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Interpreting oral fluid drug results in prisoners: monitoring current drug intake and detection times for drugs self-administered prior to detention

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Abstract

Purpose

Although urine is the most common matrix for prisoner drug testing, oral fluid offers a possible alternative. Identifying new drug intake by a prisoner results in negative sanctions. Detection times in oral fluid after chronic drug intake may be extended. Within the prison, admission population is chronic drug users. Our aim was to investigate detection windows for drugs of abuse in oral fluid from prisoners.

Methods

Nineteen frequent drug-abusing prisoners provided oral fluid and urine at admission and each morning thereafter for 9 consecutive days.

Results

The most positive findings were for amphetamine/methamphetamine, cannabis and benzodiazepines. Maximum detection times in oral fluid were ≥ 9 days for diazepam, methadone and methamphetamine, with corresponding urinary detection times of ≥ 9, 7 and 6 days, respectively. Maximum oral fluid detection times were 9 days for clonazepam, 8 for oxazepam, 3 for amphetamine and nitrazepam, and 2 for tetrahydrocannabinol, with positive urinary detection times of 8, ≥ 9, 5, 7 and ≥ 9 days, respectively. Cocaine, morphine and 6-acetylmorphine were all positive only 1 day in oral fluid; cocaine and morphine were positive 1 and 2 days, respectively, in urine, while 6-acetylmorphine was not detected in urine.

Conclusion

We confirmed oral fluid as a viable matrix for monitoring drugs of abuse in prisoners. Windows of detection for benzodiazepines and amphetamines were up to 1 week, which is an important consideration for evaluating oral fluid drug testing results. Some likely new drug exposures were observed based on urine and oral fluid drug results, but there were few data to guide these interpretations.

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Acknowledgements

We would like to thank Eirik Trøgstad, Svein Pettersen, Frank Kaasa, Leif Skaug and Stig Tore Kopperud for organizing the inclusion of prisoners in the project and excellent sample collection.

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Authors and Affiliations

  1. Department of Forensic Sciences, Oslo University Hospital, PO Box 4950, Nydalen, 0424, Oslo, Norway

    Elisabeth Leere Øiestad & Vigdis Vindenes

  2. School of Pharmacy, University of Oslo, PO Box 1068, Blindern, 0316, Oslo, Norway

    Elisabeth Leere Øiestad

  3. Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway

    Hege-Merete Krabseth

  4. Lambert Center for the Study of Medicinal Cannabis and Health, Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA, 19107, USA

    Marilyn Ann Huestis

  5. Norwegian Directorate of Health, PO Box 7000, St. Olavs Plass, 0130, Oslo, Norway

    Andreas Skulberg

  6. Norwegian Centre for Addiction Research (SERAF), University of Oslo, PO Box 1039, Blindern, 0315, Oslo, Norway

    Vigdis Vindenes

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  1. Elisabeth Leere Øiestad
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  2. Hege-Merete Krabseth
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  3. Marilyn Ann Huestis
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  4. Andreas Skulberg
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  5. Vigdis Vindenes
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Correspondence to Elisabeth Leere Øiestad.

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Conflict of interest

The authors declare no conflicts of interest. This study has not received any external financial support.

Ethical approval

The Norwegian Regional Committee for Medical and Health Research Ethics approved the study. Participation was voluntary, and participants could withdraw at any time without penalty. Written informed consent from 19 inmates from three prisons was obtained prior to inclusion after fully informing participants about the study.

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Øiestad, E.L., Krabseth, HM., Huestis, M.A. et al. Interpreting oral fluid drug results in prisoners: monitoring current drug intake and detection times for drugs self-administered prior to detention. Forensic Toxicol 37, 59–74 (2019). https://doi.org/10.1007/s11419-018-0434-9

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