Citation

Busardò FP, Pichini S, Pacifici R. Clin. Chem. 2017; 63(3): 781-783.

Affiliation

National Centre on Addiction and Doping Istituto Superiore di Sanità, Rome, Italy.

Copyright

(Copyright © 2017, American Association for Clinical Chemistry)

DOI

10.1373/clinchem.2016.268805

PMID

28087582

Abstract

Psychotropic drugs affecting the central nervous system have the potential to impair driving ability. Among the issues in assessing the impact of drugs on driving are (a) the appropriateness of the biological matrix in objectively measuring the presence of the drugs and/or metabolites, (b) the reliability of the detection method in measuring them, and (c) the “cutoff values” applied to drugs eventually found in relation to driving impairment (1).

Regarding the first issue, the effects of drugs on driving performance should associate with drug concentration in the brain. The best indicator here is the concentration of the drug and/or metabolites in blood and to a lesser extent oral fluid. Concerning the reliability of the analytical methods, fully validated chromatography-mass spectrometry hyphenated techniques are available to consistently identify and quantify several psychoactive substances in blood. Then there is the important issue of what cutoffs should be used in the unambiguous identification of drivers under the influence of drugs.

Considering that there are no therapeutic ranges for illicit drugs, an international board of scientists proposed “the use of analytical cutoff concentrations that are low, either state-of-the-art detection limits for multianalyte analytical methods or concentrations that are likely to be reached 24 h after use of a typical dose of the drug,” recommending blood collection as soon as possible (preferably within 3 h) after a road accident or injury (2). This proposal was justified by the fact that, at that time, no epidemiological studies were available on the matter and that many detection limits varied from 1–10 ng/mL blood for the same drug ...

Keywords: Cannabis impaired driving

Language: en