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Saliva test to detect GHB and alcohol poisonings

13 January, 2016
Novel saliva test could detect alcohol poisonings, ‘date rape’ drug. By Honor Whiteman. medicalnewstoday.com. January 11,  2016. There has been a dramatic rise in the number of alcohol-related emergency department visits in the US in recent years. But often, doctors find it challenging to quickly determine whether a patient’s symptoms are solely caused by too much alcohol or whether other drugs are involved. Now, researchers may have found a solution to this problem in the form of a saliva test.
Saliva test to detect GHB and alcohol poisonings
[A drunk woman]Researchers say their saliva test can detect toxic compounds often found in cheap and imitation alcohol, as well as the ‘date rape’ drug GHB.Paul Thomas, professor of analytical science at Loughborough University in the UK, and colleagues say their test could be used to detect toxic chemicals commonly found in cheap or fake alcohol, as well as the "date rape" drug γ-hydroxybutyric acid, or GHB.
They publish the details of their new creation in the Journal of Breath Research.
According to the Centers for Disease Control and Prevention (CDC), the number of alcohol-related visits to emergency departments in the US rose by 38% in men and women from 2001-2002 and 2009-2010.
But increasingly, clinicians are finding that it is not always simply excessive alcohol use that is the root cause of these visits, but the presence of other compounds that the patient is often unaware they have ingested.
Patients may have consumed drinks contaminated with other types of alcohol other than ethanol, such as methanol or ethylene glycol; these are often found in cheap and imitation beverages, and their effects can be fatal.
GHB – a common "date rape" drug – is another drug that is often unintentionally ingested; it is potent and has no color, taste or smell, so most people are unaware if it has been slipped into their drink.
GHB can cause loss of consciousness, drowsiness, relaxation, temporary memory loss and seizures, among numerous other effects. It takes around 15 minutes for the drug to start working, and the effects can last around 3-4 hours.
Toxic compounds isolated from salivaAt present, only blood tests can identify the presence of these toxic compounds in clinical settings, which can lead to delays in diagnosis and prevent effective treatment.
"Other complications arise when intoxication from sedatives, such as GHB taken intentionally or through malicious administration, is mistaken for ethanol abuse or, more seriously, is masked by ethanol consumption," note the authors.
As such, the researchers say there is a need for a faster, point-of-care screening strategy for the detection of methanol, ethanol, ethylene glycol, propan 1,3 glycol – another toxic compound found in cheap or fake alcohol – and GHB.
With this in mind, Thomas and colleagues – including researchers from the University of Cordoba in Spain – developed a test that they say can rapidly detect these chemicals in saliva.
The team added methanol, ethanol, ethylene glycol, propan 1,3 glycol and γ-hydroxybutyric acid to the fresh saliva of three participants. "It was particularly challenging stabilizing concentrations low enough to be realistic simulations of what you’d expect to find clinically," notes Thomas.
"But we’ve managed to make some sensitive measurements – which is quite pleasing as saliva is a particularly complicated material to work with due to the presence of bacteria and their metabolites from the mouth, and ammonia at high enough levels to change the chemistry of the measurement system unless carefully managed."
Next, the researchers used an oral sampler to extract the compounds, which were successfully identified using a technique called gas chromatography-differential mobility spectrometry.
"We were surprised at the ease at which we could detect γ-hydroxybutyric acid," notes Thomas. "It’s both a polar and acidic molecule – but it turned out to be easy to detect, even at the low concentrations we were studying."
Based on their findings, the team believes they are on the verge of a simple test clinicians can use to quickly identify toxic compounds among patients who present to emergency departments with suspected excessive alcohol use.
Thomas adds:
"We’re aiming to develop a test that is as simple as taking temperature with a thermometer that detects when patients are more than just drunk.
I think this is a very exciting area of research and in the next few years there will be a host of simple tests on breath, skin and saliva that will aid with diagnosis in hospitals."
Last month, Medical News Today reported on a study published in PLOS One in which researchers suggest future health risks could be identified with a simple saliva test.Written by Honor Whiteman
Fast facts about alcohol use
  • Between 2006-2010, excessive alcohol use was responsible for more than 88,000 deaths in the US
  • In 2010, the economic costs of excessive alcohol use were estimated at $249 billion
  • Moderate drinking is defined as no more than one drink per day for women and no more than two drinks per day for men.
The health risks of heavy drinking
Journal reference: L Criado-García1, D M Ruszkiewicz, G A Eiceman and C L P Thomas. A rapid and non-invasive method to determine toxic levels of alcohols and γ-hydroxybutyric acid in saliva samples by gas chromatography–differential mobility spectrometry. Published 8 January 2016 • © 2016 IOP Publishing Ltd • Journal of Breath Research, Volume 10, Number 1

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