A placebo-controlled study to assess Standardized Field Sobriety Tests performance during alcohol and cannabis intoxication in heavy cannabis users and accuracy of point of collection testing devices for detecting THC in oral fluid

Bosker, Wendy M.; Theunissen, Eef L.; Conen, Silke; Kuypers, Kim P. C.; Jeffery, W. K.; Walls, H. Chip; Kauert, G.; Toennes, Stefan W.; Moeller, Manfred R.; Ramaekers, Johannes G. · 2012 · OpenAlex-citations

DOI: 10.1007/s00213-012-2732-y

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Summary

This study investigated the sensitivity of Standardized Field Sobriety Tests (SFST) to impairment caused by cannabis and alcohol in heavy cannabis users, while also evaluating the accuracy of two oral fluid testing devices for detecting Δ9-tetrahydrocannabinol (THC). The research was motivated by the widespread prevalence of driving under the influence of cannabis and the limited validation of SFST for drug-induced impairment compared to alcohol. Additionally, existing oral fluid devices often suffer from low sensitivity due to high cutoff levels and THC ads issues, necessitating controlled studies to assess their reliability. The researchers conducted a double-blind, placebo-controlled study involving twenty heavy cannabis users (mean age 24.3 years). Participants underwent three conditions: alcohol placebo with THC, alcohol achieving a blood alcohol concentration (BAC) of 0.5 mg/mL with THC, and alcohol achieving a BAC of 0.7 mg/mL with THC. In all conditions, participants smoked a standardized cannabis cigarette containing 400 μg/kg of THC. SFST performance, comprising Horizontal Gaze Nystagmus (HGN), Walk-and-Turn (WAT), and One-Leg Stand (OLS), was assessed approximately two hours after smoking. Oral fluid samples were collected using the Dräger Drug Test® 5000 and the Securetec Drugwipe® 5 to determine THC detection sensitivity. Results indicated that SFST were only mildly sensitive to cannabis impairment in heavy users. Cannabis alone significantly increased impairment on the OLS test but did not significantly affect HGN or WAT. However, the combination of alcohol and cannabis significantly impaired performance on the HGN test. SFST remained sensitive to alcohol-induced impairment across both alcohol doses. Regarding oral fluid testing, the Dräger Drug Test® 5000 demonstrated high sensitivity (90–100%) for THC between 15 minutes and 3 hours post-smoking, with low false-negative rates. In contrast, the Securetec Drugwipe® 5 exhibited low sensitivity, with false-negative rates rising to 40–50% within an hour of smoking. The authors attributed the limited SFST sensitivity to cannabis to behavioral tolerance in heavy users and the timing of the tests relative to peak intoxication. The study concludes that while SFST are reliable for detecting alcohol impairment, their utility for detecting cannabis impairment in heavy users is limited, likely due to tolerance. The findings highlight the Dräger Drug Test® 5000 as a promising tool for roadside THC detection due to its superior sensitivity compared to the Securetec Drugwipe® 5. These results underscore the need for caution when interpreting SFST results in the context of cannabis use and suggest that lower cutoff levels in oral fluid devices improve detection accuracy.

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• cannabis
• dui enforcement