[Time profile of serum THC levels in occasional and chronic marihuana smokers after acute drog use - implication for drivind motor vehicles].

Q4 Medicine Soudni Lekarstvi Pub Date : 2014-01-01
Marie Balíková, Tomáš Hložek, Tomáš Páleníček, Filip Tylš, Michaela Viktorinová, Tomáš Melicher, Renáta Androvičová, Pavel Tomíček, Michal Roman, Jiří Horáček
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Abstract

Cannabis consumption has individual influence to cognitive and psychomotor functions of drivers and it has been generally accepted that driving under influence is risky in the perspective of traffic safety. However, rules how to assess fitness to drive are not quite clear. The psychoactive compound delta-9-tetrahydrocannabinol (THC) impairs cognition, psychomotor behaviour and driving performance in a dose-related manner approximately. After a single drug dose, THC blood concentration peaks within minutes, before the end of smoking, with a subsequent rapid decrease to the analytical limit of detection. Peak euphoria is delayed compared to THC peak blood concentration and physiological and behavioural effects return to baseline within 3-5 hours. In chronic users, the lipophilic THC accumulates in fat tissues, where its slow redistribution into blood is the rate limiting process in its terminal elimination. In our experimental study we have attempted to contribute to this discussion with results obtained from human volunteers - cannabis consumers in Czech Republic. Aim of our study was to document the time profile of serum THC level in occasional and chronic cannabis users. The observational interval covered the time immediately after the drug consumption (an own cigarette/joint) till 24 hours after. Our preliminary results have shown that in occasional users, THC serum levels cannot be detected already 4 hours after usual cannabis dose, whereas in chronic users measurable THC concentrations in serum persist longer. Moreover, some chronic consumers were practically with permanent THC detection during our observation period and also the chronic users consumed higher THC doses significantly related to doses in occasional ones. Presented results of the experimental study with human volunteers confirm a great individual variability of the kinetic profile of THC in blood due to complicated redistribution. The practical forensic question is how long the psychotropic effects of THC can persist after the last drug dose. In chronic users there are well documented indications of long term adverse effects to neurocognitive functions. THC blood level itself can not directly document the intensity of impairment of a driver. Moreover, the concentration of THC in blood at the time of driving is probably substantially higher than at the time of blood sampling. Therefore due to the prevention of traffic risk, some countries adopted per se traffic legislation based on analytical principle with minimum tolerance to illegal drugs in blood of drivers at driving. Low blood concentrations of THC close to the limit of detection of a specific toxicological method (GC-MS or LC-MS) are justified in an effective traffic legislation.

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[偶尔和长期吸食大麻者急性吸毒后血清四氢大麻酚水平的时间分布-对驾驶机动车的影响]。
大麻消费对驾驶员的认知和精神运动功能有个别影响,人们普遍认为,从交通安全的角度来看,在大麻影响下驾驶是危险的。然而,关于如何评估驾驶能力的规定并不十分明确。精神活性化合物δ -9-四氢大麻酚(THC)以剂量相关的方式损害认知,精神运动行为和驾驶性能。单次给药后,四氢大麻酚血药浓度在吸烟结束前几分钟内达到峰值,随后迅速下降至分析检出限。与四氢大麻酚血药浓度峰值相比,欣快感峰值延迟,生理和行为影响在3-5小时内恢复到基线水平。在慢性使用者中,亲脂性四氢大麻酚在脂肪组织中积累,在脂肪组织中其缓慢重新分配到血液中是其最终消除的速率限制过程。在我们的实验研究中,我们试图用人类志愿者——捷克共和国大麻消费者——获得的结果来促进这一讨论。我们研究的目的是记录偶尔和慢性大麻使用者血清四氢大麻酚水平的时间概况。观察间隔包括吸毒后立即(自己抽一支烟/大麻)至吸毒后24小时。我们的初步结果表明,在偶尔吸食大麻的人群中,在正常吸食大麻4小时后就无法检测到四氢大麻酚的血清水平,而在长期吸食大麻的人群中,血清中可测量的四氢大麻酚浓度持续时间更长。此外,在我们的观察期间,一些慢性使用者实际上是永久性的四氢大麻酚检测,并且慢性使用者消耗的四氢大麻酚剂量较高,与偶尔的剂量显著相关。目前对人类志愿者的实验研究结果证实,由于复杂的再分配,血液中四氢大麻酚的动力学特征存在很大的个体差异。实际的法医问题是四氢大麻酚的精神作用在最后一次用药后能持续多久。在长期使用者中,有充分的证据表明对神经认知功能有长期的不良影响。四氢大麻酚血药浓度本身并不能直接记录驾驶员的损伤程度。此外,驾驶时血液中THC的浓度可能大大高于采血时的浓度。因此,为了预防交通风险,一些国家采取了基于分析原则的自身交通立法,对驾驶员驾驶时血液中的非法药物最低限度的容忍。在有效的交通立法中,接近特定毒理学方法(GC-MS或LC-MS)检测极限的低血药浓度是合理的。
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Soudni Lekarstvi
Soudni Lekarstvi Medicine-Medicine (all)
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