Cited by 378Forensic Toxicology and Drug AnalysisClinical Laboratory Practices and Quality ControlSubstance Abuse Treatment and Outcomes

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Oral Fluid Testing for Drugs of Abuse

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Bosker, Wendy M, Huestis, Marilyn A·2009·Clinical Chemistry

DOI 10.1373/clinchem.2008.108670PMC PMC3165054

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Abstract

Background: Oral fluid (OF) is an exciting alternative matrix for monitoring drugs of abuse in workplace, clinical toxicology, criminal justice, and driving under the influence of drugs (DUID) programs. During the last 5 years, scientific and technological advances in OF collection, point-of-collection testing devices, and screening and confirmation methods were achieved. Guidelines were proposed for workplace OF testing by the Substance Abuse and Mental Health Services Administration, DUID testing by the European Union’s Driving under the Influence of Drugs, Alcohol and Medicines (DRUID) program, and standardization of DUID research. Although OF testing is now commonplace in many monitoring programs, the greatest current limitation is the scarcity of controlled drug administration studies available to guide interpretation. Content: This review outlines OF testing advantages and limitations, and the progress in OF that has occurred during the last 5 years in collection, screening, confirmation, and interpretation of cannabinoids, opioids, amphetamines, cocaine, and benzodiazepines. We examine controlled drug administration studies, immunoassay and chromatographic methods, collection devices, point-of-collection testing device performance, and recent applications of OF testing. Summary: Substance Abuse and Mental Health Services Administration approval of OF testing was delayed because questions about drug OF disposition were not yet resolved, and collection device performance and testing assays required improvement. Here, we document the many advances achieved in the use of OF. Additional research is needed to identify new biomarkers, determine drug detection windows, characterize OF adulteration techniques, and evaluate analyte stability. Nevertheless, there is no doubt that OF offers multiple advantages as an alternative matrix for drug monitoring and has an important role in DUID, treatment, workplace, and criminal justice programs.

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Authors: Bosker, W. M., & Huestis, M. A.
Affiliations: National Institutes of Health (US)
Corresponding author: Huestis, Marilyn A
ORCID: Huestis, Marilyn A
Venue: Clinical Chemistry
Publisher: Oxford University Press (OUP)
Published: 2009-11-01
Volume: 55
Issue: 11
Pages: 1910-1931
ISSN: 0009-9147 (ISSN-L)
1530-8561
DOI: 10.1373/clinchem.2008.108670
PMC: PMC3165054
OpenAlex: W2062866182
Cited by: 378
References: 125
Citations by year: 2026: 7 · 2025: 8 · 2024: 14 · 2023: 8 · 2022: 19 · 2021: 18 · 2020: 25 · 2019: 22 · 2018: 23 · 2017: 31 · 2016: 27 · 2015: 35 · 2014: 28 · 2013: 33 · 2012: 36
FWCI: 4.95
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: Clinical Chemistry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health
National Institute on Drug Abuse (ZIADA000412)
Topics: Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords: oral fluid testing, drugs of abuse, drug testing, workplace drug testing, drug-impaired driving, cannabinoids, opioids, amphetamine, cocaine, benzodiazepines, analyte stability, immunoassay, chromatographic methods, drug monitoring
MeSH terms: Amphetamines, Analgesics, Opioid, Benzodiazepines, Cannabinoids, Cocaine, Humans, Saliva, Substance Abuse Detection

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