A Comparative Study of Screening Instruments and Biomarkers for the Detection of Cannabis Use. Issue 1 (January 2016)

• Record Type: Journal Article
• Authors: Meersseman, Paulien; Vanhoutte, Simon; Van Damme, Joris; Maes, Lea; Lemmens, Gilbert; Heylens, Gunter; Verstraete, Alain G.
• Is Part Of: Substance abuse. Volume 37:Issue 1(2016)
• Page Start: 176
• Page End: 180
• Publication Date: 2016-01
• Subjects: CAGE-AID -- cannabis use -- ProbCannabis-DT questionnaire -- SDS -- sensitivity -- specificity; Substance abuse -- Periodicals; Medical education -- Periodicals; Education, Medical -- periodicals; Substance Abuse -- periodicals; 362.29
• DOI: 10.1080/08897077.2015.1037947
• Languages: English
• ISSNs: 0889-7077

Abstract

Background: The aim of this study was to compare the usefulness of 3 different screening instruments (questionnaires) for the detection of cannabis use (CU) with biological markers in blood and hair. Methods: Ninety-four students were recruited in October 2013. Participants filled out the Severity of Dependence Scale (SDS), the CAGE-AID ("Cut down Annoyed Guilty Eye-opener"—Adapted to Include Drugs), and ProbCannabis-DT questionnaires concerning their possible CU. Blood and hair samples were taken and analyzed by gas chromatography–mass spectrometry. Logistic regression (Nagelkerke R 2 ) and receiver operating characteristic (ROC) curve analyses were performed. THCCOOH (Δ 9 -tetrahydrocannabinoic acid) plasma of ≥5 ng/mL and THC (Δ 9 -tetrahydrocannabinol) hair concentrations of ≥0.1 and ≥0.02 ng/mg were used as the gold standard for CU. The questionnaire results were compared with different concentration ranges for THCCOOH in plasma (<5, 5–75, and >75 ng/mL, indicating the intensity of use) and THC in hair ( ≥ 0.02 ng/mg, ≥ 0.1 ng/mg). Results: The Nagelkerke R 2 for comparing the SDS, CAGE-AID, and ProbCannabis-DT with THCCOOH in plasma was 0.350, 0.489, and 0.335, respectively. The area under the ROC curve (95% confidence interval) was 0.772 (0.662–0.882), 0.797 (0.710–0.884), and 0.769 (0.669–0.870), respectively. Corresponding sensitivity/specificity were 70%/84%, 100%/59%, and 87%/67%, respectively. These values were similar to those compared to a 0.02 ng/mg THC cutoff in hair. Conclusions: Moderate agreement was found between all questionnaires and biomarkers of CU. The CAGE-AID and probCannabis-DT questionnaires were very sensitive, but less specific. SDS was less sensitive, but more specific.