Interest of adjusting urine cannabinoids to creatinine level to monitor cannabis cessation therapy in heavy smokers with psychiatric disorders
| Autor: | Fabien Lamoureux, Laurent Imbert, Zoubir Djerada, Marianne Vasse, Aurélien Schrapp, Yves Protais, Hélène Goetz, Thomas Duflot, Jennifer Guillerme, Celine Mory, Olivier Guillin |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Marijuana Abuse medicine.medical_specialty Urinary system Pharmaceutical Science Marijuana Smoking Urine 01 natural sciences Analytical Chemistry 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Elimination rate constant Humans Environmental Chemistry Medicine Weaning 030216 legal & forensic medicine Psychiatry Lead (electronics) Spectroscopy Creatinine biology Receiver operating characteristic Cannabinoids business.industry Mental Disorders 010401 analytical chemistry Middle Aged biology.organism_classification 0104 chemical sciences Substance Abuse Detection chemistry Female Cannabis business |
| Zdroj: | Drug Testing and Analysis. 11:1453-1459 |
| ISSN: | 1942-7611 1942-7603 |
| DOI: | 10.1002/dta.2672 |
| Popis: | Up to 25% of hospitalized patients in a psychiatric department exhibit troubles linked to cannabis use. Weaning patients with psychiatric disorders off drugs of abuse requires specific care to improve their clinical outcome. The present study aims to develop a predictive model of urinary excretion of creatinine-normalized cannabinoids (UCNC ) and to determine UCNC thresholds corresponding to the widely used cut-offs of 20 ng/mL and 50 ng/mL for cannabinoids. One hundred thirty-two patients with 452 urine samples were included between 2013 and 2017. Urinary cannabinoids and UCNC elimination curves were computed for each patient. Using a mono-exponential mixed effect model with 88 samples from 26 subjects exhibiting at least 3 decreasing UCNC in a row, the average calculated elimination rate constant was 0.0108 ± 0.0026 h-1 , corresponding to a mean elimination half-life of 64 ± 12 hours. The use of UCNC is of particular interest because of a high inter- and intra-individual variability of urinary creatinine concentration (from 0.06 to 3.81 mg/mL). Moreover, UCNC allows for the detection of diluted or concentrated urine specimens that may lead to false positive (FP) or false negative (FN) results. Receiver operator characteristic (ROC) curves were used to assess UCNC thresholds of 32.4 and 124.7 ng/mg that provide a strong discrimination between positive and negative samples for cannabinoids cut-offs of 20 and 50 ng/mL respectively. The developed model and the defined UCNC thresholds allowed for the accurate prediction of the time needed to reach a negative UCNC result that could be used by clinicians to optimize clinical care. |
| Databáze: | OpenAIRE |
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