Acute Pharmacokinetic Profile of Smoked and Vaporized Cannabis in Human Blood and Oral Fluid

• Published in: Journal of analytical toxicology 2019-05, Vol.43 (4), p.233-258
• Main Authors: Spindle, Tory R, Cone, Edward J, Schlienz, Nicolas J, Mitchell, John M, Bigelow, George E, Flegel, Ronald, Hayes, Eugene, Vandrey, Ryan
• Format: Article
• Language: English
• Subjects: Adult; Cannabis - chemistry; Chromatography, Liquid; Double-Blind Method; Dronabinol - administration & dosage; Dronabinol - adverse effects; Dronabinol - blood; Dronabinol - pharmacokinetics; Editor's Choice; Enzyme-Linked Immunosorbent Assay; Female; Hallucinations - etiology; Humans; Male; Marijuana Smoking - adverse effects; Marijuana Smoking - blood; Marijuana Smoking - legislation & jurisprudence; Osmolar Concentration; Psychotropic Drugs - administration & dosage; Psychotropic Drugs - adverse effects; Psychotropic Drugs - blood; Psychotropic Drugs - pharmacokinetics; Saliva - chemistry; Sensitivity and Specificity; Sex Factors; Substance Abuse Detection - methods; Tandem Mass Spectrometry; Volatilization; Vomiting - etiology; Young Adult
• ISSN: 0146-4760; 1945-2403
• DOI: 10.1093/jat/bky104

Currently, an unprecedented number of individuals can legally access cannabis. Vaporization is increasingly popular as a method to self-administer cannabis, partly due to perception of reduced harm compared with smoking. Few controlled laboratory studies of cannabis have used vaporization as a delivery method or evaluated the acute effects of cannabis among infrequent cannabis users. This study compared the concentrations of cannabinoids in whole blood and oral fluid after administration of smoked and vaporized cannabis in healthy adults who were infrequent users of cannabis. Seventeen healthy adults, with no past-month cannabis use, self-administered smoked or vaporized cannabis containing Δ9-tetrahydrocannabinol (THC) doses of 0, 10 and 25 mg in six double-blind outpatient sessions. Whole blood and oral fluid specimens were obtained at baseline and for 8 h after cannabis administration. Cannabinoid concentrations were assessed with enzyme-linked immunosorbent assay (ELISA) and liquid chromatography-tandem mass spectrometry (LC-MS-MS) methods. Sensitivity, specificity and agreement between ELISA and LC-MS-MS results were assessed. Subjective, cognitive performance and cardiovascular effects were assessed. The highest concentrations of cannabinoids in both whole blood and oral fluid were typically observed at the first time point (+10 min) after drug administration. In blood, THC, 11-OH-THC, THCCOOH and THCCOOH-glucuronide concentrations were dose-dependent for both methods of administration, but higher following vaporization compared with smoking. THC was detected longer in oral fluid compared to blood and THCCOOH detection in oral fluid was rare and highly erratic. For whole blood, greater detection sensitivity for ELISA testing was observed in vaporized conditions. Conversely, for oral fluid, greater sensitivity was observed in smoked sessions. Blood and/or oral fluid cannabinoid concentrations were weakly to moderately correlated with pharmacodynamic outcomes. Cannabis pharmacokinetics vary by method of inhalation and biological matrix being tested. Vaporization appears to be a more efficient method of delivery compared with smoking.