Bakke Eirin, Høiseth Gudrun, Arnestad Marianne, Gjerde Hallvard
Department of Forensic Sciences, Oslo University Hospital, Nydalen, Oslo, Norway.
Centre for Psychopharmacology, Diakonhjemmet Hospital, Diakonveien 12, Oslo, Norway.
J Anal Toxicol. 2019 Apr 1;43(3):228-232. doi: 10.1093/jat/bky079.
Simultaneously collected samples of oral fluid and blood in a naturalistic setting could provide a qualitative impression of the relative detection times of drugs in oral fluid compared to blood. The aim of this study was to compare detections of different drugs in oral fluid and blood from a large material of paired samples. The study included results from 930 paired oral fluid and blood samples collected from drivers suspected for driving under the influence of drugs. Oral fluid was collected using the Intercept device. Blood samples were screened using an ultra high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS-MS) method and positive results were confirmed and quantified with a different analytical method. Oral fluid samples were analyzed using UHPLC-MS-MS. The drugs included in the study were: amphetamine, methamphetamine, tetrahydrocannabinol (THC), diazepam, N-desmethyldiazepam, clonazepam, alprazolam, nitrazepam, oxazepam, morphine, 6-monoacetylmorphine (6-MAM), methadone and buprenorphine. The drugs detected more frequently in oral fluid compared to blood were amphetamine (497 positive in oral fluid/408 positive in blood), methamphetamine (332/232), oxazepam (106/36), morphine (65/31) and 6-MAM (19/0). The drugs detected less frequently in oral fluid compared to blood were THC (224 positive in oral fluid/407 positive in blood), diazepam (137/160), N-desmethyldiazepam (183/188), clonazepam (148/307), alprazolam (47/68), nitrazepam (16/29) and buprenorphine (31/59). For methadone, the number of detections was the same in oral fluid and in blood (23/23). The results indicate that for amphetamine, methamphetamine, morphine and 6-MAM, relative detection time is longer in oral fluid than in blood, while for benzodiazepines, the results indicate that relative detection time is shorter in oral fluid than in blood. For oxazepam and buprenorphine, the results were dependent on the cut-off limits used. Regarding THC, the detection time in oral fluid depends on the sampling method. The relative detection time was shorter than in blood when using the Intercept device.
在自然环境中同时采集口腔液和血液样本，可以对药物在口腔液中相对于血液的相对检测时间提供定性印象。本研究的目的是比较来自大量配对样本的口腔液和血液中不同药物的检测情况。该研究纳入了从涉嫌药物影响下驾驶的司机处采集的930对口腔液和血液样本的结果。使用Intercept装置采集口腔液样本。血液样本采用超高效液相色谱-串联质谱法（UHPLC-MS-MS）进行筛查，阳性结果用另一种分析方法进行确认和定量。口腔液样本采用UHPLC-MS-MS进行分析。研究中包括的药物有：苯丙胺、甲基苯丙胺、四氢大麻酚（THC）、地西泮、N-去甲基地西泮、氯硝西泮、阿普唑仑、硝西泮、奥沙西泮、吗啡、6-单乙酰吗啡（6-MAM）、美沙酮和丁丙诺啡。与血液相比，在口腔液中检测更频繁的药物有苯丙胺（口腔液中497例阳性/血液中408例阳性）、甲基苯丙胺（332/232）、奥沙西泮（106/36）、吗啡（65/31）和6-MAM（19/0）。与血液相比，在口腔液中检测较不频繁的药物有THC（口腔液中224例阳性/血液中407例阳性）、地西泮（137/160）、N-去甲基地西泮（183/188）、氯硝西泮（148/307）、阿普唑仑（47/68）、硝西泮（16/29）和丁丙诺啡（31/59）。对于美沙酮，口腔液和血液中的检测数量相同（23/23）。结果表明，对于苯丙胺、甲基苯丙胺、吗啡和6-MAM，口腔液中的相对检测时间比血液中长，而对于苯二氮䓬类药物，结果表明口腔液中的相对检测时间比血液中短。对于奥沙西泮和丁丙诺啡，结果取决于所使用的截断限值。关于THC，口腔液中的检测时间取决于采样方法。使用Intercept装置时，相对检测时间比血液中短。
