Can oral fluid cannabinoid testing monitor medication compliance and/or cannabis smoking during oral THC and oromucosal Sativex administration?
Can oral fluid cannabinoid testing monitor medication compliance and/or cannabis smoking during oral THC and oromucosal Sativex administration?
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DOI：
10.1016/j.drugalcdep.2012.10.011
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发表时间：
2013-06-01
影响因子：
4.2
通讯作者：
Huestis, Marilyn A.
中科院分区：
文献类型：
--
作者：
Lee, Dayong;Karschner, Erin L.;Milman, Garry;Barnes, Allan J.;Goodwin, Robert S.;Huestis, Marilyn A.
我们描述了Dronabinol，合成口服Δ 9-四氢大麻酚（THC）和Sativex（一种大麻提取物oromuclidine喷雾剂）后口腔液（OF）中大麻素的分布，并评估是否可以通过OF大麻素监测来确定吸食大麻的复发或Sativex依从性。以随机顺序施用5和15 mg合成口服THC、低剂量（5.4 mg THC，5.0 mg大麻二酚（CBD））和高剂量（16.2 mg THC，15.0 mg CBD）Sativex和安慰剂（n = 14）。给药后10.5小时收集口腔液样本，并分析THC、CBD、大麻酚（CBN）和11-去甲-9-羧基-THC（THCCOOH）。口服THC后，OF THC浓度随着时间的推移从基线下降，反映了先前自我吸食大麻的残留THC排泄。CBD和CBN也很少被检测到。Sativex处理后，THC、CBD和CBN均显著升高，在0.25~1h达到峰值。CBD/THC和CBN/THC的比例中位数分别为0.82 - 1.34和0.04 - 0.06，反映了Sativex中的大麻素成分。Sativex给药后4.5小时内的THCCOOH/THC比值≤ 1.6 pg/ng，始终低于口服THC和安慰剂后的比值。THCCOOH/THC比率在每次给药期间增加。口服THC后OF中缺乏可测量的THC，CBD和CBN，以及Sativex后高OF CBD/THC比率将口服和舌下给药途径与大麻吸烟区分开来。低THCCOOH/THC比率表明最近接触过Sativex和吸食大麻。这些数据表明，OF大麻素监测可以记录对Sativex药物治疗的依从性，并在口服THC药物治疗期间识别吸食大麻的复发，但不能识别Sativex治疗，除非在吸烟后不久收集样本。
We characterize cannabinoid disposition in oral fluid (OF) after Dronabinol, synthetic oral Δ9-tetrahydrocannabinol (THC), and Sativex, a cannabis-extract oromucosal spray, and evaluate whether smoked cannabis relapse or Sativex compliance can be identified with OF cannabinoid monitoring. 5 and 15 mg synthetic oral THC, low (5.4 mg THC, 5.0 mg cannabidiol (CBD)) and high (16.2 mg THC, 15.0 mg CBD) dose Sativex, and placebo were administered in random order (n=14). Oral fluid specimens were collected for 10.5h after dosing and analyzed for THC, CBD, cannabinol (CBN), and 11-nor-9-carboxy-THC (THCCOOH). After oral THC, OF THC concentrations decreased over time from baseline, reflecting residual THC excretion from previously self-administered smoked cannabis. CBD and CBN also were rarely detected. After Sativex, THC, CBD and CBN increased greatly, peaking at 0.25–1h. Median CBD/THC and CBN/THC ratios were 0.82–1.34 and 0.04–0.06, respectively, reflecting cannabinoids’ composition in Sativex. THCCOOH/THC ratios within 4.5h post Sativex were ≤1.6 pg/ng, always lower than after oral THC and placebo. THCCOOH/THC ratios increased throughout each dosing session. Lack of measurable THC, CBD and CBN in OF following oral THC, and high OF CBD/THC ratios after Sativex distinguish oral and sublingual drug delivery routes from cannabis smoking. Low THCCOOH/THC ratios suggest recent Sativex and smoked cannabis exposure. These data indicate that OF cannabinoid monitoring can document compliance with Sativex pharmacotherapy, and identify relapse to smoked cannabis during oral THC medication but not Sativex treatment, unless samples were collected shortly after smoking.
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