Citation

Arvidsson M, Ullah S, Franck J, Dahl ML, Beck O. Drug Test. Anal. 2019; 11(1): 27-32.

Affiliation

Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1002/dta.2384

PMID

29575801

Abstract

In the treatment of substance use disorder regular laboratory-based testing has the dual purpose of monitoring compliance to the prescribed medication and the abstention from medically non-motivated substances (i.e. drug abuse screening). The principal specimen for testing is urine, but collection of urine has some disadvantages, e.g. being more time-consuming and more intrusive compared to other matrices, and there is also the risk of adulteration. This project aims to compare exhaled breath and oral fluid as alternative matrices for drug abuse screening in patients with substance use disorder. All 51 subjects included in the study were enrolled at the Drug Addiction Emergency Unit in Stockholm. Exhaled breath, oral fluid and urine samples were collected together with a self-report. Out of all 117 self-reported drug intakes during the previous week 72% were confirmed in urine, 73 % in oral fluid and 39 % in exhaled breath. In 31% of the subjects, additional substances other than those self-reported were detected analytically. For the purpose of substance abuse screening urine had the highest detection rate for buprenorphine, cannabis and benzodiazepines, while oral fluid had the highest detection rate for amphetamines and methadone. Exhaled breath showed the highest detection rate of all matrices for cocaine. To identify significant differences in detection rates between the matrices future studies with larger sampling sizes are needed. Both OF and EB are viable alternative specimens to urine depending on the circumstances and purpose of the testing.

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Language: en

Keywords

drug abuse screening; exhaled breath; oral fluid; self-report; substance use disorder