Published: Journal of Analytical Toxicology, ISSN 0146-4760, Volume 30, Issue 7, September 2006, pp.478-485

Comparison of Urine and Oral Fluid as Matrices for Screening of Thirty-Three Benzodiazepines and Benzodiazepine-like Substances using Immunoassay and LC–MS(–MS)
B.E. Smink[1], M.P.M. Mathijssen[2], K.J. Lusthof[1], J.J. de Gier[3,4], A.C.G. Egberts[4,5], and D.R.A. Uges[6]
[1]Netherlands Forensic Institute, Department of Toxicology, P.O. Box 24044, 2490 AA The Hague, The Netherlands;
[2]SWOV Institute for Road Safety Research, P.O. Box 1090, 2260 BB Leidschendam, The Netherlands;
[3]University of Groningen, Groningen Research Institute for Pharmacy, Department of Pharmacotherapy and Pharmaceutical Care, A. Deusinglaan 2, 9713 AW Groningen, The Netherlands;
[4]Utrecht Institute for Pharmaceutical Sciences, Department of Pharmacoepidemiology and Pharmacotherapy, P.O. Box 80082, 3508 TB Utrecht, The Netherlands;
[5]Hospital Pharmacy Midden-Brabant, TweeSteden Hospital and St. Elisabeth Hospital, P.O. Box 90107, 5000 LA Tilburg, The Netherlands; and
[6]University Medical Center Groningen, Department of Pharmacy, Toxicology, and Forensic Medicine, P.O. Box 30001, 9700 RB Groningen, The Netherlands

Benzodiazepines are the most frequently detected medicinal drugs in drivers. The use of benzodiazepines is associated with an increased road accident risk. In this study, the presence of benzodiazepines detected by liquid chromatography–(tandem) mass spectrometry [LC–MS(–MS)] in oral fluid and urine samples obtained from drivers stopped during a roadside survey was compared. In addition, the sensitivity and selectivity of enzyme multiplied immunoassay technique (EMIT® II Plus) relative to LC–MS(–MS) was determined for both matrices. A total number of 1011 urine samples were collected and screened for benzodiazepines using immunoassay (IA) (EMIT II Plus; cutoff 300 ng/mL). In the IA-positive (n = 25) and a group of randomly selected negative urine samples (n = 79), the presence or absence of benzodiazepines was confirmed by LC–MS–MS after deglucuronidation. The corresponding oral fluid samples (n = 101, 3 samples omitted), were analyzed by LC–MS(–MS) and IA (EMIT II Plus; cutoff 10 ng/mL). The presence of benzodiazepines was demonstrated by LC–MS–(MS) in all IA-positive urine samples, but in only four corresponding oral fluid samples. Concentrations in oral fluid were, one substance excepted, lower than in urine. The sensitivity and specificity of EMIT II Plus were better by using urine as matrix for screening of benzodiazepines than by using oral fluid. The results show that benzodiazepines are detectable in oral fluid. More research has to be done to determine the pharmacokinetic profile of the different benzodiazepines in oral fluid and to study the relationship between dose, concentration (in oral fluid and blood), and impairment.

Reproduction of editorial content of this journal is prohibited without publisher’s permission.

| Home | Subscribe | Current Issue | Back Issues | Search | Advertise | Other Publications |