2007 National Roadside Survey of Alcohol and Drug Use by Drivers

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2007 National Roadside Survey of Alcohol and Drug Use by Drivers: Drug ResultsFigure 2. Collecting an Oral Fluid Sample with the Quantisal Oral Fluid Collection Devicedistributed by Immunalysis, Inc., Pomona, CA.http://www.immunalysis.com/quantisal_procedure.htmThe oral fluid samples were labeled with pre-printed Chain-of-Custody (CoC) labels to be linkedwith the subject and additional data collected. This allowed the specimen to be trackedthroughout the project. The CoC labels contained a unique identifier that corresponded to thatsample. This number was also entered into the PDA. CoC numbers were preprinted by thelaboratory and were used to maintain a documented link between each sample collected and therespondent who provided it. A different CoC number was assigned to the oral fluid and bloodsample for an individual subject and the laboratory was blinded to any link between them. Thisassured the oral fluid and blood analyses and results were independent of one another.The collection of oral fluid, while less invasive than the collection of blood or urine, has someassociated difficulties (O'Neal, Crouch, Rollins, & Fatah, 2000). Various researchers have notedthat the method of collection and the medium itself (oral fluid) significantly affect drugconcentration in the specimen and, consequently, whether some drugs can be detected at all.However, while some collection devices give no indication of the amount of oral fluid actuallycollected (rendering a quantitative result meaningless), the Quantisal oral fluid collectiondevice collects 1 mL (+10%) of clear oral fluid from the donor. Researchers have studied thedevice to assess the efficiency of drug release from the collection pad (Quintela, Crouch, &Andrenyak, 2006; Moore et al., 2006; Moore, Rana, & Coulter, 2007b) and have found a highrate of extraction efficiency. Tables 14 and 15 summarize the effectiveness of the Quantisaloral fluid collection device across a range of drugs by two different research groups. Findingsabove 100 percent are due to slight variations in the amount of the substances actually added tothe scientific control samples (scientific error).28
2007 National Roadside Survey of Alcohol and Drug Use by Drivers: Drug ResultsTable 14. Extraction Efficiency of Quantisal Oral Fluid Collection Deviceover a Range of Drugs: QuintelaDrug Target Value (ng/mL) Mean Recovery from the Pad (%)Amphetamine 50 94.3%Methamphetamine 50 103.8%Cocaine 20 91.2%Benzoylecgonine 20 86.9%Codeine 40 95.6%Morphine 40 92.6%6-acetylmorphine 4 92.2%THC 4 91.4%Methadone 50 99.7%Oxazepam 20 101.3%Source: Quintela et al., 2006.Table 15. Extraction Efficiency of Quantisal Oral Fluid Collection Deviceover a Range of Drugs: MooreDrug Target Value (ng/mL) Mean Recovery from the Pad (%)Meperidine 25 86.7%Tramadol 25 87.7%Oxycodone 20 96.6%Source: Moore, Rana, & Coulter, 2007a; Moore et al., 2006: THC recovery from the pad > 80%.For a more thorough discussion of the Quantisal device, see the pilot study report (Lacey et al.,2007).Blood Collection ProceduresAfter completion of the oral fluid sample and the drug questionnaire, the interviewer requestedthat the subject provide a blood sample in exchange for an additional $50 incentive. Theincentives were given as money orders so subjects could not spend the money immediately,especially on items such as alcohol and other drugs.Licensed phlebotomists conducted the blood draws. The phlebotomist set up the blood drawstation in the rear seat of a rental van. The subject sat in the back seat of the van and thephlebotomist stood just outside the van or sat in the adjoining seat.During blood draws, one gray-top tube (10 mL) of the subject’s blood was drawn. There areseveral types of tubes available for the collection of blood specimens, with different color tops.The choice of tube is dependent upon the type of test to be performed on the blood. The FederalAviation Administration (FAA) recommends the gray-topped tube for drug and alcohol testing ofblood specimens. The gray-top tube contains two preservatives: potassium oxalate and sodiumfluoride. The oxalate is an anti-coagulant, and the sodium fluoride is an anti-bacterial stabilizer.These preservatives reduce the need for refrigeration but do not affect the ability to detect andquantify drugs. Both additives are inorganic; therefore, they oxidize very slowly and areextremely stable. The preservative helps inhibit the degradation of cocaine in storage to its29
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DOT HS 811 249December 2009
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