Emerging Detection of Hexahydrocannabinol in Driver Saliva: Preliminary Data.

Introduction: Hexahydrocannabinol or HHC has recently appeared on the Internet and in cannabidiol (CBD) stores in various forms. Although the abuse and dependence potential of HHC consumption has not yet been established, HHC has been reported by consumers to have effects similar to delta-9-tetrahydrocannabinol (THC) and has been classified as narcotics in France since June 12, 2023.

Methods: We conducted a retrospective study of all cases of oral fluid samples collected from drivers by traffic police officers and sent to our laboratory to confirm the presence of illicit substances between June 12, 2023 and December 31, 2023. The presence of 33 psychoactive substances, including HHC, THC, and CBD, in the oral fluid samples was assessed by an ultra-high performance liquid chromatography system coupled to a triple quadrupole mass spectrometer.

Results: Of the 867 oral fluid samples analyzed, 16 were positive for HHC and involved only male drivers aged between 19 and 58. The mean and median HHC concentrations found in oral fluid were 35 ± 69 ng/mL and 10 ng/mL, respectively. In these preliminary data, HHC was always associated with THC, but the THC/HHC and CBD/HHC ratios were very broad. Although the kinetics of HHC and THC in saliva are different, the 11 cases with the highest THC/HHC ratios (>300) support that impaired alertness in drivers may be mainly due to THC. In these 11 cases, a linear correlation was found between THC and HHC concentrations in oral fluid.

Conclusion: Further large-scale studies are required to extend these preliminary data, but the emerging detection of HHC in oral fluid of drivers may illustrate its spreading use in the general population.