Differentiating new cannabis use from residual urinary cannabinoid excretion in chronic, daily cannabis users

被引：66

作者：

Schwilke, Eugene W. ^{[1
]}

Gullberg, Rod G. ^{[2
]}

Darwin, William D. ^{[1
]}

Chiang, C. Nora ^{[3
]}

Cadet, Jean Lud ^{[4
]}

Gorelick, David A. ^{[5
]}

Pope, Harrison G. ^{[6
]}

Huestis, Marilyn A. ^{[1
]}

机构：

[1] Natl Inst Drug Abuse, Intramural Res Program, NIH, Biomed Res Ctr, Baltimore, MD 21146 USA

[2] Washington State Patrol, Breath Test Sect, Seattle, WA USA

[3] Natl Inst Drug Abuse, Div Pharmacotherapies & Med Consequences Drug Abu, NIH, Rockville, MD USA

[4] Natl Inst Drug Abuse, Intramural Res Program, NIH, Biomed Res Ctr, Baltimore, MD USA

[5] Natl Inst Drug Abuse, Off Sci Director, Intramural Res Program, NIH,Biomed Res Ctr, Baltimore, MD USA

[6] Harvard Univ, McLean Hosp, Belmont, MA 02178 USA

来源：

ADDICTION | 2011年 / 106卷 / 03期

基金：

美国国家卫生研究院;

关键词：

New cannabis use; predictive model; residual drug excretion; urine cannabinoids; CREATININE RATIO; 11-NOR-9-CARBOXY-DELTA(9)-TETRAHYDROCANNABINOL; PROFILES; DELTA(9)-THC-COOH; MARIJUANA; HUMANS;

D O I：

10.1111/j.1360-0443.2010.03228.x

中图分类号：

R194 [卫生标准、卫生检查、医药管理];

学科分类号：

摘要：

Aims To develop and validate empirically a mathematical model for identifying new cannabis use in chronic, daily cannabis smokers. Design Models were based on urinary creatinine-normalized (CN) cannabinoid excretion in chronic cannabis smokers. Setting For model development, participants resided on a secure research unit for 30 days. For model validation, participants were abstinent with daily observed urine specimens for 28 days. Participants A total of 48 (model development) and 67 (model validation) daily cannabis smokers were recruited. Measurements All voided urine was collected and analyzed for 11-nor-9-carboxy-Delta 9-tetrahydrocannabinol (THCCOOH) by gas chromatography-mass spectrometry (GCMS; limit of quantification 2.5 ng/ml) and creatinine (mg/ml). Urine THCCOOH was normalized to creatinine, yielding ng/mg CN-THCCOOH concentrations. Urine concentration ratios were determined from 123 513 specimen pairs collected 2-30 days apart. Findings A mono-exponential model (with two parameters, initial urine specimen CN-THCCOOH concentration and time between specimens), based on the Marquardt-Levenberg algorithm, provided a reasonable data fit. Prediction intervals with varying probability levels (80, 90, 95, 99%) provide upper ratio limits for each urine specimen pair. Ratios above these limits suggest cannabis re-use. Disproportionate numbers of ratios were higher than expected for some participants, prompting development of two additional rules that avoid misidentification of re-use in participants with unusual CN-THCCOOH excretion patterns. Conclusions For the first time, a validated model is available to aid in the differentiation of new cannabis use from residual creatinine-normalized 11-nor-9-carboxy-Delta 9-tetrahydrocannabinol (CN-THCCOOH) excretion in chronic, daily cannabis users. These models are valuable for clinicians, toxicologists and drug treatment staff and work-place, military and criminal justice drug-testing programs.

引用

页码：499 / 506

页数：8

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