title: Cannabis Edibles: Blood and Oral Fluid Cannabinoid Pharmacokinetics and Evaluation of Oral Fluid Screening Devices for Predicting Δ9-Tetrahydrocannabinol in Blood and Oral Fluid following Cannabis Brownie Administration.
abstract: Roadside oral fluid (OF) Δ9-tetrahydrocannabinol (THC) detection indicates recent cannabis intake. OF and blood THC pharmacokinetic data are limited and there are no on-site OF screening performance evaluations after controlled edible cannabis.
  
  
  
  We reviewed OF and blood cannabinoid pharmacokinetics and performance evaluations of the Draeger DrugTest®5000 (DT5000) and Alere™ DDS®2 (DDS2) on-site OF screening devices. We also present data from a controlled oral cannabis administration session.
  
  
  
  OF THC maximum concentrations (Cmax) were similar in frequent as compared to occasional smokers, while blood THC Cmaxwere higher in frequent [mean (range) 17.7 (8.0-36.1) μg/L] smokers compared to occasional [8.2 (3.2-14.3) μg/L] smokers. Minor cannabinoids Δ9-tetrahydrocannabivarin and cannabigerol were never detected in blood, and not in OF by 5 or 8 h, respectively, with 0.3 μg/L cutoffs. Recommended performance (analytical sensitivity, specificity, and efficiency) criteria for screening devices of ≥80% are difficult to meet when maximizing true positive (TP) results with confirmation cutoffs below the screening cutoff. TPs were greatest with OF confirmation cutoffs of THC ≥1 and ≥2 μg/L, but analytical sensitivities were <80% due to false negative tests arising from confirmation cutoffs below the DT5000 and DDS2 screening cutoffs; all criteria were >80% with an OF THC ≥5 μg/L cutoff. Performance criteria also were >80% with a blood THC ≥5 μg/L confirmation cutoff; however, positive OF screening results might not confirm due to the time required to collect blood after a crash or police stop. OF confirmation is recommended for roadside OF screening.ClinicalTrials.gov identification number: NCT02177513.
authors.affiliation: Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD.|Program in Toxicology, University of Maryland Baltimore, Baltimore, MD.
authors.forename: Matthew N
authors.initials: MN
authors.lastname: Newmeyer
authors.affiliation: Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD.|Department of Forensic Science, College of Criminal Justice, Sam Houston State University, Huntsville, TX.
authors.forename: Madeleine J
authors.initials: MJ
authors.lastname: Swortwood
authors.affiliation: Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD.|Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institute and University Hospital, Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Andersson
authors.affiliation: Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD.
authors.forename: Osama A
authors.initials: OA
authors.lastname: Abulseoud
authors.affiliation: Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD.
authors.forename: Karl B
authors.initials: KB
authors.lastname: Scheidweiler
authors.affiliation: Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD; marilyn.huestis@gmail.com.|University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Marilyn A
authors.initials: MA
authors.lastname: Huestis
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D001826:Body Fluids / Q000378:metabolism*; D002186:Cannabinoids / Q000008:administration & dosage / Q000097:blood* / Q000493:pharmacokinetics*; D013759:Dronabinol / Q000031:analogs & derivatives* / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000378:metabolism*; D015813:Substance Abuse Detection / Q000379:methods*; D055815:Young Adult
chemical_list: D002186:Cannabinoids; C003403:tetrahydrocannabivarin 9; D013759:Dronabinol