Comparison of Zopiclone Concentrations in Oral Fluid Sampled with Intercept(R) Oral Specimen Collection Device and Statsure Saliva Sampler and Concentrations in Blood

Norwegian Institute of Public Health, Division of Forensic Toxicology and Drug Abuse, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway.
Journal of analytical toxicology (Impact Factor: 2.86). 11/2010; 34(9):590-3. DOI: 10.1093/jat/34.9.590
Source: PubMed


A clinical study of zopiclone was performed using doses of 5 and 10 mg. Samples of oral fluid were collected using the Statsure
and Intercept devices, and blood samples were collected simultaneously. Concentrations of zopiclone in samples of oral fluid
and blood were determined with liquid chromatography-mass spectrometry, and concentrations in undiluted oral fluid were calculated.
The concentrations of zopiclone in oral fluid were generally higher when using the Intercept compared to the Statsure device;
the median oral fluid/whole blood concentration ratios were 3.8 (range 1.5–15.9) and 1.9 (range 1.2–4.6), respectively (n = 21). The correlation between zopiclone concentrations in oral fluid collected with the two devices was fairly poor, r2 = 0.35. The results indicate that the type of sampling device may significantly affect the analytical result for zopiclone
in sampled oral fluid.

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    • "High-performance liquid chromatography with tandem mass spectroscopy (LC–MS/MS) was used for analysing a selection of illicit drugs, sedatives, hypnotics and analgesics [20]. The confirmation analyses of tetrahydrocannabinol (THC) were done by GC–MS [21], for amphetamine and methamphetamine by GC– MS [22], for benzodiazepines by LC–MS/MS [23], for heroin and the metabolites by LC–MS/MS [24], for other opiates by UHPLC–MS/ MS [25], for GHB by UHPLC–MS/MS [26], for LSD by UHPLC–MS/SM [27] and for z-hypnotics by LC–MS in 2010–2011 [28] "
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    ABSTRACT: Norway introduced legislative limits for driving under the influence of drugs (DUID) February 1st, 2012, to harmonize with the legislation on driving under the influence of alcohol. Per se limits corresponding to blood alcohol concentrations (BACs) of 0.02% were established for 20 drugs and concentration limits for graded sanctions corresponding to BACs of 0.05% and 0.12% were established for 13 of these drugs as well. The new system is not applied to individuals with valid prescriptions for medicinal drugs. The aim of this study was to investigate if the implementation of legislative limits for drugs affected the number of blood samples taken from suspected drugged drivers, drug findings and the number of expert witness statement requests. The number of blood samples taken in suspected DUID cases increased by 20% after introduction of legislative limits (3320 cases in 2010 and 3970 in 2013). The number of samples with at least one drug above the per se limit corresponding to BAC of 0.02% increased by 17% (from 2646 in 2010 to 3090 in 2013), whereas the number of expert witness statements was reduced by the half (from 63.4% in 2010 and 28.7% in 2013).
    Full-text · Article · Nov 2014 · Forensic Science International
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    • "Within the DRUID project, equivalent cut-off concentrations for blood and oral fluid collected by means of the Statsure device were developed for the substances in question [20]. To evaluate driving under the influence, legal concentration limits in oral fluid were calculated from legal blood concentration limits after multiplication with conversion factors [16] [20] [21]. The conversion factors should be used with caution because in some cases they were determined from few studies (MDA, MDMA, 6- MAM, and zopiclone) and no conversion factor was determined for MDEA, therefore, the MDMA factor was used. "
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    ABSTRACT: This roadside study is the Danish part of the EU-project DRUID (Driving under the Influence of Drugs, Alcohol, and Medicines) and included three representative regions in Denmark. Oral fluid samples (n=3002) were collected randomly from drivers using a sampling scheme stratified by time, season, and road type. The oral fluid samples were screened for 29 illegal and legal psychoactive substances and metabolites as well as ethanol. Fourteen (0.5%) drivers were positive for ethanol (alone or in combination with drugs) at concentrations above 0.53g/l, which is the Danish legal limit. The percentage of drivers positive for medicinal drugs above the Danish legal concentration limit was 0.4%; while, 0.3% of the drivers tested positive for one or more illicit drug at concentrations exceeding the Danish legal limit. Tetrahydrocannabinol, cocaine, and amphetamine were the most frequent illicit drugs detected above the limit of quantitation (LOQ); while, codeine, tramadol, zopiclone, and benzodiazepines were the most frequent legal drugs. Middle aged men (median age 47.5 years) dominated the drunk driving group, while the drivers positive for illegal drugs consisted mainly of young men (median age 26 years). Middle aged women (median age 44.5 years) often tested positive for benzodiazepines at concentrations exceeding the legal limits. Interestingly, 0.6% of drivers tested positive for tramadol, at concentrations above the DRUID cut off; although, tramadol is not included in the Danish list of narcotic drugs. It can be concluded that driving under the influence of drugs is as serious a road safety problem as drunk driving.
    Full-text · Article · May 2012 · Forensic science international
    • "Benzodiazepines were confirmed with UPLC–MS/MS [26], while amphetamines [23] and THC [27] were confirmed with GC–MS. Methadone and zopiclone [28] were confirmed with LC–MS. The institute does not analyse THC-COOH in blood, since this metabolite is inactive and present in very low concentrations. "
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    ABSTRACT: Blood and urine samples are collected when the Norwegian police apprehend a person suspected of driving under the influence of drugs other than alcohol. Impairment is judged from the findings in blood. In our routine samples, urine is analysed if morphine is detected in blood to differentiate between ingestion of heroin, morphine or codeine and also in cases where the amount of blood is too low to perform both screening and quantification analysis. In several cases, the collection of urine might be time consuming and challenging. The aim of this study was to investigate if drugs detected in blood were found in oral fluid and if interpretation of opiate findings in oral fluid is as conclusive as in urine. Blood, urine and oral fluid samples were collected from 100 drivers suspected of drugged driving. Oral fluid and blood were screened using LC-MS/MS methods and urine by immunological methods. Positive findings in blood and urine were confirmed with chromatographic methods. The analytical method for oral fluid included 25 of the most commonly abused drugs in Norway and some metabolites. The analysis showed a good correlation between the findings in urine and oral fluid for amphetamines, cocaine/benzoylecgonine, methadone, opiates, zopiclone and benzodiazepines including the 7-amino-benzodiazepines. Cocaine and the heroin marker 6-monoacetylmorphine (6-MAM) were more frequently detected in oral fluid than in urine. Drug concentrations above the cut-off values were found in both samples of oral fluid and urine in 15 of 22 cases positive for morphine, in 18 of 20 cases positive for codeine and in 19 of 26 cases positive for 6-MAM. The use of cannabis was confirmed by detecting THC in oral fluid and THC-COOH in urine. In 34 of 46 cases the use of cannabis was confirmed both in oral fluid and urine. The use of cannabis was confirmed by a positive finding in only urine in 11 cases and in only oral fluid in one case. All the drug groups detected in blood were also found in oral fluid. Since all relevant drugs detected in blood were possible to find in oral fluid and the interpretation of the opiate findings in oral fluid was more conclusive than in urine, oral fluid might replace urine in driving under the influence cases. The fast and easy sampling is time saving and less intrusive for the drivers.
    No preview · Article · Jan 2012 · Forensic science international
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