'Spice' users left high and dry? A DEA ban, plus new detection methods, ends the "legal" status of synthetic marijuana compounds.
Mandatory drug testing
|Publication:||Name: Behavioral Healthcare Publisher: Vendome Group LLC Audience: Academic; Trade Format: Magazine/Journal Subject: Health; Health care industry; Psychology and mental health Copyright: COPYRIGHT 2011 Vendome Group LLC ISSN: 1931-7093|
|Issue:||Date: April, 2011 Source Volume: 31 Source Issue: 3|
|Product:||Product Code: 7754001 Marijuana|
Most drug screens include a test for marijuana use, so it's no
surprise that a "legal" substitute grew in popularity so
quickly. For over a year, we've heard about synthetic THC being
sold legally in "herbal incense" products, marketed under
names like "Spice," "Genie" and "K2."
"People would take these substances hoping to prevent a positive drug screen," explains Sean Kobayashi, marketing director at Redwood Toxicology Laboratories, a national drug testing lab based in Santa Rosa, Calif. "They're being used as a way to beat the system."
Derived from chemical compounds, synthetic marijuana compounds, or cannabinoids, are usually produced in powder form, then dissolved into liquids and sprayed on herbal materials. They have been readily available on the Internet, in tobacco shops, gas stations, and even convenience stores. And not only were these "legal" substitutes for a marijuana high, but they were also undetectable to drug tests.
At least until recently.
On March 1, five of the synthetic cannabinoids identified in Spice and K2 were classified as Class I controlled substances by the U.S. Drug Enforcement Administration (DEA). And even before these ingredients were banned nationally, numerous labs had already been developing methods to add Spice and its counterparts to their drug testing panels.
"We were getting a lot of inquiries from customers who were running in to issues with Spice," notes Matt Woodcock, PhD, director of R&D for Dominion Diagnostics, a Rhode Island-based drug testing lab. "There was a clear need to develop a test for this."
Developing a reliable detection test
Over the last several months, labs have identified two compounds currently found in all Spice products as well as a number of chemically similar variations. The two, known as JWH-018 and JWH-073, serve as the primary receptor agonists that enable the synthetics to produce the marijuana-like effects.
"Most things we test for are very defined and characterized, so this was definitely different," explains Woodcock. "Initially we had to look at everything, but once we knew what to look for we were able to narrow it down and simplify the assay."
In order to come up with a test, labs had to develop standards based on the commercially available synthetics. Redwood Toxicology confirmed that JWH-018 and JWH-073 were the active ingredients in 27 herbal mixtures. Then, it established methods to test for the presence of each compound's metabolites.
Dominion Diagnostics assembled a pool of 25 patients whom clients had identified as potential Spice users. "Some were positive and some were negative," Woodcock explains, "but we saw a trend where three metabolites were present at all times when we found a positive case."
Identifying the correct metabolites has been critical to developing reliable tests, according to Kobayashi. "When we were first developing our test, some labs were claiming they hadaK2 test, but it involved parent drug detection, which is completely unreliable--and not legally defensible," he says.
In fact, the compounds themselves don't usually appear in urine samples, so "you really have to test for the metabolite to catch anyone using Spice," says Woodcock. "If you only test for the compounds, you probably aren't going to catch many users."
Weighing test options and costs
In the few months that tests have been available, labs have had a surge of inquiries. "As soon as [tests were] launched, we started seeing a very high percentage of positive results," notes Kobayashi. "So it very much confirmed our suspicions about how popular this drug has become."
From an organization's perspective, implementing Spice testing is easy: this specialty test is simply added to the more routine drug test panel. Of course, tests for more common drugs or metabolites like THC, opiates, or cocaine are less expensive because these are already built into a panel.
"Tests for Spice and K2 are specialty tests, so they are going to cost more," says Kobayashi, adding that their pricing is "very comparable to any other specialty test."
According to Woodcock, another consideration when it comes to cost is that typically, confirmation tests cost more than ELISA (enzyme-linked immune-sorbent assay) or immunoassay tests. But as confirmation tests go, it's really no different than what you would see for opiates, marijuana or cocaine.
"Essentially, testing for metabolites puts the cart before the horse, in terms of running what are typically referred to as 'confirmation tests' right off the bat," explains Woodcock. "So we know which metabolites are positive and potentially which are negative."
In terms of testing methods, organizations have options there, as well. Dominion developed its assay to detect Spice's key metabolites in urine samples, through what is called ultra-performance liquid chromatography/tandem mass spectrometry (UPLC/MS/MS).
And, while urine is currently the standard for test sample collection, tests that utilize oral fluid samples have also started to enter the market. For example, Redwood Toxicology utilizes liquid chromatography and mass spectrometry (LC/MS) for urine-based testing, but recently introduced an oral fluid test option.
"A number of clients were interested in an oral fluid test to offer a little more convenience," says Kobayashi, prompting Redwood to combine its oral Spice test with oral tests for other illicit drugs. "We thought it was important."
Compared to testing urine, oral fluid provides confirmation only of the parent drug, which typically has been converted to metabolites in a urine sample. In oral fluid tests, labs use collection devices (such as the Quantisal from ASL Testing and the Intercept from OraSure Technologies) in conjunction with traditional ELISA or LC/MS processes.
A cat and mouse game--"monitor" and "adjust"
Now that the DEA has banned the key ingredients in Spice, K2, Genie and similar products, Woodcock explains that it may be only a matter of time before clandestine labs develop and introduce new synthetic cannabinoids.
"As soon as [a compound] becomes illegal, someone else develops something similar, but chemssssssically different. And, technically, that makes it legal."
Kobayashi agrees. Now that laws and drug testing technologies have caught up with the JWH compounds found in Spice, he says that "agencies need to extend their drug testing panels to include these substances."
As to the future, he notes, "All we can do is continue to monitor and adjust our panel to reflect what might be coming up."
Who's testing for Spice?
Atlantic Diagnostic Laboratories
Avee Laboratories Inc.
MEDTOX Clinical Laboratories
Redwood Toxicology Laboratories
STERLING Reference Laboratories
U.S. Drug Testing Laboratories
BY NICK ZUBKO, ASSOCIATE EDITOR
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