Amphetamine, methamphetamine, MDA and MDMA have been detected in oral fluid. The analytical methods include immunoassays (58), GC-MS (59), LC with fluorescent detector (60) and LC-MS (61,62). Gunnar et al. (63) described a solid-phase extraction, long-column fast gas chromatography/electron impact mass spectrometry method for simultaneous determination of 30 drugs of abuse including amphetamines, opiates, methadone, cocaine, alprazolam, midazolam, fentanyl and Zolpidem. Amphetamine-type stimulant drugs were acylated with heptafluo-robutyric anhydride; benzodiazepines and THC were silylated with N-methyl-N-(tert-butyldimethylsilyl)-trifluoroacetamide; and benzoylecgonine, codeine, ethylmor-phine, 6-MAM, morphine, pholcodine, buprenorphine and norbuprenorphine were derivatized with N-methyl-N-(trimethylsilyl)trifluoroacetamide. The concentration of amphetamine in oral fluid is generally comparable to whole blood, and d-amphetamine is eliminated faster than l-amphetamine.

In another study using human volunteers who received four doses of 10 and/or 20 mg S-(+)-methamphetamine within 7 days, oral fluid methamphetamine concentrations were higher than plasma methamphetamine concentrations. Average area under the curve (AUC), for the 24-h time period for oral fluid, was on average 3.8 times higher than the plasma AUC. Disposition of methamphetamine in oral fluid was dose related, though there was high intra- and inter-individual variability (64)

SAMHSA-proposed guidelines provide cutoff values for amphetamine, metham-phetamine, MDMA, MDA and MDEA. Like urine, these guidelines require the presence of amphetamine on methamphetamine-positive samples (3).

Drug Addiction Report

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