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Interpretation of Cannabis Findings in the Hair of Very Young Children: Mission Impossible.
Curr Pharm Biotechnol. 2017; 18(10):791-795.CP

Abstract

BACKGROUND

Hair has been suggested since the middle of the 90's to be a suitable matrix to document repetitive exposure to cannabis. Because it is possible to detect Δ9-tetrahydrocannabinol (THC), cannabinol (CBN) and cannabidiol (CBD) in cannabis smoke, the identification of the metabolite, 11-nor-Δ9-tetrahydrocannabinol carboxylic acid (THC-COOH) has been considered to allow the discrimination of active use.

OBJECTIVE

Although the identification of an active compound in a child's hair shows contamination of the local environment, it is a challenge to discriminate between hair incorporation after ingestion or inhalation and environmental external deposition from dust, smoke, or even contaminated surfaces by hand contact. However, it is particularly important in case of children to correctly interpret the data, particularly for a realistic assessment of the health risk. We present here a series of hair tests for cannabis where the interpretation was almost impossible to establish.

METHOD

Hair specimens were collected during the autopsy of the 12 children, aged 2 to 24 months, either deceased from shaken baby syndrome (SBS, n=4), mechanic asphyxia (MA, n=1) or sudden infant death (SID, n=7) during January 2015 to April 2017. After decontamination, the hair specimens were tested for THC, CBN and CBD and THC-COOH. The whole length of hair was submitted to analysis.

RESULTS

The amount of hair from children can be as low as 8 mg. This may affect the limit of quantitation of all drugs, but particularly THC-COOH. Eight from twelve hair tests were positive for cannabis markers, i.e. THC (39 to 1890 pg/mg, n=8), CBN (< 5 to 1300 pg/mg n=8), CBD (10 to 2300 pg/mg, n=8) and THC-COOH (not detected to < 0.5 pg/mg, n=5). In 4 cases from 8 positive findings, it was not possible to test for THC-COOH (not enough material).

CONCLUSION

Establishing a window of detection when testing for drugs in young children is a very complicated task. Hair from children is finer and more porous in comparison with adult (the risk of contamination from sweat and environmental smoke is higher than in adults). The final interpretation of cannabinoid findings in the children's hair is very complicated as this can result from in utero exposure (although none of the mother admitted cannabis use during pregnancy), oral cannabis administration by the parents to achieve sedation, close contact to cannabis consumers (hands, bedding, dishes) and inhalation of side-stream smoke. Over-interpreting cannabis findings in hair can have very serious legal implication in child protection cases. Practicing scientists have the responsibility to inform the child protection authorities, courts, etc. about these limitations.

Authors+Show Affiliations

Institut de Medecine legale, 11 rue Humann, 67000 Strasbourg, France.Institut de Medecine legale, 11 rue Humann, 67000 Strasbourg, France.Institut de Medecine legale, 11 rue Humann, 67000 Strasbourg, France.Institut de Medecine legale, 11 rue Humann, 67000 Strasbourg, France.Institut de Medecine legale, 11 rue Humann, 67000 Strasbourg, France.Institut de Medecine legale, 11 rue Humann, 67000 Strasbourg, France.Institut de Medecine legale, 11 rue Humann, 67000 Strasbourg, France.Institut de Medecine legale, 11 rue Humann, 67000 Strasbourg, France.Institut de Medecine legale, 11 rue Humann, 67000 Strasbourg, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29189142

Citation

Kintz, Pascal, et al. "Interpretation of Cannabis Findings in the Hair of Very Young Children: Mission Impossible." Current Pharmaceutical Biotechnology, vol. 18, no. 10, 2017, pp. 791-795.
Kintz P, Ameline A, Eibel A, et al. Interpretation of Cannabis Findings in the Hair of Very Young Children: Mission Impossible. Curr Pharm Biotechnol. 2017;18(10):791-795.
Kintz, P., Ameline, A., Eibel, A., Gheddar, L., Feisthauer, E., Geraut, A., Berthelon, L., Farrugia, A., & Raul, J. S. (2017). Interpretation of Cannabis Findings in the Hair of Very Young Children: Mission Impossible. Current Pharmaceutical Biotechnology, 18(10), 791-795. https://doi.org/10.2174/1389201019666171129180206
Kintz P, et al. Interpretation of Cannabis Findings in the Hair of Very Young Children: Mission Impossible. Curr Pharm Biotechnol. 2017;18(10):791-795. PubMed PMID: 29189142.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interpretation of Cannabis Findings in the Hair of Very Young Children: Mission Impossible. AU - Kintz,Pascal, AU - Ameline,Alice, AU - Eibel,Aude, AU - Gheddar,Laurie, AU - Feisthauer,Emilie, AU - Geraut,Annie, AU - Berthelon,Laurent, AU - Farrugia,Audrey, AU - Raul,Jean-Sebastien, PY - 2017/07/03/received PY - 2017/08/11/revised PY - 2017/11/09/accepted PY - 2017/12/1/pubmed PY - 2018/5/31/medline PY - 2017/12/1/entrez KW - Biological fluids KW - cannabis KW - children KW - forensic toxicology KW - hair KW - interpretation SP - 791 EP - 795 JF - Current pharmaceutical biotechnology JO - Curr Pharm Biotechnol VL - 18 IS - 10 N2 - BACKGROUND: Hair has been suggested since the middle of the 90's to be a suitable matrix to document repetitive exposure to cannabis. Because it is possible to detect Δ9-tetrahydrocannabinol (THC), cannabinol (CBN) and cannabidiol (CBD) in cannabis smoke, the identification of the metabolite, 11-nor-Δ9-tetrahydrocannabinol carboxylic acid (THC-COOH) has been considered to allow the discrimination of active use. OBJECTIVE: Although the identification of an active compound in a child's hair shows contamination of the local environment, it is a challenge to discriminate between hair incorporation after ingestion or inhalation and environmental external deposition from dust, smoke, or even contaminated surfaces by hand contact. However, it is particularly important in case of children to correctly interpret the data, particularly for a realistic assessment of the health risk. We present here a series of hair tests for cannabis where the interpretation was almost impossible to establish. METHOD: Hair specimens were collected during the autopsy of the 12 children, aged 2 to 24 months, either deceased from shaken baby syndrome (SBS, n=4), mechanic asphyxia (MA, n=1) or sudden infant death (SID, n=7) during January 2015 to April 2017. After decontamination, the hair specimens were tested for THC, CBN and CBD and THC-COOH. The whole length of hair was submitted to analysis. RESULTS: The amount of hair from children can be as low as 8 mg. This may affect the limit of quantitation of all drugs, but particularly THC-COOH. Eight from twelve hair tests were positive for cannabis markers, i.e. THC (39 to 1890 pg/mg, n=8), CBN (< 5 to 1300 pg/mg n=8), CBD (10 to 2300 pg/mg, n=8) and THC-COOH (not detected to < 0.5 pg/mg, n=5). In 4 cases from 8 positive findings, it was not possible to test for THC-COOH (not enough material). CONCLUSION: Establishing a window of detection when testing for drugs in young children is a very complicated task. Hair from children is finer and more porous in comparison with adult (the risk of contamination from sweat and environmental smoke is higher than in adults). The final interpretation of cannabinoid findings in the children's hair is very complicated as this can result from in utero exposure (although none of the mother admitted cannabis use during pregnancy), oral cannabis administration by the parents to achieve sedation, close contact to cannabis consumers (hands, bedding, dishes) and inhalation of side-stream smoke. Over-interpreting cannabis findings in hair can have very serious legal implication in child protection cases. Practicing scientists have the responsibility to inform the child protection authorities, courts, etc. about these limitations. SN - 1873-4316 UR - https://www.unboundmedicine.com/medline/citation/29189142/Interpretation_of_Cannabis_Findings_in_the_Hair_of_Very_Young_Children:_Mission_Impossible_ L2 - https://www.eurekaselect.com/157855/article DB - PRIME DP - Unbound Medicine ER -