Rocky Mountain Poison and Drug Safety, Denver Health, Denver, CO, USA.
Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Clin Toxicol (Phila). 2023 May;61(5):363-369. doi: 10.1080/15563650.2023.2173076. Epub 2023 Mar 20.
The determination of recent cannabis use is of forensic interest in the investigation of automotive crashes, workplace incidents and other mishaps. Because Δ9-tetrahydrocannabinol may persist in blood after psychoactive effects of intoxication resolve, particularly in regular users, short-lived minor cannabinoids such as cannabigerol have merited examination as adjunct indicators of recent cannabis inhalation.
As part of an observational cohort study, whole blood cannabinoids including cannabigerol were measured in whole blood by liquid chromatography with tandem mass spectrometry at baseline, and 30 minutes after initiation of a 15-minute supervised interval of cannabis smoking in occasional (1-2 days/week over the past 30 days) ( = 24) and daily cannabis smokers ( = 32). Per protocol, subjects self-reported abstention from inhaling cannabis (>8 h) or ingesting cannabis (>12 h) prior to baseline measurement.
At baseline, none of the occasional users had detectable cannabigerol (limit of detection = 0.2 µg/L), whereas cannabigerol was detectable post-smoking in 7 of 24 (29%). Among daily cannabis users, 2 of 32 (6%) had detectable cannabigerol at baseline, increasing to 21 of 32 (66%) post-smoking. The odds ratio for recent cannabis smoking associated with a detectable cannabigerol was 27 (95% confidence interval: 6.6, 110.3). In this mixed cohort of occasional and daily cannabis users, receiver operator characteristic curve analysis indicated that whole blood cannabigerol concentration of ≥ 0.2 µg/L had 96% specificity, 50% sensitivity, and 73% accuracy for identifying a 15-minute interval of cannabis smoking initiated 30 minutes earlier. Post smoking blood Δ9-tetrahydrocannabinol (median = 5.6 µg/L in occasional users, 21.3 µg/L in daily users) was significantly correlated with post-smoking cannabigerol ( < 0.0001).
Whole blood cannabigerol may have forensic utility as a highly specific albeit insensitive biomarker of recent cannabis smoking.
在调查汽车事故、工作场所事故和其他事故时,近期大麻使用的确定具有法医学意义。由于 Δ9-四氢大麻酚在中毒的精神活性作用消退后可能会在血液中持续存在,尤其是在经常使用者中,短暂的次要大麻素如大麻二醇已被视为近期大麻吸入的辅助指标。
作为一项观察性队列研究的一部分,在基线时通过液相色谱-串联质谱法测量全血中的大麻素,包括大麻二醇,然后在 15 分钟监督吸烟间隔的 30 分钟后测量,在偶尔(过去 30 天中每天 1-2 天)吸烟的( = 24)和每日吸烟的( = 32)。根据方案,受试者在基线测量前报告已停止吸入大麻(>8 小时)或摄入大麻(>12 小时)。
在基线时,没有偶尔使用者可检测到大麻二醇(检测限=0.2µg/L),而在吸烟后,24 名参与者中有 7 名(29%)可检测到大麻二醇。在每日吸烟的人群中,有 2 名(6%)在基线时可检测到大麻二醇,而在吸烟后有 32 名(66%)可检测到。与可检测到大麻二醇相关的近期大麻吸烟的比值比为 27(95%置信区间:6.6,110.3)。在这组偶尔和每日吸食大麻的混合人群中,接受者操作特征曲线分析表明,全血大麻二醇浓度≥0.2µg/L 对识别 30 分钟前开始的 15 分钟大麻吸烟间隔具有 96%的特异性、50%的敏感性和 73%的准确性。吸烟后血液中的 Δ9-四氢大麻酚(偶尔使用者的中位数=5.6µg/L,每日使用者的中位数=21.3µg/L)与吸烟后大麻二醇显著相关( < 0.0001)。
全血大麻二醇可能具有法医学用途,作为一种高度特异性但不敏感的近期大麻吸烟生物标志物。