Are oral fluid testing devices effective for the roadside detection of recent cannabis use? A systematic review

Abstract

Objectives: Although laws related to drug impairment may deter some drivers, enforcement requires effective detection. There are different methods and devices to test for cannabis use, but it is unclear if these devices meet the necessary criteria to be implemented at the roadside. This systematic review synthesized research that investigated on-site oral fluid drug screening devices.

Study design: This is a systematic review.

Methods: Eight databases (PubMed, Web of Science, MEDLINE, Engineering Village, Embase, Compendex, CINAHL, and Scopus) were searched to identify research that had evaluated the effectiveness of oral fluid testing devices. Fifteen articles that used an on-site testing device to detect cannabis use were selected for review.

Results: There is a lack of standardized test protocols with respect to biological matrices used for confirmation analysis (blood and oral fluid), concentration detection cutoff, population sample, and contamination with other drugs (alcohol). There is also a lack of device consistency making it difficult to draw conclusions. Sensitivity, specificity, and accuracy of nine devices showed that none of the current devices meet the minimum requirements suggested by the ROSITA, ROSITA-2, and DRUID projects (80% for all three parameters).

Conclusions: The results of this systematic review indicated that the devices with the ability to detect lower Δ9-tetrahydrocannabinol concentration levels achieved better results with respect to sensitivity, specificity, and accuracy than those with higher detection levels. However, research must be focused on developing a roadside detection oral fluid technique that meets the ROSITA, ROSITA-2, and DRUID projects' guidelines.

Keywords: Cannabis; On-site testing; Oral fluid; Roadside; THC.