"This study will clarify the risks involved in driving following CBD use and assist in ensuring the safe use of CBD by drivers."

"Self reporting revealed higher rates of illicit substance use than oral fluid testing in preanaesthetic patients, and may lead to more interventions and more appropriately tailored treatment and anaesthesia compared with oral fluid testing."

"The oral fluid sampling device (Dräger DCD 5000) is designed for confirmatory analysis of preliminary results from Dräger DrugTest 5000, a mobile oral fluid testing system. Our study design simulates a non-cooled sample shipment as widely used by police and companies performing workplace drug testing. We found different recoveries of benzodiazepines depending on the type of storage. Highest degrees of stability of benzodiazepines can be obtained by addition of methanol to the collection device..."

While the Dräger DrugTest 5000 significantly increased the detection of drug-impaired drivers in Norway, its accuracy remains inconsistent compared to blood analysis. High false-positive rates for cocaine and opiates, alongside notable false negatives for cannabis and benzodiazepines, indicate that the device is an effective screening tool for law enforcement but cannot replace confirmatory laboratory testing.

Alcohol consumption does not significantly alter the pharmacokinetic properties of THC in oral fluid or the performance of on-site screening tests. While drinking 300 mL of fluid can slightly lower THC concentrations, it does not prevent the detection of recent cannabis use, as most rapid tests (like the Dräger DrugTest 5000) remain highly sensitive up to four hours after smoking. Consequently, oral fluid remains a reliable medium for identifying recent use regardless of simultaneous ethanol intake.

"Drivers with a confirmed positive roadside test for morphine, codeine, and methadone had also consumed heroin and/or other illicit drugs, such as cocaine and/or THC, and at relevant concentrations. Improving interventions to combat the problem of driving under the influence of driving-impairing substances is a priority."

"LC-MS/MS confirmation result was negative in only 1.5% of the cases. The DUID driver profile was a young man, consuming cannabis or a combination of cannabis and cocaine."

This study establishes oral fluid as a robust specimen for DUID investigations through the first comprehensive U.S. testing program. By integrating roadside devices (Dräger DrugTest® 5000, Abbott SoToxa®, and Randox Evidence MultiSTAT™) with LC-MS-MS confirmation (via Integra and Hamilton STARlet), the program achieved >80% accuracy for most drugs. With higher detection rates for THC and cocaine than blood, oral fluid collected near the driving event is an essential tool for identifying recent drug use and enhancing forensic evidence.

"We observed a high prevalence of drivers testing positive for cocaine and cannabinoids. Most devices [MDML™, Dräger DrugTest 5000™, DOA MultiScreen™] achieved good reliability performance for cocaine detection using cutoffs proposed by Walsh et al. or using the device's own cutoff. Instead, the reliability for cannabinoid detection obtained the desired parameters in just one device [Dräger DrugTest 5000™] using cut-offs proposed by Walsh et al. and its own cutoff. Difficulties in detecting cannabinoids at the roadside should be better evaluated before the implementation of such tests."

"Based on the selected criteria, 3 of the 4 devices [DDS2, Dräger DrugTest 5000, Multi-Drug Multi-Line Twist Screen Device] were considered useful by traffic agents in routine roadblock operations. The weighted evaluations suggest that their ease of use (handling, sampling analysis, and reliability), as well as their agreement with findings obtained by other means, defined their utility to traffic agents, although such appraisals must be further analyzed in future studies."

The study concludes that while oral fluid devices like Rapid STAT®, DrugWipe 5/5+®, and Dräger DrugTest® 5000 offer a practical alternative to the DrugScreen® urine test for roadside screening, they still struggle with limited specificity for THC and inconsistent sensitivity for methamphetamine and benzodiazepines. Despite their high performance in detecting opiates and cocaine, further refinements are needed to reduce false positives and ensure reliable diagnostic accuracy in police procedures.

This analytical evaluation compared the performance of four prominent on-site oral fluid drug testing devices: the Dräger DrugTest 5000, Cozart DDS, Mavand Rapid STAT, and Innovacon OrAlert. By using UPLC-MS-MS results as a gold-standard reference, the study determined that while all four devices maintained high levels of specificity across various drug classes, their sensitivity levels fluctuated significantly depending on the specific analyte. Ultimately, the Dräger DrugTest 5000 emerged as the most effective overall tool, demonstrating the highest sensitivity for most substances, including THC and opiates, despite the general finding that on-site sensitivity for certain drugs like cocaine remains a challenge for these technologies.

"The three tested on-site screening devices, Mavand RapidSTAT®, Securetec Drugwipe-5+® and Dräger DrugTest 5000® were able to detect about 70% of all cocaine and cannabis users in a roadside setting. Amphetamine/MDMA users were detected more easily with a sensitivity higher than 92%. The sensitivity of the oral fluid screening tests for THC is increasing as manufactures are still trying to lower the cut-off of their devices. First results using the new DrugTest 5000 test cassette® demonstrate..."

"We evaluated the performance of two commonly used POCT devices, DW5S and DT5000, against LC–MS/MS‐quantified OF THC concentrations following controlled oral administration of 10 mg THC (in combination with 200 mg CBD) oil and placebo. The DT5000 device performed somewhat better than the DW5S device; however, there was overall high risk for FP and FN results at short intervals after oral administration (0.5 h post‐treatment) in the face of high variability in OF THC concentrations across participants. The next day (10 and 18 h post‐treatment), both devices accurately produced negative results reflecting the fact that all samples had THC concentrations lower than the screening cut‐offs on the POCT devices at these time points. Overall, these findings indicate a low probability of obtaining a positive THC result the next day after evening consumption of an oral cannabis oil containing 10 mg THC (in combination with 200 mg CBD) in individuals who infrequently use cannabis. However, these results cannot necessarily be generalised to those who regularly use THC or cannabis, including medicinal cannabis patients. Regular users may accumulate residual THC in OF, leading to higher baseline readings and an increased risk of obtaining a positive THC result with commonly used POCT devices."

"Here we have compared, for the first time, cannabinoid concentrations in oral fluid following controlled administration of THC‐dominant, THC/CBD equivalent, and placebo cannabis. There were few differences in confirmed oral fluid THC concentrations between the two active cannabis conditions, suggesting that CBD has little effect on oral fluid THC concentrations when the two compounds are vaporized in a 1:1 ratio. It may not be possible to generalize these results to other routes of administration and to cannabis or cannabinoid products containing higher CBD to THC ratios. We also evaluated the performance of the DW5s and DT5000 POCT devices that are widely used to detect DUIC. Both devices performed acceptably when oral fluid THC concentrations were well above or below the screening cut‐off, but neither device exhibited >80% sensitivity, specificity, and accuracy. A considerable number of false positive and false negative results were observed. While these devices are useful tools for detecting recent cannabis use, confirmatory testing is absolutely necessary and of the utmost importance. This is especially important in contexts (eg, DUIC) where positive tests results may lead to criminal convictions."

"This study suggests that orally administered CBD is unlikely to elicit false‐positive (or true‐positive) tests for THC on the DW‐5S or DT5000 POC oral fluid testing devices. The likelihood of an individual who is using a CBD (only) oral formulation being falsely accused of DUIC therefore appears low. However, further research is required to determine whether inhaled CBD and CBD formulations containing small amounts of THC have the potential to elicit positive tests."

The study confirms that Approved Drug Screening Equipment (ADSE) is a highly reliable tool for detecting THC-impaired drivers. With 98% of blood samples confirming THC and 90% meeting or exceeding Canada’s 2.0 ng/mL legal limit, a positive roadside oral fluid test serves as a strong predictor of significant blood-THC concentrations. Consequently, these devices provide law enforcement with a robust, objective basis for establishing grounds to believe a driver has exceeded federal impairment limits.

"The present manuscript describes the successful development and validation of a LC–MS/MS method for the determination of methylone, methedrone, fluoromethamphetamine, fluoromethcathinone, mephedrone, MDPV, mCPP and TFMPP in oral fluid. Two out of the ten analyzed drivers’ oral fluid specimens gave a positive result for mCPP and MDPV. Moreover, cross reactivity produced by the studied synthetic cathinones in the Dräger DrugTest5000 was assessed. All the analytes produced a positive result for..."