Detection of cannabinoids in urine is subject to both physiological and pharmacological influences, including individual metabolism, hydration, frequency, concentration, and quantity of cannabis used. Frequent cannabis users may submit positive urine samples for extended periods of time beyond initial abstinence, a particularly challenging issue in cannabis cessation clinical trials.
Using a combination of self-reported cannabis abstinence with urine testing for cannabinoids concentrations in a clinical trials setting may improve accuracy, but this has not been well characterized.
In an effort to remedy that, this study assessed the agreement between various cannabinoid cutoffs and self-reported abstinence across three clinical trials, one including contingency management for abstinence (CTN-0053).
All three trials included both participant self-report and weekly urine samples for cannabis and creatinine concentration measurements. Four hundred and seventy-three participants with 3787 valid urine specimens were included. Data were assessed for agreement between self-reported 7+day abstinence and urine cannabinoid tests, using biological cutoffs of 50, 100, and 200ng/mL of THCCOOH (metabolized THC excreted in urine). Changes in creatinine-normalized THCCOOH (25%/50% decrease) were also evaluated.
Results found that:
Funding for this Addiction Science Made Easy project is provided by the Addiction Technology Transfer Center National Office, under the cooperative agreement from the Center for Substance Abuse Treatment of SAMHSA.
Articles were written based on the following published research:
Baker NL, et al. Biological Correlates of Self-Reported New and Continued Abstinence in Cannabis Cessation Treatment Clinical Trials. Drug and Alcohol Dependence 2018;178:270-277.