Abstract
Background: Together with coffee and tobacco, Cannabis is the most commonly used psychoactive drug worldwide, and it is the single most popular illegal drug. Recent studies have demonstrated increase in the prevalence of the use of cannabis. A limitation inherent in all urine drug testing is the possibility of sample adulteration or substitution. Aim of study: To detect qualitative and quantitative effects of five adulterants on positive urine samples for tetrahydrocannabinol carboxylic acid (THC-COOH). Material and Method(s): This analytical study was conducted in Clinical Toxicology Laboratory in Sohag University Hospitals. Urine samples positive to cannabis adulterated with vinegar, drano liquid hand soap, visine eye drops and bleach were tested by immunoassay (RIA) then confirmed and quantified by GC-MS. Results: Urine samples adulterated with vinegar, drano liquid hand soap, visine and bleach generated false negative results by immunoassay testing. GC-MS confirmation showed that addition of vinegar, bleach, visine, drano and liquid hand soap decrease THC-COOH significantly with increased concentration. Conclusion: Some adulterants make it easy to produce false negative results on RIA testing for cannabis and GC-MS is important to overcome adulteration methods in urine analysis
Highlights
Substance abuse in Egypt is a serious public health threat
Urine samples adulterated with vinegar, drano liquid hand soap, visine and bleach generated false negative results by immunoassay testing
On other hand addition of bleach, drano whatever their concentration were able to mask THC-COOH detection by immunoassay. For visine it was effective for decreasing the response rate for THCCOOH using immunoassay method at high conc. 40% and 20% while 10% had no effect on THCCOOH result as shown in table (1) and figure (1). 4
Summary
Substance abuse in Egypt is a serious public health threat. Recent studies have demonstrated increase in the prevalence of the use of cannabis and tramadol (Saleh, 2015).Together with coffee and tobacco, Cannabis is the most commonly used psychoactive drug worldwide, and it is the single most popular illegal drug. Recent studies have demonstrated increase in the prevalence of the use of cannabis and tramadol (Saleh, 2015). Worldwide over 160 million people are using Cannabis regularly and these numbers are still rising (Grotenhermen and Russo, 2002). Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) are the most important constituents of the plant cannabinoids. Δ9-THC is thought to be the principal intoxicant constituent of cannabis. Cannabis can impair driving skills and people driving under the influence of cannabis are 20–30% more likely to be involved in a car accident (Hall and Degenhardt, 2015). Together with coffee and tobacco, Cannabis is the most commonly used psychoactive drug worldwide, and it is the single most popular illegal drug. Recent studies have demonstrated increase in the prevalence of the use of cannabis. A limitation inherent in all urine drug testing is the possibility of sample adulteration or substitution
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