MDMA and metabolite disposition in expectorated oral fluid after controlled oral MDMA administration.
Study Goal
The researchers aimed to characterize the detection windows of MDMA and its metabolites in oral fluid after controlled administration to inform drug testing programs.
Results Summary
MDMA was the primary analyte detected in oral fluid, with detection windows up to 71 hours, while its metabolite MDA was detected up to 47 hours. The study found that oral fluid monitoring effectively detects single recreational MDMA use for 1-2 days.
Population
29 healthy adults with histories of MDMA use.
Effective Dosage
Low (1.0 mg/kg) and high (1.6 mg/kg) oral doses.
Duration
Specimens collected up to 7 days after dosing.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
oral MDMA administration (1.0 mg/kg) | increase | MDMA in expectorated oral fluid | 29 healthy adults with histories of MDMA use | concentrations up to 12,000 ng/mL | detected | #1 |
oral MDMA administration (1.6 mg/kg) | increase | MDMA in expectorated oral fluid | 29 healthy adults with histories of MDMA use | concentrations up to 12,000 ng/mL | detected | #2 |
oral MDMA administration | increase | MDA (3,4-methylenedioxyamphetamine) in expectorated oral fluid | 29 healthy adults with histories of MDMA use | concentrations <403 ng/mL | detected | #3 |
oral MDMA administration | no change | HMA (4-hydroxy-3-methoxyamphetamine) in expectorated oral fluid | 29 healthy adults with histories of MDMA use | - | not detected | #4 |
oral MDMA administration | no change | HMMA (4-hydroxy-3-methoxymethamphetamine) in expectorated oral fluid | 29 healthy adults with histories of MDMA use | - | not detected | #5 |
oral MDMA administration | increase | MDMA oral fluid test at Talloires cutoff (20 ng/mL) | 29 healthy adults with histories of MDMA use | 59.8% of specimens | positive | #6 |
oral MDMA administration | increase | MDMA oral fluid test at Driving under the Influence of Drugs, Alcohol, and Medicines cutoff (25 ng/mL) | 29 healthy adults with histories of MDMA use | 58.6% of specimens | positive | #7 |
oral MDMA administration | increase | MDMA oral fluid test at proposed US Substance Abuse and Mental Health Services Administration cutoff (50 ng/mL) | 29 healthy adults with histories of MDMA use | 54.9% of specimens | positive | #8 |
oral MDMA administration | increase | MDMA in oral fluid | 29 healthy adults with histories of MDMA use | 0.25-1.25 hours after dosing | first observed | #9 |
oral MDMA administration | increase | MDA in oral fluid | 29 healthy adults with histories of MDMA use | 0.5-1.75 hours after dosing | initially detected | #10 |
oral MDMA administration | increase | MDMA window of detection in oral fluid | 29 healthy adults with histories of MDMA use | 47 hours (up to 71 hours) | detected | #11 |
oral MDMA administration | increase | MDA window of detection in oral fluid | 29 healthy adults with histories of MDMA use | 29 hours (up to 47 hours) | detected | #12 |
oral fluid monitoring | increase | single, recreational 70-150 mg of MDMA use | - | for 1-2 days | efficiently detects | #13 |
INTRODUCTION: The use of 3,4-methylenedioxymethamphetamine (MDMA) is increasing, enhancing the need for its detection in clinical, workplace, pain management, and driving under the influence of drugs testing programs. Oral fluid is an important alternative matrix for drug testing, but little is known about MDMA detection windows in oral fluid. AIMS: The aim was to characterize MDMA and metabolite disposition in expectorated oral fluid after controlled MDMA administration. METHODS: Placebo, low (1.0 mg/kg), and high (1.6 mg/kg) oral MDMA doses were given double-blind in random order in separate sessions to 29 healthy adults with histories of MDMA use. One thousand two hundred eighty-six expectorated oral fluid specimens collected up to 7 days after dosing were analyzed for MDMA, 3,4-methylenedioxyamphetamine (MDA), 4-hydroxy-3-methoxymethamphetamine (HMMA), and 4-hydroxy-3-methoxyamphetamine (HMA) by gas chromatography mass spectrometry. The limits of quantification were 5 ng/mL for MDMA and MDA and 10 ng/mL for HMA and HMMA. RESULTS: MDMA was the primary analyte detected, with concentrations up to 12,000 ng/mL in 872 specimens (67.8%). MDA was quantified in 656 specimens (51.0%) at concentrations <403 ng/mL and was never present without concurrent MDMA. HMA and HMMA were not detected. Of the specimens, 59.8%, 58.6%, and 54.9% were found to be MDMA positive at the Talloires (20 ng/mL), Driving under the Influence of Drugs, Alcohol, and Medicines (25 ng/mL) and proposed US Substance Abuse and Mental Health Services Administration (50 ng/mL) confirmation cutoffs, respectively. MDMA was first observed in oral fluid 0.25-1.25 hours after dosing; MDA was initially detected at 0.5-1.75 hours. In general, the windows of detection for MDMA and MDA were 47 and 29 hours, respectively, although a few specimens were positive up to 71 and 47 hours. CONCLUSIONS: Oral fluid monitoring efficiently detects single, recreational 70-150 mg of MDMA use for 1-2 days. These controlled administration data provide a scientific basis for interpreting MDMA oral fluid test results.