Abstract
Legalization of cannabis for medicinal and/or recreational use is expanding globally. Although cannabis is being regulated country by country, an accurate recent use test with indisputable results correlated with impairment has yet to be discovered. In the present study, a new approach for determining recent cannabis use within the impairment window after smoking was developed by studying 74 subjects with a mean age of 25 years and average use history of 9 years. Horizontal gaze nystagmus was evaluated along with subject self-assessments of impairment, and blood and breath samples were collected before and after smoking cannabis. Breath and blood pharmacokinetic parameters and cannabinoid profiles determined recent use within the impairment window. No subjects were positive for recent use pre-smoking, although all subjects had detectable cannabinoids in breath samples. We describe an inhaled cannabis recent use test that correlates with impairment and helps protect against wrongful prosecution and workplace discrimination.
Highlights
Legalization of cannabis for medicinal and/or recreational use is expanding globally
We hypothesized that incorporating both exhaled breath and blood testing could improve the accuracy of current breath-based testing methods for recent cannabis use, prevent false positive test results, and definitively establish whether a subject is in the impairment window following the use of cannabis through inhalation
We sought to develop a test that incorporates pharmacological changes in ∆9-THC and other cannabinoids in breath over time after smoking, which is the most common route of cannabis administration[13]. This approach requires collection of two breath samples separated by a known time interval, which is a critical difference compared to current testing methods that rely on a single sample, as well as a blood sample
Summary
Legalization of cannabis for medicinal and/or recreational use is expanding globally. A new type of test that can identify recent cannabis use within the impairment window is needed to help bring an end to cannabis discrimination practices in the workplace while accurately detecting inappropriate cannabis use, e.g., driving under the influence (DUI), to protect public safety While it has been known for over 30 years that ∆9-tetrahydrocannabinol (∆9-THC) can be detected in exhaled breath[7], only relatively recently has this matrix been explored as a potential means of establishing recent cannabis use within the impairment window[8,9]. We sought to develop a test that incorporates pharmacological changes in ∆9-THC and other cannabinoids in breath over time after smoking, which is the most common route of cannabis administration[13] This approach requires collection of two breath samples separated by a known time interval, which is a critical difference compared to current testing methods that rely on a single sample, as well as a blood sample. We describe the clinical development of a comprehensive breath and blood-based test and its application in determining recent cannabis use and impairment after smoking
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