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Orally administered cannabidiol does not produce false-positive tests for Δ⁹ -tetrahydrocannabinol on the Securetec DrugWipe® 5S or Drager DrugTest® 5000.

ABSTRACT: Many jurisdictions use point-of-collection (POC) oral fluid testing devices to identify driving under the influence of cannabis, indexed by the presence of Δ⁹ -tetrahydrocannabinol (THC), an intoxicating cannabinoid, in oral fluid. Although the use of the non-intoxicating cannabinoid, cannabidiol (CBD), is not prohibited among drivers, it is unclear whether these devices can reliably distinguish between CBD and THC, which have similar chemical structures. This study determined whether orally administered CBD produces false-positive tests for THC on standard, POC oral fluid testing devices. In a randomised, double-blind, crossover design, healthy participants (n = 17) completed four treatment sessions involving the administration of either placebo or 15-, 300- or 1500-mg pure CBD in a high-fat dietary supplement. Oral fluid was sampled, and the DrugWipe®-5S (DW-5S; 10 ng·ml^-1 THC cut-off) and Drug Test® 5000 (DT5000; 10 ng·mL^-1 THC cut-off) devices administered, at baseline (pretreatment) and ~20-, ~145- and ~185-min posttreatment. Oral fluid cannabinoid concentrations were measured using ultra-high performance liquid chromatography-tandem mass spectrometry. Median (interquartile range [IQR]) oral fluid CBD concentrations were highest at ~20 min, quantified as 0.4 (6.0), 15.8 (41.6) and 167 (233) ng·ml^-1 on the 15-, 300- and 1500-mg CBD treatments, respectively. THC, cannabinol and cannabigerol were not detected in any samples. A total of 259 DW-5S and 256 DT5000 tests were successfully completed, and no THC-positive tests were observed. Orally administered CBD does not appear to produce false-positive (or true-positive) tests for THC on the DW-5S and DT5000. The likelihood of an individual who is using a CBD (only) oral formulation being falsely accused of DUIC therefore appears low.

SUBMITTER: McCartney D

PROVIDER: S-EPMC9292716 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ImportanceControlled clinical laboratory studies have shown that cannabidiol (CBD) can sometimes attenuate or exacerbate the effects of Δ9-tetrahydrocannabinol (Δ9-THC). No studies have evaluated differences in pharmacokinetics (PK) of Δ9-THC and pharmacodynamics (PD) between orally administered cannabis extracts that vary with respect to Δ9-THC and CBD concentrations.ObjectiveTo compare the PK and PD of orally administered Δ9-THC-dominant and CBD-dominant cannabis extracts that contained the same Δ9-THC dose (20 mg).Design, setting, and participantsThis randomized clinical trial was a within-participant, double-blind, crossover study conducted from January 2021 to March 2022 at the Johns Hopkins University Behavioral Pharmacology Research Unit, Baltimore, MD. Eighteen healthy adults completed 3 randomized outpatient experimental test sessions that were each separated by at least 1 week.InterventionsBrownies containing (1) no cannabis extract (ie, placebo); (2) Δ9-THC-dominant extract (20 mg Δ9-THC with no CBD); and (3) CBD-dominant extract (20 mg Δ9-THC + 640 mg CBD) were administered to participants 30 minutes prior to administering a cytochrome P450 (CYP) probe drug cocktail, which consisted of 100 mg caffeine, 20 mg omeprazole, 25 mg losartan, 30 mg dextromethorphan, and 2 mg midazolam.Main outcomes and measuresChange-from-baseline plasma concentrations for Δ9-THC or Δ9-THC metabolites and scores for subjective drug effects, cognitive and psychomotor performance, and vital signs. The area under the plasma vs concentration vs time curve (AUC) and maximum plasma concentration (Cmax) were determined.ResultsThe participant cohort of 18 adults included 11 males (61.1%) and 7 females (38.9%) with a mean (SD) age of 30 (7) years who had not used cannabis for at least 30 days prior to initiation of the study (mean [SD] day since last cannabis use, 86 [66] days). The CYP cocktail + placebo brownie and the CYP cocktail did not affect any PD assessments. Relative to CYP cocktail + Δ9-THC, CYP cocktail + Δ9-THC + CBD produced a higher Cmax and area under the plasma concentration vs time curve for Δ9-THC, 11-OH-Δ9-THC, and Δ9-THC-COOH. The CYP cocktail + Δ9-THC + CBD increased self-reported anxiety, sedation, and memory difficulty, increased heart rate, and produced a more pronounced impairment of cognitive and psychomotor performance compared with both CYP cocktail + Δ9-THC and CYP cocktail + placebo.Conclusions and relevanceIn this randomized clinical trial of oral Δ9-THC and CBD, stronger adverse effects were elicited from a CBD-dominant cannabis extract compared with a Δ9-THC-dominant cannabis extract at the same Δ9-THC dose, which contradicts common claims that CBD attenuates the adverse effects of Δ9-THC. CBD inhibition of Δ9-THC and 11-OH-Δ9-THC metabolism is the likely mechanism for the differences observed. An improved understanding of cannabinoid-cannabinoid and cannabinoid-drug interactions are needed to inform clinical and regulatory decision-making regarding the therapeutic and nontherapeutic use of cannabis products.Trial registrationclinicaltrials.gov Identifier: NCT04201197.

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Orally administered cannabidiol does not produce false-positive tests for Δ⁹ -tetrahydrocannabinol on the Securetec DrugWipe® 5S or Drager DrugTest® 5000.

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Dataset Information

Orally administered cannabidiol does not produce false-positive tests for Δ9 -tetrahydrocannabinol on the Securetec DrugWipe® 5S or Drager DrugTest® 5000.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Orally administered cannabidiol does not produce false-positive tests for Δ⁹ -tetrahydrocannabinol on the Securetec DrugWipe® 5S or Drager DrugTest® 5000.