Do crashed drivers need more drug testing? A retrospective analysis of blood samples from hospitalised post-crash drivers in New Zealand.

Driving under the influence of alcohol and other drugs is a prominent safety concern in New Zealand and across the world. While alcohol testing is routinely performed for drivers involved in hospitalisation crashes, testing for other drugs is often not undertaken. The present study refers to 530 traffic crashes that occurred from October 2019 to January 2020 on New Zealand roads. The blood samples from 550 drivers who were injured in a crash and were admitted to a hospital (66% of all drivers involved in these crashes), previously tested for drugs and/or alcohol, were retested for a wider range of drugs. Alcohol above the applicable limit was found to be present in 38% of hospitalised drivers, while other drugs of interest were found in 47% of hospitalised drivers. Binary logistic regression was used to predict the presence of drugs of interest for a crashed driver using previous offence data. A driver having at least one prior drink and drug driving offence is 61% more likely to be positive for a drug of interest when involved in a crash. Similarly, a driver having at least one prior non-traffic drug offence is 4.7 times more likely to be positive for at least a drug of interest when involved in a crash. While the presence of a drug or drugs cannot be presumed to have played a role in the occurrence of the crash, this study has provided a unique and comprehensive picture of the presence of various drugs present in New Zealand drivers' blood. It is recommended to consider standardising drug testing on all blood specimens taken in relation to a serious injury or fatal crash. This procedure is not only of interest for information purposes but may importantly inform appropriate charging decisions.

How Saliva Interferes with Colorimetric Gold Nanoparticle Aptasensors: Understanding and Mitigating Surface Interactions.

Colorimetric gold-nanoparticle-based biosensors are an attractive platform for the detection of small-molecule analytes. Taking advantage of the adsorption of DNA aptamer probes on AuNPs, these sensors can be simple, rapid, sensitive, selective, and cost-effective. These properties are important for rapid detection of drugs like methamphetamine in biological matrices. Saliva is a highly desirable matrix for development of diagnostic tests because saliva sampling is minimally invasive and drug levels relate to recent use rather than accumulation from historical use. However, saliva is a complex fluid that presents a multitude of challenges when applying colorimetric aggregation assays. Here, we show that the contents of saliva interfere with the sensor in two main ways: (i) suppressing color change signals due to proteins nonspecifically adsorbing to nanoparticles and (ii) blocking aggregation and generating false signals due to specific electrolytes that induce aggregation. With this knowledge, we examine strategies to mitigate these effects, including sample collection and pretreatment procedures. These measures ultimately result in a sensor that can detect methamphetamine spiked into saliva samples and suggest immense promise for the feasibility of these platforms for on-site diagnostic applications.

Accounting for Interaction Kinetics between Gold Nanoparticles and Aptamers Enables High-Performance Colorimetric Sensors.

DNA aptamers have emerged as promising probes for challenging analytes that cannot be easily detected by conventional probes, including small-molecule targets. Among the different signal transduction approaches, gold nanoparticle (AuNP) aggregation assays have been widely used to generate a colorimetric response from aptamer-target interactions. This sensor design relies on the competition between the aptamer adsorbing to the AuNP surface versus interacting with the target, whereby target binding reduces the number of adsorbed aptamers that destabilizes AuNPs toward salt-induced aggregation, thereby inducing a color change. However, this thermodynamic framework overlooks the potential influence of interaction kinetics of different aptamer conformations with AuNP surfaces and with targets in solution or near surfaces. Here, we show that aptamers become more strongly adsorbed on AuNPs over time, and these trapped aptamers are less responsive toward the target analyte. By varying the sequence of addition in sensing assays, we demonstrate that these interaction kinetics have a significant effect on the sensor response and thereby produce an effective sensor for methamphetamine (meth) at biologically relevant levels in oral fluids. Along with underpinning new tools for assay development, this new knowledge also highlights the need for aptamer selection strategies that evolve aptamer sequences based on the functionality that they need to exhibit in an actual sensor.

Toxicological Assessment of the Role of Alcohol and Drugs in Drug-Facilitated Sexual Assault Cases in New Zealand.

This report details the toxicology profile of victims of drug-facilitated sexual assault (DFSA) in New Zealand from 2015 to 2018. This study represents all of the toxicology results for DFSA cases in New Zealand during this time period, of which there were 161 cases. Blood and urine samples were screened for legal and illicit drugs in addition to testing for alcohol and correlating alcohol concentration with sampling delay. Our results indicate that increased delay in sampling time resulted in a corresponding decrease in alcohol concentration. In victims who had declared alcohol use but of which none was detected, the average sampling time was 14 hours for blood and 17 hours for urine, which is in excess of the average sampling delay for even the lowest alcohol-positive samples. The most frequently detected alcohol concentration was in the range of 51-80 mg/100 mL for blood and 121-200 mg/100 mL for urine with an average sampling time of 8.5 and 6.5 hours, respectively. We also examined acetone concentrations in alcohol-positive samples, and our results indicate that 82% of blood alcohol-positive samples contained acetone at concentrations between 5 and 10 mg/L and 68% of alcohol-positive urine samples contained acetone at a concentration >20 mg/L. It may be that the nature of sexual assault affects an individual's metabolism of alcohol and results in increased acetone production. Cannabis was the most commonly detected illicit drug, followed by methamphetamine. In relation to medicinal drugs, there was a high usage of antidepressants and antipsychotics, suggesting the victims may have been people of vulnerable personality. Based on case information, it does not appear there are many cases where stupefaction by unknown administration of a drug has occurred, instead loss of consent through voluntary alcohol and drug consumption is more common and poses a greater risk than surreptitious drug administration.

Simultaneous analysis of 29 synthetic cannabinoids and metabolites, amphetamines, and cannabinoids in human whole blood by liquid chromatography-tandem mass spectrometry - A New Zealand perspective of use in 2018.

We describe the validation of a method for the simultaneous analysis of 29 synthetic cannabinoids (SCs) and metabolites, 4 amphetamines, and 2 cannabinoids in human whole blood. This method enables one analysis to cover what previously required multiple analyses for these classic and novel drugs-of-abuse with diverse physicochemical properties. The scope of targeted analytes was based on the most prevalent drugs-of-abuse and SCs encountered at the New Zealand border in 2017 and included parent compounds and metabolites belonging to the indole and indazole carboxamide, quinolinyl indole carboxylate, and naphthoylindole classifications. Samples were prepared by supported-liquid-extraction (SLE) followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis with positive electrospray ionization (ESI). The method was validated with respect to selectivity, matrix effects, process efficiency, sensitivity, repeatability, extract stability, and carryover for qualitative confirmation. Linearity as well as accuracy and precision data at target decision concentrations were also evaluated. The limits of detection and confirmation ranged from 0.1 to 6.0 ng/mL and 1.0 to 6.0 ng/mL, respectively. The described method was successfully applied to the analysis of 564 ante- and post-mortem blood samples in 2018. There were 132 cases (23%) with positive findings of at least one SC, with the five most commonly detected SCs being AMB-FUBINACA and/or acid (61%), 5F-ADB and/or acid (40%), ADB-FUBINACA (11%), 5F-MDMB-PICA acid (6%), and MDMB-FUBINACA acid (6%). The results also demonstrate the predominant presence of metabolites at higher levels than the unchanged parent SCs in blood, highlighting the need to maintain forensic screening methods capable of the simultaneous detection of both parent compounds and metabolites.

Parents' prenatal joint attachment representations and early caregiving: the indirect role of prenatal marital affect.

This research examined couples' marital affect as a mediator between the couples' combined attachment representations (assessed prenatally) and each of their caregiving quality at 8 months postpartum. We followed 125 couples pregnant with their first child over the transition to parenthood. Prenatally, the Adult Attachment Interview was administered and marital interactions were observed. Parents were categorized in joint attachment pairs: secure/secure, secure mother/insecure father, secure father/insecure mother, and insecure/insecure. Caregiving in dyadic parent-infant interactions was observed at home, 8 months postpartum. Results indicated the secure/secure pairing displayed the most positive marital affect overall and predicted higher sensitivity in both mothers and fathers compared to parents in secure mother/insecure father pairs. Indirect effects indicate marital affect mediated the relations between joint attachment pairs and caregiving. Findings suggest that joint attachment pairs relate to prenatal marital quality, which in turn spills over to predict each parent's later caregiving quality.

The Effect of Lowering the Legal Drink-Drive Limit on the Toxicological Findings in Driver Fatalities: A Comparison of Two Jurisdictions.

In December 2014, the legal blood alcohol limit for drivers in both Scotland and New Zealand was reduced from 80 to 50 mg/100 mL. This paper reports a retrospective study comparing changes in the toxicological findings in deceased drivers and motorcyclists before and after the limit change in both jurisdictions. A year of fatal motor vehicle crashes prior to and following the limit change is examined for both countries. In Scotland, there was an increase in drug prevalence among fatally injured drivers and motorcyclists, with the use of all drug groups increasing after the limit change, with the exception of cannabinoids. In New Zealand, there was a reduction in cases involving drugs only, but increases in the numbers of deceased drivers and motorcyclists positive for alcohol only and co-using alcohol and drugs.

The culpability of drivers killed in New Zealand road crashes and their use of alcohol and other drugs.

Over a period of five years, blood samples were taken from 1046 drivers killed as a result of a motor vehicle crash on New Zealand roads. These were analysed for the presence of alcohol and a range of both illicit drugs and psychoactive medicinal drugs. Driver culpability was determined for all crashes. The control group of drug- and alcohol-free drivers comprised 52.2% of the study population. Drivers positive for psychoactive drugs were more likely to be culpable (odds ratio (OR) 3.5, confidence interval (CI) 95% 2.4-5.2) than the control group. Driver culpability exhibited the expected positive association with alcohol use (OR 13.7, 95% CI 4.3-44) and with combined alcohol and cannabis use (OR 6.9, 95% CI 3.0-16). There was only a weak positive association between cannabis use (with no other drug) and culpability (OR 1.3, CI 95% 0.8-2.3). Furthermore, the OR for drivers with blood tetrahydrocannabinol (THC) concentrations greater than 5 ng/mL was lower (OR 1.0, CI 95% 0.4-2.4) than drivers with blood THC concentrations less than 2 ng/mL (OR 3.1, CI 95% 0.9-10). This is inconsistent with results reported by other studies where a significant increase in crash risk was found with blood THC levels greater than 5 ng/mL. In this study, there were very few drivers who had used a single drug, other than cannabis or alcohol. Therefore, from this study, it is not possible to comment on any relationship between opioid, stimulant or sedative drug use and an increased risk of being killed in a crash for the drivers using these drugs. The results from a multivariate analysis indicate that driver gender, age group and licence status, (P=0.022, P=0.016, P=0.026, respectively), the type of vehicle being driven (P=0.013), the number of vehicles in the crash (P<0.001), the blood alcohol concentration of the driver (P<0.001) and the use of any drug other than alcohol and cannabis (P=0.044), are all independently associated with culpability.

The incidence of alcohol and other drugs in drivers killed in New Zealand road crashes 2004-2009.

Alcohol is a drug known to impair the ability to drive safely and is acknowledged as a major factor in New Zealand road crashes. However, the use of other impairing drugs by New Zealand drivers is largely unknown. This paper reports the prevalence of drug use by drivers killed on New Zealand roads. As this is a biased population sample the results can only indicate possible drug use in the wider driving population. Blood samples taken from 1046 deceased drivers were analysed for the presence of alcohol and a range of both illicit drugs and psychoactive medicinal drugs. Five hundred and forty-six (52%) of these drivers had not used alcohol or other potentially impairing drugs. Five hundred (48%) had alcohol and/or other drugs in their blood that may have impaired their ability to drive safely. Of these 500 drivers, 135 had used alcohol alone, 96 had used cannabis alone and 142 had used a combination of alcohol and cannabis, but no other drug. Alcohol concentrations in 351 drivers who had drunk alcohol ranged from 5 to 354 mg per 100 mL (mean 152 mg/100 mL). Levels of tetrahydrocannabinol (THC) in the blood of the 314 drivers who had used cannabis ranged from approximately 0.1 ng/mL to 44 ng/mL (mean 5.6 ng/mL). There were 127 drivers who had used some other combination of drugs, many still including alcohol and/or cannabis. Only 29 of the 500 drivers who had used a drug, had not used either cannabis or alcohol and 240 (48%) of the 500 drivers had used more than one potentially impairing drug.

The results of an experimental indoor hydroponic Cannabis growing study, using the 'Screen of Green' (ScrOG) method-Yield, tetrahydrocannabinol (THC) and DNA analysis.

The results of an indoor hydroponic Cannabis growth study are presented. It is intended that this work will be of assistance to those with an interest in determining an estimation of yield and value of Cannabis crops. Three cycles of six plants were grown over a period of 1 year in order to ascertain the potential yield of female flowering head material from such an operation. The cultivation methods used were selected to replicate typical indoor hydroponic Cannabis growing operations, such as are commonly encountered by the New Zealand Police. The plants were also tested to ascertain the percentage of the psychoactive chemical Δ-9 tetrahydrocannabinol (THC) present in the flowering head material, and were genetically profiled by STR analysis. Phenotypic observations are related to the data collected. The inexperience of the growers was evidenced by different problems encountered in each of the three cycles, each of which would be expected to negatively impact the yield and THC data obtained. These data are therefore considered to be conservative. The most successful cycle yielded an average of 881g (31.1oz) of dry, groomed female flowering head per plant, and over the whole study the 18 plants yielded a total of 12,360g (436.0oz), or an average of 687g (24.2oz) of dry head per plant. THC data shows significant intra-plant variation and also demonstrates inter-varietal variation. THC values for individual plants ranged from 4.3 to 25.2%. The findings of this study and a separate ESR research project illustrate that the potency of Cannabis grown in New Zealand has dramatically increased in recent years. DNA analysis distinguished distinct groups in general agreement with the phenotypic variation observed. One plant however, exhibiting a unique triallelic pattern at two of the five loci tested, while remaining phenotypically indistinguishable from three other plants within the same grow.