title: A placebo-controlled study to assess Standardized Field Sobriety Tests performance during alcohol and cannabis intoxication in heavy cannabis users and accuracy of point of collection testing devices for detecting THC in oral fluid.
abstract: BACKGROUND
  Standardized Field Sobriety Tests (SFST) and oral fluid devices are used to screen for driving impairment and roadside drug detection, respectively. SFST have been validated for alcohol, but their sensitivity to impairment induced by other drugs is relatively unknown. The sensitivity and specificity for Δ(9)-tetrahydrocannabinol (THC) of most oral fluid devices have been low.
  
  
  OBJECTIVE
  This study assessed the effects of smoking cannabis with and without alcohol on SFST performance. Presence of THC in oral fluid was examined with two devices (Dräger Drug Test® 5000 and Securetec Drugwipe® 5).
  
  
  METHODS
  Twenty heavy cannabis users (15 males and 5 females; mean age, 24.3 years) participated in a double-blind, placebo-controlled study assessing percentage of impaired individuals on the SFST and the sensitivity of two oral fluid devices. Participants received alcohol doses or alcohol placebo in combination with 400 μg/kg body weight THC. We aimed to reach peak blood alcohol concentration values of 0.5 and 0.7 mg/mL.
  
  
  RESULTS
  Cannabis was significantly related to performance on the one-leg stand (p = 0.037). Alcohol in combination with cannabis was significantly related to impairment on horizontal gaze nystagmus (p = 0.029). The Dräger Drug Test® 5000 demonstrated a high sensitivity for THC, whereas the sensitivity of the Securetec Drugwipe® 5 was low.
  
  
  CONCLUSIONS
  SFST were mildly sensitive to impairment from cannabis in heavy users. Lack of sensitivity might be attributed to tolerance and time of testing. SFST were sensitive to both doses of alcohol. The Dräger Drug Test® 5000 appears to be a promising tool for detecting THC in oral fluid as far as correct THC detection is concerned.
authors.affiliation: Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands. Wendy.Bosker@maastrichtuniversity.nl
authors.forename: W M
authors.initials: WM
authors.lastname: Bosker
authors.forename: E L
authors.initials: EL
authors.lastname: Theunissen
authors.forename: S
authors.initials: S
authors.lastname: Conen
authors.forename: K P C
authors.initials: KP
authors.lastname: Kuypers
authors.forename: W K
authors.initials: WK
authors.lastname: Jeffery
authors.forename: H C
authors.initials: HC
authors.lastname: Walls
authors.forename: G F
authors.initials: GF
authors.lastname: Kauert
authors.forename: S W
authors.initials: SW
authors.lastname: Toennes
authors.forename: M R
authors.initials: MR
authors.lastname: Moeller
authors.forename: J G
authors.initials: JG
authors.lastname: Ramaekers
mesh_terms: D000435:Alcoholic Intoxication / Q000175:diagnosis*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D013759:Dronabinol / Q000009:adverse effects / Q000032:analysis*; D000431:Ethanol / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis*; D011597:Psychomotor Performance / Q000187:drug effects; D012463:Saliva / Q000737:chemistry; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000379:methods*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000431:Ethanol; D013759:Dronabinol