1. THCA in Head Hair: A Comparison with Fingernail

2. Conflict of Interest  Employees of USDTL Privately held company Commercial laboratory Sells hair testing services Internally funded No role in: Study design Data collection Analysis publication

3.  Marijuana usage trends  THCA in hair and nail  Validation w 10 fg/mg LOD  Comparison hair and nail  Conclusions OBJECTIVES

4.  Most common illicit drug  2010-17.4 M past month users  2009 factor 376k ED visits Trends of Marijuana Use

5. Trends of Marijuana Use 23 States and DC Legalized Medical use Decriminalized Both

6. Trends of Marijuana Use Daily use 12 th graders 6.5% from 5.1% in 2007 12 th graders negative perception of regular use 44.1%, lowest since 1979

7. What Do We Look For? THCTHCA

8. Detection Windows

9. #1 ENVIRONMENTAL EXPOSURE SMOKE TRANSFERANCE CONTACT FUMES HOW DO DRUGS GET INTO THE HAIR?

10. #2 SWEAT AND OIL THESE DRUG AND METABOLITE CONTAINING FLUIDS BATHE THE HAIR SHAFT

11. HOW DO DRUGS GET INTO THE HAIR? #3 THE BLOOD

12. Specimen Type: Why Fingernail?

13. Anatomy of Fingernail NAIL MATRIX NAIL PLATE NAIL BED

14. Fingernails Are Made of Keratin o Keratin: fibrous structural protein of hair, nails, horn, hoofs, wool, feathers, and of the epithelial cells in the outermost layers of the skin. The polypeptide chains of keratin are arranged in parallel sheets held together by hydrogen bonding. ~ Encyclopedia Britannica

15. Fingernails Are Made of Keratin o These keratin sheets stack on top of each other, giving the nail thickness and length, making adulteration of the specimen difficult.

16. Incorporation of Drug Biomarker: a measurable substance whose presence is indicative of ingestion or exposure to substances of abuse (SOA).

17. NAIL MATRIX NAIL BED o Biomarkers can be found in nails as early as 1-2 weeks after substances of abuse are ingested. o The time period during which drug ingestion can be detected depends on the substance used, the amount used, and personal metabolism. Biomarker Absorption

18.  Single point Calibrator – 50 fg/mg  LOQ – 20 fg/mg  LOD – 10 fg/mg  ULOL – 1000 fg/mg  Controls 20, 62.5, and 400 fg/mg  Robust – minimum 22 consecutive days THCA Validation Specs

19.  LOD 10 fg/mg  LOQ 20 fg/mg  ULOL 500 fg/mg  Imprecision < 13.5%  Bias < 13.8%  Stable THCA Validation Results

20.  1000 fg = 1 pg  1000 pg = 1 ng What is a Femtogram

21. THCA Low Control

22. The Collection of Specimen  NIAAA – 1 R44 AA016463-02 (Phase II)  UW- Milwaukee- CABHR  De-identified Remnants

23. POSITIVITY RATE THCA HAIR/NAIL

24. MEAN CONCENTRATIONS THCA HAIR/NAIL Paired Sample t-Test Difference 1449.2 +/- 745.3 t = 1.944, df = 59, P < 0.05

25. 60 Matched Pairs of Hair and Nail

26. LIMITATIONS  Accurate self-report  Verified dose administration  Demographics  Prevalence not generalizable  Personal hygiene  Cosmetic treatment

27. Published Results

28. CONCLUSION  Method is very sensitive & robust  Nail is a suitable alternative  [THCA] hair/nail strongly associated  Slightly higher positivity rate in nail  [THCA] up to 5x higher

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