlach
authors.forename: S
authors.initials: S
authors.lastname: Broecker
authors.forename: F
authors.initials: F
authors.lastname: Pragst
authors.forename: K-D
authors.initials: KD
authors.lastname: Wernecke
authors.forename: C
authors.initials: C
authors.lastname: Spies
mesh_terms: D000328:Adult; D001826:Body Fluids / Q000737:chemistry*; D003710:Demography; D004636:Emergency Service, Hospital; D005260:Female; D005858:Germany; D006403:Hematologic Tests; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000737:chemistry*; D011229:Preanesthetic Medication; D012017:Referral and Consultation; D012307:Risk Factors; D057566:Self Report; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis*