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Urinary cannabinoid mass spectrometry profiles differentiate dronabinol from cannabis use.
Clin Chim Acta. 2020 Nov; 510:515-521.CC

Abstract

BACKGROUND

Dronabinol is used to treat a variety of conditions, including loss of appetite in people with AIDS and severe nausea and vomiting caused by cancer chemotherapy. Its therapeutic potential for pain management is now being explored in specific populations. Monitoring dronabinol compliance is challenging because its active ingredient, Δ-9-tetrahydrocannabinol (THC), is also present in cannabis. We developed a rapid LC-MS/MS assay with minimal specimen preparation to quantitate 11 cannabinoids in urine. Using this assay coupled with urine samples from normal controls, cannabis, and dronabinol users, we show the ability to differentiate cannabis from dronabinol use.

METHODS

Residual clinical urine samples from 55 cannabinoid positive subjects and 31 negative controls, as well as prospective samples from 5 patients receiving dronabinol therapy were obtained for analysis.

RESULTS

In the dronabinol group, only the THC metabolites 11-nor-9-carboxy-tetrahydrocannabinol (THC-COOH) and 11-hydroxy-Δ-9-tetrahydrocannabinol (THC-OH) were detected. Minor cannabinoids were detected in 91% of cannabis group samples and their detection was more frequent in samples with increased THC metabolite concentrations. Of minor cannabinoids evaluated, cannabigerol (CBG) and cannabidiol (CBD) had the greatest sensitivity in detecting cannabis use.

CONCLUSIONS

This method has a high sensitivity for the detection of cannabis use with implications for evaluating dronabinol compliance.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Koch CD
Department of Laboratory Medicine, Yale University, New Haven, CT, United States.
Xu L
Tianjin Key Laboratory on Technologies Enabling Development of Clinical Therapeutics and Diagnostics (Theranostics), School of Pharmacy, Tianjin Medical University, Tianjin, China; Department of Pharmacy and Medical Examination Technology, Tianjin Medical College, Tianjin, China.
Curtis SA
Division of Hematology/Oncology, Yale University, New Haven, CT, United States.
Roberts JD
Department of Medicine, Yale University, New Haven, CT, United States.
Bunch DR
Department of Laboratory Medicine, Yale University, New Haven, CT, United States.
El-Khoury JM
Department of Laboratory Medicine, Yale University, New Haven, CT, United States. Electronic address: joe.el-khoury@yale.edu.

MeSH

CannabinoidsCannabisChromatography, LiquidDronabinolHumansProspective StudiesSubstance Abuse DetectionTandem Mass Spectrometry

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32795544

Citation

Koch, Christopher D., et al. "Urinary Cannabinoid Mass Spectrometry Profiles Differentiate Dronabinol From Cannabis Use." Clinica Chimica Acta; International Journal of Clinical Chemistry, vol. 510, 2020, pp. 515-521.
Koch CD, Xu L, Curtis SA, et al. Urinary cannabinoid mass spectrometry profiles differentiate dronabinol from cannabis use. Clin Chim Acta. 2020;510:515-521.
Koch, C. D., Xu, L., Curtis, S. A., Roberts, J. D., Bunch, D. R., & El-Khoury, J. M. (2020). Urinary cannabinoid mass spectrometry profiles differentiate dronabinol from cannabis use. Clinica Chimica Acta; International Journal of Clinical Chemistry, 510, 515-521. https://doi.org/10.1016/j.cca.2020.08.014
Koch CD, et al. Urinary Cannabinoid Mass Spectrometry Profiles Differentiate Dronabinol From Cannabis Use. Clin Chim Acta. 2020;510:515-521. PubMed PMID: 32795544.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urinary cannabinoid mass spectrometry profiles differentiate dronabinol from cannabis use. AU - Koch,Christopher D, AU - Xu,Liang, AU - Curtis,Susanna A, AU - Roberts,John D, AU - Bunch,Dustin R, AU - El-Khoury,Joe M, Y1 - 2020/08/12/ PY - 2020/06/26/received PY - 2020/07/29/revised PY - 2020/08/07/accepted PY - 2020/8/17/pubmed PY - 2021/6/22/medline PY - 2020/8/16/entrez KW - Cannabinoid KW - Cannabis KW - Dronabinol KW - Mass spectrometry KW - Urine SP - 515 EP - 521 JF - Clinica chimica acta; international journal of clinical chemistry JO - Clin Chim Acta VL - 510 N2 - BACKGROUND: Dronabinol is used to treat a variety of conditions, including loss of appetite in people with AIDS and severe nausea and vomiting caused by cancer chemotherapy. Its therapeutic potential for pain management is now being explored in specific populations. Monitoring dronabinol compliance is challenging because its active ingredient, Δ-9-tetrahydrocannabinol (THC), is also present in cannabis. We developed a rapid LC-MS/MS assay with minimal specimen preparation to quantitate 11 cannabinoids in urine. Using this assay coupled with urine samples from normal controls, cannabis, and dronabinol users, we show the ability to differentiate cannabis from dronabinol use. METHODS: Residual clinical urine samples from 55 cannabinoid positive subjects and 31 negative controls, as well as prospective samples from 5 patients receiving dronabinol therapy were obtained for analysis. RESULTS: In the dronabinol group, only the THC metabolites 11-nor-9-carboxy-tetrahydrocannabinol (THC-COOH) and 11-hydroxy-Δ-9-tetrahydrocannabinol (THC-OH) were detected. Minor cannabinoids were detected in 91% of cannabis group samples and their detection was more frequent in samples with increased THC metabolite concentrations. Of minor cannabinoids evaluated, cannabigerol (CBG) and cannabidiol (CBD) had the greatest sensitivity in detecting cannabis use. CONCLUSIONS: This method has a high sensitivity for the detection of cannabis use with implications for evaluating dronabinol compliance. SN - 1873-3492 UR - https://www.unboundmedicine.com/medline/citation/32795544/Urinary_cannabinoid_mass_spectrometry_profiles_differentiate_dronabinol_from_cannabis_use_ DB - PRIME DP - Unbound Medicine ER -

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