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Short communication: Urinary excretion of 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol in a pregnant woman following heavy, chronic cannabis use.

Abstract

Differentiating new intake of drugs-of-abuse from residual drug excretion may be difficult, especially following chronic drug usage and for drugs with long elimination half-lives such as cannabis. In the present case, cannabis was found in the urine of a young pregnant woman following heavy and chronic cannabis use. She was warned that if she continued using cannabis while pregnant she would be forced to be hospitalized. She was subjected to serial urine testing with 2-7-day intervals. Urinary 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol (THCCOOH) concentrations, measured by liquid chromatography-mass spectrometry, declined from 348 to 3.9 ng/mL over a surprisingly long period of 12 weeks (84 days). Several algorithms for detecting new drug intake were applied during this time course; most indicated that the woman continued to smoke cannabis following the first urine test. The woman denied any use after the first specimen collection. In retrospect, her THCCOOH excretion profile supports her story. Algorithms for detecting new drug intake have been validated for occasional cannabis users only. We advise caution when interpreting urine test results from heavy, chronic cannabis users, especially when serious consequences are involved.

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  • Authors+Show Affiliations

    ,

    Department of Clinical Pharmacology, St. Olav University Hospital, N-7006 Trondheim, Norway. andreas.westin@legemidler.no

    , ,

    Source

    MeSH

    Algorithms
    Chromatography, Liquid
    Dronabinol
    Female
    Half-Life
    Humans
    Marijuana Abuse
    Marijuana Smoking
    Mass Spectrometry
    Metabolic Clearance Rate
    Predictive Value of Tests
    Pregnancy
    Reproducibility of Results
    Substance Abuse Detection
    Young Adult

    Pub Type(s)

    Case Reports
    Journal Article
    Research Support, N.I.H., Intramural

    Language

    eng

    PubMed ID

    20040136

    Citation

    Westin, Andreas A., et al. "Short Communication: Urinary Excretion of 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol in a Pregnant Woman Following Heavy, Chronic Cannabis Use." Journal of Analytical Toxicology, vol. 33, no. 9, 2009, pp. 610-4.
    Westin AA, Huestis MA, Aarstad K, et al. Short communication: Urinary excretion of 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol in a pregnant woman following heavy, chronic cannabis use. J Anal Toxicol. 2009;33(9):610-4.
    Westin, A. A., Huestis, M. A., Aarstad, K., & Spigset, O. (2009). Short communication: Urinary excretion of 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol in a pregnant woman following heavy, chronic cannabis use. Journal of Analytical Toxicology, 33(9), pp. 610-4.
    Westin AA, et al. Short Communication: Urinary Excretion of 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol in a Pregnant Woman Following Heavy, Chronic Cannabis Use. J Anal Toxicol. 2009;33(9):610-4. PubMed PMID: 20040136.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Short communication: Urinary excretion of 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol in a pregnant woman following heavy, chronic cannabis use. AU - Westin,Andreas A, AU - Huestis,Marilyn A, AU - Aarstad,Kjell, AU - Spigset,Olav, PY - 2009/12/31/entrez PY - 2009/12/31/pubmed PY - 2010/3/26/medline SP - 610 EP - 4 JF - Journal of analytical toxicology JO - J Anal Toxicol VL - 33 IS - 9 N2 - Differentiating new intake of drugs-of-abuse from residual drug excretion may be difficult, especially following chronic drug usage and for drugs with long elimination half-lives such as cannabis. In the present case, cannabis was found in the urine of a young pregnant woman following heavy and chronic cannabis use. She was warned that if she continued using cannabis while pregnant she would be forced to be hospitalized. She was subjected to serial urine testing with 2-7-day intervals. Urinary 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol (THCCOOH) concentrations, measured by liquid chromatography-mass spectrometry, declined from 348 to 3.9 ng/mL over a surprisingly long period of 12 weeks (84 days). Several algorithms for detecting new drug intake were applied during this time course; most indicated that the woman continued to smoke cannabis following the first urine test. The woman denied any use after the first specimen collection. In retrospect, her THCCOOH excretion profile supports her story. Algorithms for detecting new drug intake have been validated for occasional cannabis users only. We advise caution when interpreting urine test results from heavy, chronic cannabis users, especially when serious consequences are involved. SN - 1945-2403 UR - https://www.unboundmedicine.com/medline/citation/20040136/abstract/Short_communication:_Urinary_excretion_of_11_nor_9_carboxy_Delta_9__tetrahydrocannabinol_in_a_pregnant_woman_following_heavy_chronic_cannabis_use_ L2 - https://academic.oup.com/jat/article-lookup/doi/10.1093/jat/33.9.610 DB - PRIME DP - Unbound Medicine ER -