Pharmacokinetics and drug impairment

Pharmacokinetics describes what happens to a drug after it is administered throughout its distribution and metabolism within the body until it is finally eliminated from the body. This knowledge is essential in pharmacology, and vitally important to a forensic toxicology lab. Our laboratory performs analyses mainly in blood, urine and hair.

Drug impairment is a deterioration of physical and/or mental functions caused by medical, recreational or illegal drugs. Knowledge and research on the topic, especially on drug impaired driving, is important for the interpretation of drug findings in biological samples.

In the Forensic Toxicology and Pharmacology of Drugs of Abuse research group we perform research related to both topics.

In 2012 Norway introduced legal limits for driving under the influence of non-alcohol drugs. Research specifically aimed to provide further information on all aspects of impaired driving is performed. This includes research based on data from routine work. We annually perform analysis in more than 9,000 samples collected from apprehended drivers.

Photo: Pixabay

Ongoing projects

Relation between blood concentrations of stimulant drugs compared to results from a clinical test of impairment
Sensitivity and specificity of a clinical test of impairment in detecting presence of stimulating drugs at different concentration levels
THC-acid in hair
Detection of opioids in oral fluid and urine after intake of poppy seeds

Past projects

Elimination of THC in two consecutive samples in drugged drivers
Therapeutic drug monitoring (TDM) of oxycodone
Amphetamine use and nystagmus
Zopiclone elimination in drugged drivers

Collaboration

Professor Siri Leknes, UiO: Oxycodone and psychomotor impairment
St. Olavs Hospital, Trondheim
Fürst laboratory, Oslo, Norway

If you have questions about the projects or suggestions for research collaboration, please contact: Dr. Maren Strand (macest@ous-hf.no) at the Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.

Publications

Chalabianloo F, Fadnes LT, Johansson KA, Høiseth G, Vold JH, Kringen MK, Spigset O, Bramness JG (2023)
Methadone pharmacokinetics in opioid agonist treatment: Influencing factors and clinical implications
Basic Clin Pharmacol Toxicol (in press)
DOI 10.1111/bcpt.13975, PubMed 38124280

Holman POS, Høiseth G, Bachs L, Thaulow CH, Vevelstad MS, Mørland J, Strand MC (2023)
A two-sample approach to retrograde extrapolation of blood THC concentrations - Is it feasible?
Forensic Sci Int, 352, 111833
DOI 10.1016/j.forsciint.2023.111833, PubMed 37793282

Strand MC, Bleka Ø, Kristoffersen L, Høiseth G (2023)
Driving under the influence of zopiclone: Elimination between two consecutive blood samples
Forensic Sci Int, 349, 111764
DOI 10.1016/j.forsciint.2023.111764, PubMed 37352736

Strand MC, Gjerde H, Høiseth G (2023)
Nystagmus among suspected amphetamine impaired drivers
J Forensic Leg Med, 95, 102502
DOI 10.1016/j.jflm.2023.102502, PubMed 36924680

Thaulow CH, Helland A, Kongsgaard UE, Høiseth G (2023)
Oxycodone, Morphine, and Fentanyl in Patients With Chronic Pain: Proposal of Dose-Specific Concentration Ranges
Ther Drug Monit, 45 (6), 777-785
DOI 10.1097/FTD.0000000000001112, PubMed 37296504

Chalabianloo F, Høiseth G, Vold JH, Johansson KA, Kringen MK, Dalgard O, Ohldieck C, Druckrey-Fiskaaen KT, Aas C, Løberg EM, Bramness JG, Fadnes LT (2022).
Impact of liver fibrosis and clinical characteristics on dose-adjusted serum methadone concentrations
J Addict Dis, 1-11 (in press). DOI 10.1080/10550887.2022.2057140, PubMed 35356868

Øiestad EL, Krabseth HM, Huestis MA, Skulberg A, Vindenes V (2019)
Interpreting oral fluid drug results in prisoners: monitoring current drug intake and detection times for drugs self-administered prior to detention
Forensic Toxicol., 37 (1), 59-74
DOI 1007/s11419-018-0434-9

Fosen JT, Mørland J, Høiseth G (2020)
The Relationship Between Ingested Dose of Ethanol and Amount of Ethyl Glucuronide Formed in Blood
J Anal Toxicol, 44 (8), 861-863
DOI 1093/jat/bkaa090, PubMed 32743665

Heide G, Høiseth G, Middelkoop G, Øiestad ÅML (2020)
Blood Concentrations of Designer Benzodiazepines: Relation to Impairment and Findings in Forensic Cases
J Anal Toxicol, 44 (8), 905-914
DOI 1093/jat/bkaa043, PubMed 32369173

Høiseth G, Hjelmeland K, Mørland J (2020)
A comparison of driving related skills impaired by ethanol and zopiclone
Traffic Inj Prev, 22 (1), 26-31
DOI 1080/15389588.2020.1849643, PubMed 33320019

Waade RB, Solhaug V, Høiseth G (2020)
Impact of CYP2D6 on serum concentrations of flupentixol, haloperidol, perphenazine and zuclopenthixol
Br J Clin Pharmacol, 87 (5), 2228-2235
DOI 1111/bcp.14626, PubMed 33118660

Årnes M, Bachs L, Sammarai MA, Jones AW, Høiseth G (2020)
Rate of elimination of γ-hydroxybutyrate from blood determined by analysis of two consecutive samples from apprehended drivers in Norway
Forensic Sci Int, 314, 110374
DOI 1016/j.forsciint.2020.110374, PubMed 32604006

Bruun LD, Kjeldstadli K, Temte V, Birdal M, Bachs L, Langødegård M, Strand DH, Gaare KI, Øiestad E, Høiseth G (2019)
Detection Time of Oxazepam and Zopiclone in Urine and Oral Fluid after Experimental Oral Dosing
J Anal Toxicol, 43 (5), 369-377
DOI 1093/jat/bky083, PubMed 30615130

Gjerde H, Ramaekers JG, Mørland JG (2019)
Methodologies for establishing the relationship between alcohol/drug use and driving impairment - Differences between epidemiological, experimental, and real-case studies
Forensic Sci Rev, 31 (2), 141-160
PubMed 31270059

Oiestad EL, Krabseth HM, Huestis MA, Skulberg A, Vindenes V (2019)
Interpreting oral fluid drug results in prisoners: monitoring current drug intake and detection times for drugs self-administered prior to detention
Forensic Toxicol., 37 (1), 59-74
DOI 1007/s11419-018-0434-9

Strand MC, Ramaekers JG, Gjerde H, Mørland J, Vindenes V (2019)
Pharmacokinetics of Single Doses of Methadone and Buprenorphine in Blood and Oral Fluid in Healthy Volunteers and Correlation With Effects on Psychomotor and Cognitive Functions
J Clin Psychopharmacol, 39 (5), 489-493
DOI 1097/JCP.0000000000001077, PubMed 31305338

Temte V, Kjeldstadli K, Bruun LD, Birdal M, Bachs L, Karinen R, Middelkoop G, Øiestad E, Høiseth G (2019)
An Experimental Study of Diazepam and Alprazolam Kinetics in Urine and Oral Fluid Following Single Oral Doses
J Anal Toxicol, 43 (2), 104-111
DOI 1093/jat/bky062, PubMed 30517712

Tveito M, Molden E, Høiseth G, Correll CU, Smith RL (2019)
Impact of age and CYP2D6 genetics on exposure of aripiprazole and dehydroaripiprazole in patients using long-acting injectable versus oral formulation: relevance of poor and intermediate metabolizer status
Eur J Clin Pharmacol, 76 (1), 41-49
DOI 1007/s00228-019-02768-0, PubMed 31637453

Tveito M, Smith RL, Høiseth G, Molden E (2019)
The Effect of Valproic Acid on Olanzapine Serum Concentration: A Study Including 2791 Patients Treated With Olanzapine Tablets or Long-Acting Injections
J Clin Psychopharmacol, 39 (6), 561-566
DOI 1097/JCP.0000000000001126, PubMed 31688390

Strand MC, Vindenes V, Gjerde H, Mørland JG, Ramaekers JG (2018)
A clinical trial on the acute effects of methadone and buprenorphine on actual driving and cognitive function of healthy volunteers
Br J Clin Pharmacol, 85 (2), 442-453
DOI 1111/bcp.13818, PubMed 30515857

Fosen JT, Morini L, Sempio C, Giarratana N, Enger A, Mørland J, Høiseth G (2017)
Ethyl Glucuronide Elimination Kinetics in Fingernails and Comparison to Levels in Hair
Alcohol Alcohol, 52 (5), 580-586
DOI 1093/alcalc/agx035, PubMed 28591773

Havig SM, Høiseth G, Strand MC, Karinen RA, Brochmann GW, Strand DH, Bachs L, Vindenes V (2017)
THC and CBD in blood samples and seizures in Norway: Does CBD affect THC-induced impairment in apprehended subjects?
Forensic Sci Int, 276, 12-17
DOI 1016/j.forsciint.2017.04.006, PubMed 28463706

Hjelmeland K, Gustavsen I, Øiestad EL, Øiestad ÅML, Høiseth G, Mørland J (2017)
Zopiclone concentrations in oral fluid and blood after, administration of therapeutic doses of zopiclone
Forensic Sci Int, 278, 177-183
DOI 1016/j.forsciint.2017.07.004, PubMed 28735217

Kringen MK, Chalabianloo F, Bernard JP, Bramness JG, Molden E, Høiseth G (2017)
Combined Effect of CYP2B6 Genotype and Other Candidate Genes on a Steady-State Serum Concentration of Methadone in Opioid Maintenance Treatment
Ther Drug Monit, 39 (5), 550-555
DOI 1097/FTD.0000000000000437, PubMed 28723731

Strand MC, Arnestad M, Fjeld B, Mørland J(2017)
Acute impairing effects of morphine related to driving: A systematic review of experimental studies to define blood morphine concentrations related to impairment in opioid-naïve subjects
Traffic Inj Prev, 18 (8), 788-794
DOI 1080/15389588.2017.1326595, PubMed 28481682

Strand MC, Mørland J, Slørdal L, Riedel B, Innerdal C, Aamo T, Mathisrud G, Vindenes V (2017)
Conversion factors for assessment of driving impairment after exposure to multiple benzodiazepines/z-hypnotics or opioids
Forensic Sci Int, 281, 29-36
DOI 1016/j.forsciint.2017.10.022, PubMed 29101905

Vevelstad M, Øiestad EL, Nerem E, Arnestad M, Bogen IL (2017)
Studies on Para-Methoxymethamphetamine (PMMA) Metabolite Pattern and Influence of CYP2D6 Genetics in Human Liver Microsomes and Authentic Samples from Fatal PMMA Intoxications
Drug Metab Dispos, 45 (12), 1326-1335
DOI 1124/dmd.117.077263, PubMed 28978661