Driving under the influence of drugs — evaluation of analytical data of drugs in oral fluid, serum and urine, and correlation with impairment symptoms

• Published in: Forensic science international 2005-09, Vol.152 (2), p.149-155
• Main Authors: Toennes, Stefan W., Kauert, Gerold F., Steinmeyer, Stefan, Moeller, Manfred R.
• Format: Article
• Language: English
• Subjects: Amphetamines; Amphetamines - analysis; Automobile Driving; Biological and medical sciences; Cannabinoids - analysis; Central Nervous System Depressants - blood; Classification; Cocaine; Cocaine - analysis; Criminal investigations; Derivatives; Disability evaluation; Dopamine Uptake Inhibitors - analysis; Driving under the influence; Drug abuse; Drug testing; Drugs of abuse; Drunk driving; Ecstasy; Ethanol - blood; Evaluation; Flame Ionization; Forensic Medicine; Forensic sciences; Gas Chromatography-Mass Spectrometry; Humans; Impairment symptoms; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Narcotics - analysis; Onsite; Pilot Projects; Police; Public health. Hygiene; Public health. Hygiene-occupational medicine; Saliva; Saliva - chemistry; Saliva/oral fluid; Salivary glands; secretions; Serum; Substance Abuse Detection - methods; Urinalysis; Urine
• ISSN: 0379-0738; 1872-6283
• DOI: 10.1016/j.forsciint.2004.08.002

A study was performed to acquire urine, serum and oral fluid samples in cases of suspected driving under the influence of drugs of abuse. Oral fluid was collected using a novel sampling/testing device (Dräger DrugTest ® System). The aim of the study was to evaluate oral fluid and urine as a predictor of blood samples positive for drugs and impairment symptoms. Analysis for cannabinoids, amphetamine and its derivatives, opiates and cocaine was performed in urine using the Mahsan Kombi/DOA4-test, in serum using immunoassay and gas chromatography–mass spectrometry (GC–MS) confirmation and in oral fluid by GC–MS. Police and medical officer observations of impairment symptoms were rated and evaluated using a threshold value for the classification of driving inability. Accuracy in correlating drug detection in oral fluid and serum were >90% for all substances and also >90% in urine and serum except for THC (71.0%). Of the cases with oral fluid positive for any drug 97.1% of corresponding serum samples were also positive for at least one drug; of drug-positive urine samples this were only 82.4%. In 119 of 146 cases, impairment symptoms above threshold were observed (81.5%). Of the cases with drugs detected in serum, 19.1% appeared not impaired which were the same with drug-positive oral fluid while more persons with drug-positive urine samples appeared uninfluenced (32.7%). The data demonstrate that oral fluid is superior to urine in correlating with serum analytical data and impairment symptoms of drivers under the influence of drugs of abuse.