Detection Times of Diazepam, Clonazepam, and Alprazolam in Oral Fluid Collected From Patients Admitted to Detoxification, After High and Repeated Drug Intake.

Ther Drug Monit

*Department of Clinical Pharmacology, Oslo University Hospital HF, Rikshospitalet; †Department of Drug Abuse Research and Method Development, Division of Forensic Sciences, Norwegian Institute of Public Health; and ‡Emergency Department for Addictive Disorders, Oslo University Hospital HF, Aker, Oslo, Norway.

Published: August 2015

Background: Clonazepam, diazepam, and alprazolam are benzodiazepines with sedative, anticonvulsant, and anxiolytic effects, but their prevalence in drug abuse and drug overdoses has long been recognized. When detection times for psychoactive drugs in oral fluid are reported, they are most often based on therapeutic doses administered in clinical studies. Repeated ingestions of high doses, as seen after drug abuse, are however likely to cause positive samples for extended time periods. Findings of drugs of abuse in oral fluid collected from imprisoned persons might lead to negative sanctions, and the knowledge of detection times of these drugs is thus important to ensure correct interpretation. The aim of this study was to investigate the time window of detection for diazepam, clonazepam, and alprazolam in oral fluid from drug addicts admitted to detoxification.

Methods: Twenty-five patients with a history of heavy drug abuse admitted to a detoxification ward were included. Oral fluid was collected daily in the morning and the evening and urine samples every morning for 10 days, using the Intercept device. Whole blood samples were collected if the patient accepted. The cutoff levels in oral fluid were 1.3 ng/mL for diazepam, N-desmethyldiazepam, and 7-aminoclonazepam and 1 ng/mL for clonazepam and alprazolam. In urine, the cutoff levels for quantifications were 30 ng/mL for alprazolam, alpha-OH-alprazolam, and 7-aminoclonazepam, 135 ng/mL for N-desmethyldizepam, and 150 ng/mL for 3-OH-diazepam and for all the compounds, the cutoff for the screening analyses were 200 ng/mL.

Results: The maximum detection times for diazepam and N-desmethyldiazepam in oral fluid were 7 and 9 days, respectively. For clonazepam and 7-aminoclonazepam, the maximum detection times in oral fluid were 5 and 6 days, respectively. The maximum detection time for alprazolam in oral fluid was 2.5 days. New ingestions were not suspected in any of the cases, because the corresponding concentrations in urine were decreasing. Results from blood samples revealed that high doses of benzodiazepines had been ingested before admission, and explains the longer detection times in oral fluids than reported previously after intake of therapeutic doses of these drugs.

Conclusions: This study has shown that oral fluid might be a viable alternative medium to urine when the abuse of benzodiazepines is suspected.

Download full-text PDF

Source
http://dx.doi.org/10.1097/FTD.0000000000000174DOI Listing

Publication Analysis

Top Keywords

oral fluid
40
detection times
24
clonazepam alprazolam
12
alprazolam oral
12
fluid collected
12
drug abuse
12
maximum detection
12
fluid days
12
oral
11
fluid
10

Similar Publications

Background: Oral fluid contains analytes that may be reflective of health and welfare in pig herds. Additionally, oral fluid collection is a more convenient and cost-effective option when compared to blood sampling, increasing the potential of oral fluid as a non-invasive alternative tool. While a growing number of biomarkers can be measured in porcine oral fluid, the use of these analytes to compare commercial herds in veterinary practice is still limited.

View Article and Find Full Text PDF

Background/aim: Enhanced recovery after surgery (ERAS) protocol is adopted in clinical practice worldwide, but a lack of evidence for measurable benefits after upper gastrointestinal (GI) surgeries can be detected especially regarding early oral feeding.

Patients And Methods: A propensity score-matching study was conducted at the Department of Surgery of the University of Pécs between January 2020 and December 2023. The study included patients who underwent upper GI cancer surgery and were treated according to an early oral feeding protocol (EOF).

View Article and Find Full Text PDF

Background/aim: In a tongue-submandibular lymph node (SLN) metastasis model, the cystine/glutamate transporter solute carrier family 7, member 11 (Slc7a11), also known as xCT, was found to increase in lymphatic endothelial cells (LECs) within SLNs prior to melanoma cell metastasis. However, the precise mechanism by which xCT influences LECs remains unclear. This study aimed to explore the role of xCT in primary cultured LECs.

View Article and Find Full Text PDF

Airway microbiota dysbiosis and metabolic disorder in ozone and PM co-exposure induced lung inflammatory injury in mice.

Ecotoxicol Environ Saf

December 2024

School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China. Electronic address:

Co-exposure to ground-level ozone (O) and fine particles (PM, ≤ 2.5 µm in diameter) has become a primary scenario for air pollution exposure of urbanites in China. Recent studies have suggested a synergistic effect of PM and O on induction of lung inflammatory injury.

View Article and Find Full Text PDF

Dopamine and alkylated silica functionalized Janus gauze with fluid control capability for rapid hemostasis.

Biomater Adv

December 2024

State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China. Electronic address:

Hemorrhage caused by trauma is a global public health issue. While traditional cotton gauze compression is commonly used for hemostasis, its efficacy is limited in severe hemorrhage cases. Herein, we developed a gauze with Janus wettability (JW-G).

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!