Assessing cannabis consumption frequency: Is the combined use of free and glucuronidated THCCOOH blood levels of diagnostic utility?

Hädener, Marianne; Martin Fabritius, Marie; König, Stefan; Giroud, Christian; Weinmann, Wolfgang (2017). Assessing cannabis consumption frequency: Is the combined use of free and glucuronidated THCCOOH blood levels of diagnostic utility? Drug testing and analysis, 9(7), pp. 1043-1051. Wiley 10.1002/dta.2114

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Heavy cannabis consumption is considered incompatible with safe driving. In Swiss traffic policy, drivers suspected of regular cannabis use are therefore required to undergo medical assessment of their long-term fitness to drive. A whole blood concentration of the cannabis metabolite 11-nor-9-carboxy-Δ(9) -tetrahydrocannabinol (THCCOOH) of 40 µg/L is currently used by Swiss forensic experts as decision limit for regular cannabis consumption. The present study aimed to investigate the suitability of THCCOOH-glucuronide blood levels as an additional and/or better marker for the frequency of cannabis use. Whole blood samples collected from 23 heavy (≥10 joints/month) and 25 occasional smokers (≥1 joint/month, but ≤ 1 joint/week) enrolled in a placebo-controlled cannabis smoking study were analyzed for THCCOOH and THCCOOH-glucuronide. Based on ROC curve analysis concentration thresholds could be established for distinguishing between these two groups. Proposed thresholds for heavy use were THCCOOH-glucuronide > 52 µg/L (100% specificity; 41% sensitivity) and/or total THCCOOH > 58 µg/L (100% specificity; 43% sensitivity). Optimum thresholds for occasional use were THCCOOH-glucuronide < 5 µg/L (73% specificity; 97% sensitivity) and/or total THCCOOH < 5 µg/L (62% specificity; 98% sensitivity). Our results indicate that the THCCOOH-glucuronide whole blood concentration is a useful parameter that complements the free THCCOOH level to assess the frequency of cannabis consumption. The consideration of the blood concentrations of both free and glucuronidated THCCOOH improves the identification of heavy users whose fitness to drive has to be carefully assessed.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute of Legal Medicine > Forensic Chemistry and Toxicology
04 Faculty of Medicine > Service Sector > Institute of Legal Medicine

UniBE Contributor:

Hädener, Marianne; König, Stefan and Weinmann, Wolfgang

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1942-7603

Publisher:

Wiley

Language:

English

Submitter:

Antoinette Angehrn

Date Deposited:

25 Oct 2016 11:08

Last Modified:

13 Oct 2017 02:30

Publisher DOI:

10.1002/dta.2114

PubMed ID:

27732768

Uncontrolled Keywords:

THCCOOH; THCCOOH-glucuronide; cannabis; consumption frequency; whole blood

BORIS DOI:

10.7892/boris.89396

URI:

https://boris.unibe.ch/id/eprint/89396

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