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Implications of drug levels in body fluids: basic concepts.

C N Chiang, R L Hawks

    NIDA Research Monograph
    |January 1, 1986
    PubMed
    Summary

    Measuring drug concentrations in blood or urine is complex. Individual variations and other factors limit the ability to accurately predict drug impairment or time of use from these measurements.

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    Area of Science:

    • Pharmacology
    • Toxicology
    • Forensic Science

    Background:

    • Drug concentrations in biological fluids are influenced by dose, administration route, usage patterns, and drug disposition kinetics (distribution, metabolism, excretion).
    • Blood drug concentration is a key indicator for potential behavioral effects like driving impairment or psychological highs due to drug distribution via circulation.

    Purpose of the Study:

    • To evaluate the utility of biological fluid drug concentrations for predicting drug impairment and time of use.
    • To identify limitations in interpreting drug concentrations in plasma and urine for forensic and clinical purposes.

    Main Methods:

    • Review of factors affecting drug concentrations in biological fluids.
    • Analysis of pharmacokinetic and pharmacodynamic variability in drug response.
    • Consideration of complicating factors in urinalysis, such as urine flow and pH.

    Main Results:

    • Plasma drug concentrations are not reliably established for estimating impairment due to significant individual pharmacokinetic and pharmacodynamic variations.
    • Urine drug concentrations are further complicated by factors like urine flow and pH, limiting precise interpretation.
    • Quantitation of specific drugs in forensic samples has limited ability to predict exact time of use or impairment, except within broad ranges.

    Conclusions:

    • Interpreting biological fluid drug concentrations for impairment or time of use is challenging due to inherent biological variability and external factors.
    • Current methods for measuring drug concentrations in plasma and urine have significant limitations for precise forensic interpretation.
    • Further research is needed to establish reliable correlations between drug concentrations and functional impairment or precise timing of drug intake.

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