Accuracy

The accuracy of the oral fluid technology used in the OraPoint has been quantified via direct comparsion to GC/MS analytical laboratory testing.   The sample data shown below is for detecting THC, one of the hardest substances to detect.   An accuracy of 91% was attained for native THC in oral fluid.  Accuracy for other drug classes is as high at 100%, providing an overall accuracy in the 95% to 98% range.  

Oral fluid / saliva results, unlike urine, detect current drug use, and provide a drug concentration which correlates to blood. Urine testing focuses upon metabolites and has no correlation to drug levels within the blood stream. Think of saliva as equivalent to serum, through glands, instead of a needle.  1. Can all drugs be detected in Oral Fluid?  All the drugs that can be found in blood, can also be detected in oral fluid. Drug traditionallly tested via urine, referred to as the NIDA/SAMHSA 5, which include Marijuana, Cocaine, Opiates, Methamphetamines, Amphetamines, and PCP can be tested, however PCP is rarely encountered and the value of testing for it can not be justified. Additional drugs which should be tested for include Ecstasy, prescription pain releivers (Oxycontin, Hydrocodone, etc.), and alcohol. Benzodiazepines, Barbiturates, Propoxephene, Methadone, and Methqualone can also be added to the test spectrum.  2. What is the detection window for Oral Fluid?  All methods of drug testing, which include oral fluid, urine, hair, blood, and sweat, have different windows of detection. Oral fluid and blood samples identify drug usage within the first four or five hours, this will be missed by urine or hair sample. A sample of 1.5 inches of hair will detected drugs up to 90 days earlier, but not the first 10 to 14 days after usage. Urine, because it is a metabolite, will detect drugs for a slightly longer period than oral fluid and blood. In oral fluid, most drugs can be found for one to three days, after the last dose (this is also true with blood and urine).  3. What laboratory methods are used for Oral Fluid?  The first step of testing is called screening, and is done with the same methodology as urine and blood. The on-site technology used is typically lateral fluid immunnoassay. Laboratory screening is called ELISA, enzyme-linked immunosorbent assay. Any sample that screens non-negative is then retested with LC/MS/MS, (or GC/MS) the latest in drug confirmation technology. LC/MS/MS, liquid chromatography tandem mass spectrometry, is the most sensitive confirmation method available, it will detect drug amounts of 0.5ng/mL and lower. It can be used for oral fluid, urine, hair, blood, and sweat samples. LC/MS/MS positively identifies and quantitates each drug separately.  4. Can you cheat with Oral Fluid testing?  Unlike urine testing, we have tested wide range of adulterants and have not found any that interfere with an oral fluid test, as long as the donor is constantly observed. This is the advantage of oral fluid, it CAN be observed without embarrassment, is collected by the donor themselves, is very fast to collect (2 to 5 minutes), and has a more sensitive testing procedure than urine. Urine has many ways to cheat.  5. Is Oral Fluid considered a hazardous fluid?  No. Collection is not considered a dental process, so OSHA does not consider oral fluid a bio-hazard, and is not subject to the same handling and disposal issues as urine and blood.  6. Can I detect marijuana in Oral Fluid?  Yes. THC (parent Delta 9), can be detected from initial smoking sage, up to approximately 24 hours after consumption, in oral fluid. In urine, THC will screen positive, at > 50ng/mL 3-5 days, and sometime longer. Ask us for scientific literature available to read concerning this subject.       Sample Listing of Technical Papers  K.B. Scheidweiler, M.A. Huestis. A validated gas chromatographic-electron impact ionization mass spectrometric method for methylenedioxymethamphetamine (MDMA), methamphetamine and metabolites in oral fluid. Journal of Chromatography B. 835: 90-99 (2006)  K. Deventer, P. Van Eenoo, and F.T. Delbeke. Screening for amphetamine and amphetamine-type drugs in doping analysis by liquid chromatography/mass spectrometry. Rapid Communications in Mass Spectrometry. 20: 877-882 (2006)  T. Kuiper, Lacinda DeCicco, V. Spiehler, G. Sneed, and P. Kemp. Choice of an ELISA assay for screening postmortem blood for amphetamine and/or methamphetamine. Journal of Analytic Toxicology. 26: 513-518 (2002)  S.W.Toennes, S. Steinmeyer, H. Maurer, M.R. Moeller, and G.F. Kauert. Screening for drugs of abuse in oral fluid-correlation of analysis results with serum in forensic cases. Journal of Analytical Toxicology 29: 22-27 (2005)  S.W.Toennes, S. Steinmeyer, M.R. Moeller, and G.F. Kauert. Driving under the influence of drugs-evaluation of analytical data of drugs in oral fluid, serum and urine, and correlation with impairment symptoms. Forensic Science International 152: 149-255 (2005)  F.M. Wylie, H. Torrance, R.A. Anderson, and J.S. Oliver. Drugs in oral fluid Part I. Validation of an analytical procedure for licit and illicit drugs in oral fluid Forensic Science International. 150: 191-198 (2005)  R.J.F. Schepers, J.M. Oyler, R.E. Joseph, E.J. Cone, E.T. Moolchan, andM.A. Huestis. Methamphetamine and amphetamine pharmacokinetics in oral fluid and plasma after controlled oral methamphetamine administration to human volunteers. Clinical Chemistry 49: 121-132 (2003)  K.B. Scheidweiler, and M.A. Huestis. A validated gas chromatographic-electron impact ionization mass spectrometric method for methylenedioxymethamphetamine (MDMA), methamphetamine and metabolites in oral fluid. Journal of Chromotography B 835: 90-99 (2006)  M. Yonamine, N. Tawil, R.L. de Moraes Moreau, and O.A. Silva. Solid-phase micro-extraction-gas chromatography-mass spectrometry and headspace-gas chromatography of tetrahydrocannabinol, amphetamine, methamphetamine, cocaine and ethanol in saliva samples. Journal of Chromatography B 789: 73-78 (2003)  C. Chou, and M. Lee. Solid phase microextraction with liquid chromatography-electrospray ionization-tandem mass spectrometry for analysis of amphetamine and methamphetamine in serum. Analytica Chimica Acta 538: 49-56 (2005)  K.A. Mortier, K.E. Maudens, W.E. Lambert, K.M. Clauwaert, J.F. Van Bocxlaer, D.L. Deforce, C.H. Van Peteghem, A.P. De Leenheer. Simultaneous, quantitative determination of opiates, amphetamines, cocaine and benzoylecgonine in oral fluid by liquid chomatography quadrupole-time-of-flight mass spectometry. Journal of Chromatography B 779: 321-330 (2002)  K. Clauwaert, T. Decaestecker, K. Mortier, W. Lambert, D. Deforce, C. Van Peteghem, and J. Van Bocxlaer. The determination of cocaine, benzoylecgonine, and cocaethylene in small-volume oral fluid samples by liquid chromatography-quadrupole-time-of-flight mass spectrometry. Journal of Analytical Toxicology. 28: 655-659 (2004)  B.A. Tomkins, G.J. Van Berkel, R.A. Jenkins, and R.W. Counts. Quantitation of cotinine in nonsmoker saliva using chip-based nanoelectrospray tandem mass spectrometry. Journal of Analytical Toxicology. 30: 178-186 (2006)  M.R. Brunetto, Y.D. Cayama, L.G. Garcia, M. Gallignani, M.A. Obando. Determination of cocaine and benzoylecgonine by direct injection of human urine into a column-switching liquid chromatography system with diode-array detection. Journal of Pharmaceutical and Biomedical Analysis. 37: 115-120 (2004)  R.S. Niedbala, K. Kardos, T. Fries, A. Cannon, and A. Davis. Immunoassay for detection of cocaine/metabolites in oral fluids. Journal of Analytical Toxicology. 25: 62-68 (2001)  J. Robb, E.J. Cone, R.S. Niedbala, K.W. Kardos, D.F. Fritch, S. Kardos, T. Fries and J. Waga. Detection of marijuana use by oral fluid and urine analysis following single-dose administration of smoked and oral marijuana. Journal of Analytical Toxicology 25: 289-303 (2001)  M. Laloup, M.R. Fernandez, M. Wood, G. De Boeck, C. Henquet, V. Maes, N. Samyn. Quantitative analysis of delta-9-tetrahydrocannabinal in preserved oral fluid by liquid chromatography-tandem mass spectrometry. Journal of Chromatography A 1082: 15-24 (2005)  A.A.M. Stolker, J. Van Schoonhoven, A.J. de Vries, I. Bobeldijk-Pastorova, W.H.J. Vaes, R. van den Berg. Determination of cannabinoids in cannabis products using liquid chromatography-ion trap mass spectrometry. Journal of Chromatography A 1058: 143-151 (2004)  O. Quintela, A. Cruz, A. de Castro, M. Concheiro, M. Lopez-Rivadulla. Development and validation of a method for the quantitation of delta-9-tetrahydrocannabinol in oral fluid by liquid chromatography electrospray-mass-spectrometry. Journal of Chromatography B 810: 319-324 (2004)  H. Teixera, P. Proenca, A. Castanheira, S. Santos, M. Lopez-Rivadulla, F. Corte-Real, E. P. Marques and D. N. Vieira. Cannabis and driving: the use of LC-MS to detect delta-9-tetrahydrocannabinol in oral fluid samples. Forensic Science International 146S: S61-S63 (2004)  M.A. Huestis and E.J. Cone. Relationship of delta-9-tetrahydrocannabinol concentrations in oral fluid and plasma after controlled administration of smoked cannabis. Journal of Analytical Toxicology 28: 394-399 (2004)  H. Teixera, P. Proenca, A. Verstraete, F. Corte-Real, and D. N. Vieira. Analysis of delta-9-tetrahydrocannabinol in oral fluid samples using solid-phase extraction and high-performance liquid chromatography-electrospray ionization mass spectrometry. Forensic Science International 150: 205-211 (2005)  S.W.Toennes, S. Steinmeyer, H. Maurer, M.R. Moeller, and G.F. Kauert. Screening for drugs of abuse in oral fluid-correlation of analysis results with serum in forensic cases. Journal of Analytical Toxicology 29: 22-27 (2005)M. Thevis, H. Geyer, D. Bahr, and W. Schanzer. Identification of fentanyl, alfentanil, sufentanil, remifentanil and their major metabolites in human urine by liquid chromatography/tandem mass spectrometry for doping control purposes. European Journal of Mass Spectrometry 11: 419-427 (2005)  P. Campora, A.M. Bermejo, M. J. Tabernero, and P. Fernandez. Use of gas chromatography/mass spectrometry with positive chemical ionization for the determination of opiates in human oral fluid. Rapid Communications in Mass Spectrometry. 20: 1288-1292 (2006)  K.R. Allen, R. Azad, H.P. Field, and D.K. Blake. Replacement of immunoassay by LC tandem mass spectrometry for the routine measurement of drugs of abuse in oral fluid. Annals of Clinical Biochemistry 42: 277-284 (2005)  R.S. Niedbala, K. Kardos, J. Waga, D. Fritch, L. Yeager, S. Doddamane, and E. Schoener. Laboratory analysis of remotely collected oral fluid specimens for opiates by immunoassay. Journal of Analytical Toxicology 25: 310-315 (2001)  E.J. Rook, M.J.X. Hillebrand, H. Rosing, J.M. van Ree, and J.H. Beijnen. The quantitative analysis of heroin, methadone and their metabolites and the simultaneous detection of cocaine, acetylcodeine and their metabolites in human plasma by high-performance liquid chromatography coupled with tandem mass spectrometry. Journal of Chromatography B 824: 213-221 (2005)    M. Scislowski, W. Piekoszewski, A. Kamenczak, and E. Florek. Simultaneous determination of buprenorphine and norbuprenorphine in serum by high-performance liquid chromatography-electrospray ionization-mass spectrometry. Journal of Analytical Toxicology. 29: 249-253 (2005)  D.E. Moody, M.H. Slawson, E.C. Strain, J.D. Laycock, A.C. Spanbauer, and R.L. Foltz. A liquid chromatographic-electrospray ionization-tandem mass spectrometric method for determination of buprenorphine, its metabolite, norbuprenorphine, and a coformulant, naloxone, that is suitable for in vivo and in vitro metabolism. Analytical Biochemistry 306: 31-39 (2002)  M. Z. Mintzer, C.J. Correia, and E.C. Strain. A dose-effect study of repeated administration of buprenorphine/naloxone on performance in opioid-dependent volunteers. Drug and Alcohol Dependence. 74: 205-209 (2004)  D. Ortelli, S. Rudaz, A. Chevalley, A. Mino, J. Deglon, L. Balant, and J. Veuthey. Enantioselective analysis of methadone in saliva by liquid chromatography-mass spectrometry. Journal of Chromatography A. 871: 163-172 (2000)  P. Kintz, M. Villain, M. Concheiro, and V. Cirimele. Screening and confirmatory method for benzodiazepenes and hypnotics in oral fluid by LC-MS/MS. Forensic Science International 150: 213-220 (2005)  E. Mikami, T. Goto, T. Ohno, H. Oka, and H. Kanamori. Simultaneous analysis of seven benzodiazepines in dietary supplements as adulterants using high performance liquid chromatography and its application to an identification system for diazepam. Journal of Health Science 51: 278-283 (2005)  J.J. Jones, H. Kidwell, and D. E. Games. Application of atmospheric pressure chemical ionisation mass spectrometry in the analysis of barbiturates by high-speed analytical countercurrent chromatography. Rapid Communications in Mass Spectrometry 17: 1565-1572 (2003)  J.C. Spell, K. Srinivasan, J.T. Stewart, and M.G. Bartlett. Supercritical fluid extraction and negative ion electrospray liquid chromatography tandem mass spectrometry analysis of phenobarbital, butalbital, pentobarbital and thiopental in human serum. Rapid Communications in Mass Spectrometry 12: 890-894 (1998)  J. Eichhorst, M. Etter, J. Lepage, and D.C. Lehotay. Urinary screening for methylphenidate (Ritalin) abuse: a comparison of liquid chromatography-tandem mass spectrometry, gas chromatography-mass spectrometry, and immunoassay methods. Clinical Biochemistry 37: 175-183 (2004)  Barbs-Others J.J. Jones, H. Kidwell, and D. E. Games. Application of atmospheric pressure chemical ionisation mass spectrometry in the analysis of barbiturates by high-speed analytical countercurrent chromatography. Rapid Communications in Mass Spectrometry 17: 1565-1572 (2003)  J.C. Spell, K. Srinivasan, J.T. Stewart, and M.G. Bartlett. Supercritical fluid extraction and negative ion electrospray liquid chromatography tandem mass spectrometry analysis of phenobarbital, butalbital, pentobarbital and thiopental in human serum. Rapid Communications in Mass Spectrometry 12: 890-894 (1998)  S.S. Johansen, and J.L. Jensen. Liquid chromatography-tandem mass spectrometry determination of LSD, ISO-LSD, and the main metabolite 2-oxo-3-hydroxy-LSD in forensic samples and application in a forensic case. Journal of Chromatography B 825: 21-28 (2005)  S.W.Toennes, S. Steinmeyer, H. Maurer, M.R. Moeller, and G.F. Kauert. Screening for drugs of abuse in oral fluid-correlation of analysis results with serum in forensic cases. Journal of Analytical Toxicology 29: 22-27 (2005)  A.A. Grove, E.R. Rohwer, J.B. Laurens, and B.C. Vorster. The analysis of illicit methaqualone containing preparations by gas chromatography-mass spectrometry for forensic purposes. Journal of Forensic Science 51: (2006)