Response to "Comparison of urine to oral fluid and the recommendation for routine drug analysis for driving under the influence cases".

Abstract

We have reviewed the critique by Tiscione of our report evaluating the use of field based oral fluid drug testing in suspected impaired drivers in Miami (1). Based on our understanding of the author's concerns we offer the following rebuttal. Tiscione asks: Is the scope of testing in our study design representative of a 'real world comparison' between oral fluid and urine drug testing and does it demonstrate that oral fluid testing is superior to urine drug testing? We are comparing a proposed solution, oral fluid drug testing, using two commercially available platforms with the at-that-time urine drug testing procedure used in Miami Dade County at the University of Miami, Toxicology Laboratory. Based on that comparison, higher rates of drug positives for the most frequently encountered impairing drugs were obtained by testing oral fluid samples rather than urine. No doubt the urine drug testing procedures could be improved to detect more drugs or to have greater sensitivity, and produce a more favorable comparison with oral fluid; however based on current practice, our data support a preference for oral fluid for the drugs targeted in the scope of the Drager Drug Test 5000 and DrugWipe devices. While the oral fluid test is targeted to the most prevalent impairing drugs in driving under the influence (DUI) cases, it is not comprehensive, and the urine tests using gas chromatography-mass spectrometry (GC-MS) do have a broader scope than the scope of either field based oral fluid device. Subjects' … Language: en