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采血时间对测得的Δ9-四氢大麻酚浓度的影响:对驾驶解读和药物政策的启示。

Effect of Blood Collection Time on Measured Δ9-Tetrahydrocannabinol Concentrations: Implications for Driving Interpretation and Drug Policy.

作者信息

Hartman Rebecca L, Brown Timothy L, Milavetz Gary, Spurgin Andrew, Gorelick David A, Gaffney Gary R, Huestis Marilyn A

机构信息

Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD;

National Advanced Driving Simulator, University of Iowa, Iowa City, IA;

出版信息

Clin Chem. 2016 Feb;62(2):367-77. doi: 10.1373/clinchem.2015.248492.

Abstract

BACKGROUND

In driving-under-the-influence cases, blood typically is collected approximately 1.5-4 h after an incident, with unknown last intake time. This complicates blood Δ(9)-tetrahydrocannabinol (THC) interpretation, owing to rapidly decreasing concentrations immediately after inhalation. We evaluated how decreases in blood THC concentration before collection may affect interpretation of toxicological results.

METHODS

Adult cannabis smokers (≥1×/3 months, ≤3 days/week) drank placebo or low-dose alcohol (approximately 0.065% peak breath alcohol concentration) 10 min before inhaling 500 mg placebo, 2.9%, or 6.7% vaporized THC (within-individuals), then took simulated drives 0.5-1.3 h postdose. Blood THC concentrations were determined before and up to 8.3 h postdose (limit of quantification 1 μg/L).

RESULTS

In 18 participants, observed Cmax (at 0.17 h) for active (2.9 or 6.7% THC) cannabis were [median (range)] 38.2 μg/L (11.4-137) without alcohol and 47.9 μg/L (13.0-210) with alcohol. THC Cmax concentration decreased 73.5% (3.3%-89.5%) without alcohol and 75.1% (11.5%-85.4%) with alcohol in the first half-hour after active cannabis and 90.3% (76.1%-100%) and 91.3% (53.8%-97.0%), respectively, by 1.4 h postdose. When residual THC (from previous self-administration) was present, concentrations rapidly decreased to preinhalation baselines and fluctuated around them. During-drive THC concentrations previously associated with impairment (≥8.2 μg/L) decreased to median <5 μg/L by 3.3 h postdose and <2 μg/L by 4.8 h postdose; only 1 participant had THC ≥5 μg/L after 3.3 h.

CONCLUSIONS

Forensic blood THC concentrations may be lower than common per se cutoffs despite greatly exceeding them while driving. Concentrations during driving cannot be back-extrapolated because of unknown time after intake and interindividual variability in rates of decrease.

摘要

背景

在酒驾案件中,血液通常在事件发生后约1.5 - 4小时采集,末次摄入时间未知。由于吸入后浓度迅速下降,这使得血液中Δ⁹ - 四氢大麻酚(THC)的解读变得复杂。我们评估了采集前血液中THC浓度的下降如何影响毒理学结果的解读。

方法

成年大麻吸烟者(≥每月1次,≤每周3天)在吸入500毫克安慰剂、2.9%或6.7%的雾化THC(个体内)前10分钟饮用安慰剂或低剂量酒精(呼气酒精浓度峰值约为0.065%),然后在给药后0.5 - 1.3小时进行模拟驾驶。在给药前及给药后长达8.3小时测定血液THC浓度(定量限为1微克/升)。

结果

在18名参与者中,活性(2.9%或6.7% THC)大麻的观察到的Cmax(在0.17小时)[中位数(范围)]在未饮酒时为38.2微克/升(11.4 - 137),饮酒时为47.9微克/升(13.0 - 210)。活性大麻摄入后的前半小时内,THC Cmax浓度在未饮酒时下降了73.5%(3.3% - 89.5%),饮酒时下降了75.1%(11.5% - 85.4%),给药后1.4小时分别下降了90.3%(76.1% - 100%)和91.3%(53.8% - 97.0%)。当存在残留THC(来自先前的自我给药)时,浓度迅速降至吸入前基线并在其周围波动。先前与损伤相关的驾驶期间THC浓度(≥8.2微克/升)在给药后3.3小时降至中位数<5微克/升,在4.8小时降至<2微克/升;只有1名参与者在3.3小时后THC≥5微克/升。

结论

尽管在驾驶时法医血液THC浓度可能大大超过常见的自身临界值,但实际浓度可能较低。由于摄入后时间未知以及个体间下降速率的差异,驾驶期间的浓度无法回溯推断。

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