Chapter 1: Introduction
1.3 Testing Strategies for Drugs of Abuse
1.3.1 Physical/Behavioral Testing Regimes
The following are components of a standardized approach to the physical testing of drugs: (a) observing physical signs and (b) attention distributive tests (Van der
Linden, Wille, Ramírez-Fernandez, Verstraete, & Samyn, 2015). The physical signs of a seizure include these symptoms: the eyes may appear flickering, blurry, or irregular; and there may be shaking or trembling in any part of the body. The following are some examples of attention tests: (i) the one-leg stand test; (ii) the Romberg test; (iii) the walk and turn test; and (iv) the finger-to-nose test. A positive test result includes indicators from any of the following groups: (a) eyes (shiny, hazy, red/bloodshot, constricted pupils), (b) face (dehydrated lips, grating teeth, repetitive snorting), (c) behavior (anxious, violent, confused), (d) state of mind (changing mood, overly excited), (e) language (mumbling, long-winded, repetition of words), (f) walk (unbalanced), and (g) others (shaking, sweating, reflexes that are overly fast or slow) (Van der Linden et al., 2015).
1.3.2 On-site/Roadside Drugs of Abuse Testing
Over the course of the past two decades, there has been a growing interest in conducting research on the subject of developing the most accurate and suitable roadside drug testing devices. Law enforcement agencies have access to a wide variety of drug testing devices that can be used on the side of the road.
The legal processes that law enforcement agencies in the UAE adhere to are depicted in Figure 5. The process basically starts with testing the physical/behavioral signs of a suspicious driver and releasing the driver if the test was negative. On the contrary, those drivers who did not meet the requirements of the physical/behavioral analysis, will have to undergo an on-site drug screening test to check for any
psychotropic or narcotic substances. If the result was positive or there was strong suspicion of such, a sample will be collected from the suspect at an appropriate place, and this will be sent directly to the forensic toxicology lab to receive a confirmatory result.
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Figure 5: The legal pathway flow diagram in the UAE
The drugs found on the side of the road are put through additional tests to ensure their authenticity (Van der Linden et al., 2015). The technology that is used for on-site screening enables multiple drugs to be tested simultaneously using only a single sample of body fluid. These tests are made to be straightforward, with a limited number of steps;
in addition, they are disposable and can only be utilized once (Bryant, Stevens, &
Hansen, 2009). Some other examinations might have a greater number of steps, some of which are timed. The first step in the process of performing an immunoassay test is to
11 collect a sample of body fluid using a collector. This sample is then either immediately added to the testing cartridge, or in some instances, a buffer is added. The sample is then added to the immunoassay strip. While the majority of tests can be run at the temperature of the surrounding environment, certain tests need to be incubated to reach specific temperatures (Lillsunde, 2008; Van der Linden et al., 2015). Dried blood spots may also be considered as a method for collecting blood on-site (Evans-Nguyen, Stelmack,
Clowser, Holtz, & Mulligan, 2021; Kyriakou et al., 2016).
The cut-off limits for drugs, the amount of time it takes to collect a body fluid sample, and the length of time it takes to conduct the actual test all vary from country to country. Some police departments use electronic devices, while others still use non- electronic devices, which require the test results to be read and recorded visually. These parameters are determined by what the police hopes to accomplish with the device and how much money they have available (Asbridge, M, Ogilvie, 2015; G. A. A. Cooper et al., 2012; D’Elia, García, & Ruiz, 2015; Lillsunde, 2008).
The type of body fluid specimen which is taken on the roadside for drug testing, usually depends on how easy it is to obtain the sample, and the analytical and testing implications of the results. Usually, on-site testing involves the collection of oral fluid or exhaled breath (Alhefeiti et al., 2021). The majority of on-site drug testing systems, as illustrated in Table 1, rely on the use of the saliva matrix due to its ready accessibility for collection. In addition, the principle operation of these systems vary from colorimetric to immunoassay techniques (e.g. lateral flow immunoassay and particle-based
immunoassay) (Alhefeiti et al., 2021).
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Table 1: On-site systems are employed for the determination of various types of drugs
Device Principle of Operation
Tested Drugs/Drug
Classes
Cutoff Time of Analysis
Body Sample Used
Complexity/
difficulty Reference
Securetec Drugwipe
Immunological rapid screening
test.
Cannabis, Opiates, Cocaine, Amphetamines, Methamphetamines
(MDMA, ecstasy), Benzodiazepines
and Ketamine.
Amphetamine: 50 ng/mL Methamphetamine: 25
ng/mL MDMA: 25 ng/mL Cocaine: 30 ng/mL Opiates: 10 ng/mL Cannabis: 30 ng/mL
5 min saliva, sweat, surface
easy
(Asbridge, M, Ogilvie,
2015;
Crouch, Walsh, Cangianelli,
& Quintela, 2008;
Cusack, 2012)
Draeger DrugTest
5000 Analyzer
Colorimetric technique.
Amphetamines, Benzodiazepine, THC, Cocaine, Methamphetamines,
Opiates and Methadone.
Amphetamine: 50 ng/mL Methamphetamine: 35
ng/mL Cocaine: 20 ng/mL
Opiates: 20 ng/mL Cannabis: 25 ng/mL Benzodiazepines: 15
ng/mL Cannabis: 5 ng/mL
It depends on the test
kit (normally less than 9
min)
Saliva/surfaces moderately easy
(Blencowe et al., 2010;
Gjerde, Clausen, Andreassen,
&
Furuhaugen, 2018;
Labianca, 2018)
Alere DDS2
A lateral flow immunoassay
device.
Amphetamine, Benzodiazepines, Cannabis, Cocaine, Methamphetamine,
and Opiates.
Cannabis: 25 ng/mL Cocaine: 30 ng/mL
Amphetamine: 50 ng/mL Methamphetamine: 50
ng/mL Benzodiazepines: 20
ng/mL Opiates: 40 ng/mL
within 5
min saliva easy
(Krotulski, Mohr, Friscia, &
Logan, 2018;
Moore, Kelley- Baker, &
Lacey, 2013)
Mavand Rapid STAT
A lateral flow immunoassay
device.
Amphetamines, Benzodiazepines,
Cocaine, Methamphetamines,
MDMA, Opiates and Marijuana
(THC).
Amphetamine: 25 ng/mL Benzodiazepines: 25
ng/mL Cocaine: 12 ng/mL Methamphetamine: 25
ng/mL MDMA: 50 ng/mL Opiates: 25 ng/mL Cannabis: 15 ng/mL
Results are ready
within around 7 to 12 min
saliva less easy
(Blencowe et al., 2010;
Pehrsson et al., 2011)
iScreen Test Device
A lateral flow chromatography
immunoassay.
Cocaine (COC), Marijuana (THC), Methamphetamine
(Meth), Amphetamine (AMP), Opiate (OPI), and Phencyclidine
(PCP).
THC: 100 ng/mL Cocaine: 20 ng/mL Methamphetamine: 50
ng/mL Amphetamine: 50
ng/mL Phencyclidine: 10
ng/mL Opiates: 40 ng/mL
Within around 10
min
Saliva/surfaces easy
(Sniegoski, Welch,
Fatah, Gackstetter,
&
Thompson, 2009)
OraLab
A lateral flow immunoassay
device.
Amphetamines, Methamphetamine,
Cocaine, Opiates, Cannabis (THC), and Phencyclidine
(PCP).
Amphetamine: 50 ng/mL Cocaine: 20 ng/mL Methamphetamine 50
ng/mL PCP: 10 ng/mL Opiates: 40 ng/mL Cannabis: 50 ng/mL
Results will be obtained in 10 to 15
min.
saliva moderately easy
(Blencowe et al., 2010;
Freye, 2010;
Goessaert, Pil, Veramme,
&
Verstraete, 2010)
AconLabs Oral Fluid Drug Screen
A lateral flow immunoassay technique.
Cocaine, Cannabis, Amphetamines, Methamphetamines,
Opiates, and Phencyclidine.
THC: 12 ng/mL Cocaine: 20 ng/mL
Amphetamine: 50 ng/mL Methamphetamine: 50
ng/mL Phencyclidine: 10
ng/mL Opiate: 40 ng/mL
Within about 10
min
saliva moderately easy
(Alhefeiti et al., 2021;
Sniegoski et al., 2009)
13 Table 1: On-site systems are employed for the determination of various types of drugs (Continued)
Device Principle of Operation
Tested Drugs/Drug
Classes
Cutoff Time of Analysis
Body Sample Used
Complexity/
difficulty Reference
OralStat Lateral flow immunoassay
testing.
Including but not limited to:
Benzodiazepines, Amphetamines,
Cocaine, Methadone, Methamphetamines,
Opiates, Phencyclidine,
Barbiturates, Buprenorphine,
MDMA, Oxycodone,
Tricyclic antidepressants and
THC.
Amphetamine: 25 ng/mL Methamphetamine: 25
ng/mL Benzodiazepines: 25
ng/mL Cocaine: 12 ng/mL Methadone: 25 ng/mL
Opiate: 20 ng/mL Phencyclidine: 5
ng/mL THC: 25 ng/mL
2 to 4 min saliva less easy (Alhefeiti et al., 2021)
Oratect II Immunoassay technique.
Amphetamine, Marijuana, Cocaine,
Benzodiazepines, Opiates, Phencyclidine and Methamphetamine
Amphetamine: 25 ng/mL Methamphetamine: 25
ng/mL MDMA: 25 ng/mL Cocaine: 20 ng/mL Opiates: 10 ng/mL Cannabis: 40 ng/mL
Benzodiazepines: 5 ng/mL
8 min saliva easy
(Sniegoski et al., 2009;
Wong &
Tse, 2005)
RapiScan Immunoassay technique.
Opiates, Cannabinoids, Benzodiazepines,
Methadone, Amphetamine, Methamphetamine
and Cocaine.
Opiates: 45 ng/mL THC: 150 ng/mL Benzodiazepines: 60
ng/mL Methadone: 15 ng/mL
Amphetamine: 45 ng/mL Methamphetamine: 45
ng/mL Cocaine. 30 ng/mL
few
minutes saliva moderately easy
(Flaherty, 2008;
Sniegoski et al., 2009; L.
Wilson, 2007)
Sali•Chek™
System
Immunoassay technique.
Methamphetamines, Amphetamine,
THC, Phencyclidine,
Cocaine and Opiates.
THC: 12 ng/mL Cocaine. 20 ng/mL
Opiates: 40 ng/mL Phencyclidine: 10
ng/mL Amphetamine: 50
ng/mL Methamphetamine: 50
ng/mL
10 to 20
min saliva less easy
(Alhefeiti et al., 2021;
Carlin, 2009)
SalivaScreen 5
Immunoassay technique.
THC, Cocaine, Opiates, Methadone, Amphetamine and Methamphetamine.
THC: 2 ng/mL Cocaine. 30 ng/mL Morphine: 30 ng/mL Methadone: 30 ng/mL
Amphetamine: 50 ng/mL Methamphetamine: 50
ng/mL
10 min saliva easy (Kacinko et
al., 2004)
Smartclip Multidrug
Immunoassay technique.
Amphetamine, Methamphetamine,
Cocaine and Morphine.
Amphetamine: 50 ng/mL (saliva)/20 ng/mL (sweat) Methamphetamine:
100 ng/mL (saliva)/40 ng/mL (sweat) Cocaine: 20 ng/mL
(saliva)/
8 ng/mL (sweat) Morphine: 40 ng/mL
(saliva)/
16 ng/mL (sweat)
60 s saliva, sweat easy
(Alhefeiti et al., 2021;
Niedbala et al., 2001)
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Table 1: On-site systems are employed for the determination of various types of drugs (Continued)
Device Principle of Operation
Tested Drugs/Drug
Classes
Cutoff Time of Analysis
Body Sample Used
Complexity/
difficulty Reference
Uplink/Drug Test
Immunoassay technique using
up-converting phosphor technology.
Amphetamine, Methamphetamine,
THC, Cocaine and opiates.
THC: 20 ng/mL Cocaine. 5 ng/mL Opiates: 5 ng/mL Methamphetamine: 10
ng/mL Amphetamine: 10
ng/mL
4 min saliva moderately easy
(Niedbala et al., 2001)
Fingerprint Drug Test
Particle-based immunoassay.
Amphetamines, Opiates, Cocaine, Methamphetamine,
Benzodiazepines (BNZ), Buprenorphine, Methadone and
Cannabis.
THC: 190 pg/fingerprint BNZ: 90 pg/fingerprint
Morphine: 68 pg/fingerprint Amphetamine: 80
pg/fingerprint
10 min fingerprint-
based easy
(Alhefeiti et al., 2021;
Hudson et al., 2019)