1. The Science Behind Drugs Testing -Past, Present and Future- Dr Francois Oosthuizen – Senior Chemist & Research Officer, Toxicology laboratory, ChemCentre

2. ChemCentre provides chemical and forensic testing for the State We provide forensic toxicology services (including drug testing) to: WA Police Office of the State Coroner A wide range of private clients About ChemCentre

3. The Challenge Increased importance of Drug testing in society Wide spectrum of services (coronial, sobriety, criminal, workplace) Meeting their individual needs Adapting to a fast changing market

4. Common Categories: Cannabinoids Amphetamine Opiates Cocaine Benzodiazepines other

5. Drug Testing – Current Approaches: Blood Urine (AS/NZ 4308-2008) Oral Fluid (AS 4760-2006)

6. Blood: Closest relationship to brain concentrations Parent Drug Extensive literature Somewhat invasive Limited Detection Window No on-site testing capability Keith R. Allen, Annals of Clinical Biochemistry, 48, 2011, 531-541 (and references therein)

7. Urine: Less Invasive sample collection Some on-site testing capabilities Broad detection time window Targets metabolites No relationship to brain concentrations No relationship between urine concentration and effect Time delay for collection.

8. Urine cont’d: Adulteration, dilution or falsification of samples ‘Shy Bladder’ syndrome Broad detection time window Special facilities needed

9. Oral Fluid: Least invasive sample collection No time delay for collection Targets parent drugs Some on-site testing capabilities Limited relationship to blood concentrations Relationship between oral fluid concentration and effect? Limited detection window.

10. Oral Fluid cont’d: Limited adulteration Buffer solutions can pose restrictions on type of analysis Collecting enough – ‘dry mouth syndrome’ Keith R. Allen, Annals of Clinical Biochemistry, 48, 2011, 531-541 (and references therein)

11. Time Window for Detection: Depends on several factors: Dose of drugs Frequency of dosing Individual metabolism Cut-off used to measure drugs Matrix tested Keith R. Allen, Annals of Clinical Biochemistry, 48, 2011, 531-541 (and references therein)

12. Detection Times - Urine Detection (h)max. Det (days)cut-off (ng/ml) MA (10 mg)87 ± 51 hours6 days max2.5 MDMA (100 mg)48 hours20 THCA (1.75%)349515 (3.50%)8715 Heroin (morphine)11 – 5411.3 Cocaine(BZE)48 – 72221000 Alaine G. Verstraete, Therapeutic Drug Monitoring, vol 26, No. 2, April 2004 (and references therein)

13. Detection Times – Oral Fluid Detection (h)cut-off (ng/ml) MA (10 mg)24 hours2.5 MDMA (100 mg)24 hours126 THC 340.5 Heroin (MAM) (20 mg)0.5 – 81 Morphine (20 mg)12 – 241 Cocaine(cocaine)5 – 121 Cocaine(BZE)12 –241 Alaine G. Verstraete, Therapeutic Drug Monitoring, vol 26, No. 2, April 2004 (and references therein)

14. Adulteration Added to urine in an attempt to interfere with the screening and/or confirmatory assays themselves or reduce the drug level by chemical destruction. -Altering pH of sample -Sample dilution or replacement (creatinine testing) (in-vitro or in-vivo) -Oxidising agents (bleach, conc. lemon juice, vinegar) -More recently products sold on internet include ‘Urine Luck’, ‘Klear’, ‘Instant Clean’ -Active ingredient Pyridinium chlorochromate, gluteraldehyde and peroxidase with peroxide. -Guidelines with regards to level of adulterants and pH in urine have been published (laboratory-based and on-site adulteration tests available) -Visual inspection to be carried out

15. Adulteration cont’d No doubt that more novel ways of beating the urine drug test will be pursued and hence the attraction of drug testing moving toward oral fluid. -Easier supervision renders tampering with sample difficult -Several commercial oral fluid adulterants available but their mode of action very similar to common mouthwash. They do not destroy or change pH of the oral fluid. -Sucking sterilising tablets (sodium dichloroisocyanurate) immediately prior to sample collection – will destroy lot of drug(s) present Keith R. Allen, Annals of Clinical Biochemistry, 48, 2011, 531-541 (and references therein)

16. Instrumentation LCMS – QQQ LCMS – QTOF GCMS

17. Lab Confirmations (LCMS-QQQ)

18. Future Challenges Synthetic Cannabinoids DMAA ‘Bath Salts’ (MDPV, 4-MMC) Salvia Divinorum Tryptamines Designer Amphetamine Drugs