Urinary cannabinoid detection times after controlled oral administration of Delta(9)-tetrahydrocannabinol to humans
Gustafson, R. A., Levine, B., Stout, P., Klette, K. L., George, M. P., Moolchan, E. T., & Huestis, M. A. (2003). Urinary cannabinoid detection times after controlled oral administration of Delta(9)-tetrahydrocannabinol to humans. Clinical Chemistry, 49(7), 1114-1124.
Background: Urinary cannabinoid excretion and immunoassay performance were evaluated by semiquantitative immunoassay and gas chromatography-mass spectrometry (GC/MS) analysis of metabolite concentrations in 4381 urine specimens collected before, during, and after controlled oral administration of tetrahydrocannabinol (THC). Methods: Seven individuals received 0, 0.39, 0.47, 7.5, and 14.8 mg THC/day in this double-blind, placebo-controlled, randomized, clinical study conducted on a closed research ward. THC doses (hemp oils with various THC concentrations and the therapeutic drug Marinol(R)) were administered three times daily for 5 days. All urine voids were collected over the 10-week study and later tested by Emit II(R), DRI(R), and CEDIA(R) immunoassays and by GC/MS. Detection rates, detection times, and sensitivities, specificities, and efficiencies of the immunoassays were determined. Results: At the federally mandated immunoassay cutoff (50 mug/L), mean detection rates were <0.2% during ingestion of the two low doses typical of current hemp oil THC concentrations. The two high doses produced mean detection rates of 23-46% with intermittent positive tests up to 118 h. Maximum metabolite concentrations were 5.4-38.2 mug/L for the low doses and 19.0-436 mug/L for the high doses. Emit II, DRI, and CEDIA immunoassays had similar performance efficiencies of 92.8%, 95.2%, and 93.9%, respectively, but differed in sensitivity and specificity. Conclusions: The use of cannabinoid-containing foodstuffs and cannabinoid-based therapeutics, and continued abuse of oral cannabis require scientific data for accurate interpretation of cannabinoid tests and for making reliable administrative drug-testing policy. At the federally mandated cannabinoid cutoffs, it is possible but unlikely for a urine specimen to test positive after ingestion of manufacturer-recommended doses of low-THC hemp oils. Urine tests have a high likelihood of being positive after Marinol therapy. The Emit II and DRI assays had adequate sensitivity and specificity, but the CEDIA assay failed to detect many true-positive specimens. (C) 2003 American Association for Clinical Chemistry