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Citation
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Kintz P, Ameline A, Eibel A, Geraut A, Farrugia A, Berthelon L, Raul JS. Curr. Pharm. Biotechnol. 2017; 18(10): 791-795. |
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Abstract
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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 ∆9-tetrahydrocannabinol (THC), cannabinol (CBN) and cannabidiol (CBD) in cannabis smoke, the identification of the metabolite, 11-nor-∆9-tetrahydrocannabinol carboxylic acid (THC-COOH) has been considered to allow the discrimination of active use.
OBJECTIVE: Whereas the detection of drugs in a child's hair unambiguously shows drug handling in the environment of the child, it is difficult to distinguish between systemic incorporation into hair after ingestion or inhalation and external deposition into hair from smoke, dust, or contaminated surfaces. However, the interpretation is particularly important in case of children for a realistic assessment of the health risk. We present here a series of hair tests for cannabis where the interpretation was 2 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 low, down to 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: It is very difficult to put any window of detection when testing for drugs in young children. It has also been demonstrated that drugs can be incorporated during pregnancy in the hair of the foetus, which can contribute to the positive findings after delivery. Hair from children is finer and more porous in comparison with adult (risk of higher contamination by sweat and environmental smoke versus adults). The final interpretation of cannabinoid findings in the children' hair is very complicated as this can result from in utero exposure (although none of the mother admitted cannabis use during pregnancy), cannabis oral administration by the parents to obtain 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. Active scientists have the responsibility to inform about these limitations.
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Language: en |