Analysis index

Saliva: We offer to our customers 2 different types of saliva collection systems with corresponding instructions (Quantisal from Immunalysis and Saliva Collection System (SCS) from Greiner Bio-One). Advantages and disadvantages can be discussed on request. The saliva collection tubes are issued by Labor Krone free of charge when used within the context of a substitution therapy.

Please refer to findings report

Suspicion of drug abuse, intoxication

Drug screening in saliva via LC-MS/MS either covers

the four main groups (abbreviation: SPEIL4):

• Cannabinoids
• Cocaine (Benzoylecgonine, norcocaine)
• Amphetamines (Amphetamine, methamphetamines, MDA, MDMA)
• Opiates (Morphin, 6-monoacetylmorphine, codeine, dihydrocodeine)

or seven main groups (abbreviation: SPEILC):

• Speil4, in addition to
• Methadon (EDDP)
• Benzodiazepines (Diazepam, nordiazepam, oxazepam, alprazolam, bromazepam, flunitrazepam, 7-amino flunitrazepam, clonazepam), Z-substances (Zolpidem, zopiclone, zaleplon)
• Opioids (Buprenorphine, norbuprenorphine, tilidin, nortilidin, oxycodone, tramadol, O-desmethyl tramadol, fentanyl, norfentanyl), ketamine

The test material saliva, in comparison to urine, offers a number of advantages. A manipulation is near enough impossible. For the medical staff, the material collection is easier and less time-consuming than for urine. Sample collection is fast and is possible even in patients with a dry mouth. Privacy is not neglected unlike in case of urine sample collection under visual control. Whilst usually only drug metabolites are found in the urine, in saliva  generally the main substance as well as the metabolites are detected. Demonstration of the metabolites benzoylecgonin, 6-monoacetylmorphine, EDDP and norbuprenorphin confirms active use and aleady completed metabolisation of cocaine, heroin, methadon or buprenorphin.

In most of the new synthetic drugs (NPS - new psycoactive substances) only the main substance is known and metabolites are often unidentified. Here the saliva test is of advantage. A further advantage is that matrix effects in the analysis of saliva are usually less than in urine (Demonstration of synthetic drugs in saliva is in the process of preparation). Diluted samples caused by excessive fluid intake or purposely diluting samples pose a recurrent problem in urine analysis. Standardized reference values for drugs per gramm of creatinine are usually unavailable. Whilst drug- and medication concentration is severely less in saliva compared to urine, with the current sensitive chromatographic analytic methods this does not lead to considerable disadvantages. Any detection of drugs in saliva is a very reliable indicator for recent consumption.

Amphetamine, methamphetamine, cocaine, morphine and codein are generally detectable longer in saliva than in blood. THC concentration is higher in saliva than in blood, which in turn leads to a longer detection period. For benzodiazepines however, the detection period in saliva is generally shorter than in blood. Cost for chromatographic screening in urine and in saliva are very much the same.