{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:14:35Z","timestamp":1788329675721,"version":"build-2803163510"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["P30DA01104"],"award-info":[{"award-number":["P30DA01104"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA057289"],"award-info":[{"award-number":["R01DA057289"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA060207"],"award-info":[{"award-number":["R01DA060207"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Forensic Sciences"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Recreational ketamine use and related adverse outcomes have been increasing; however, correct diagnostic classification of quantitative oral fluid test results remains challenging, considering the potential for unintentional exposure to ketamine as an adulterant in other drugs. We surveyed and collected oral fluid from 1819 adults entering nightclubs and compared detection results with past 24\u2010h self\u2010reported ketamine use. Other drug use (based on detection and on self\u2010reported past 24\u2010h use) was considered a risk factor for unintentional ketamine exposure as an adulterant. Oral fluid specimens were analyzed via liquid chromatography quadrupole time\u2010of\u2010flight mass spectrometry. 10.8% of participants reported past 24\u2010h ketamine use, 23.7% tested positive for ketamine (\u2265\u20091\u2009ng\/mL), and 10.9% tested positive for norketamine (\u2265\u20091\u2009ng\/mL). 46.0% tested positive for drugs other than ketamine, primarily cocaine. Among those testing positive for ketamine (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009431), 41.5% reported past 24\u2010h use. Among these cases, the optimal ketamine concentration cut\u2010point for predicting self\u2010report was \u2265\u200918\u2009ng\/mL. In analyses using the full sample (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091819) and a subsample with data on past 48\u2010h use (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009795), optimal cut\u2010points were \u2265\u20092\u2009ng\/mL and \u2265\u20095\u2009ng\/mL, respectively. However, norketamine detection was the strongest predictor of self\u2010reported use across the full sample and subsamples examined. Using self\u2010report as the comparison, norketamine detection most accurately classified reported use; however, relying solely on higher concentration thresholds of ketamine or norketamine detection alone may lead to underdetection in some cases. Findings indicate the importance of carefully selected biological markers and thresholds when interpreting oral fluid results in settings where adulterant exposure is common.\n                  <\/jats:p>","DOI":"10.1111\/1556-4029.70391","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T04:10:16Z","timestamp":1781928616000},"page":"2322-2333","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Differentiating intentional ketamine use from unintentional exposure as an adulterant using oral fluid testing"],"prefix":"10.1111","volume":"71","author":[{"given":"Joseph J.","family":"Palamar","sequence":"first","affiliation":[{"name":"Department of Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1775-1882","authenticated-orcid":false,"given":"Alex J.","family":"Krotulski","sequence":"additional","affiliation":[{"name":"Center for Forensic Science Research and Education Fredric Rieders Family Foundation  Horsham Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Abukahok","sequence":"additional","affiliation":[{"name":"Department of Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Acosta","sequence":"additional","affiliation":[{"name":"Department of Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara E.","family":"Walton","sequence":"additional","affiliation":[{"name":"Center for Forensic Science Research and Education Fredric Rieders Family Foundation  Horsham Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna","family":"Stang","sequence":"additional","affiliation":[{"name":"Center for Forensic Science Research and Education Fredric Rieders Family Foundation  Horsham Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles M.","family":"Cleland","sequence":"additional","affiliation":[{"name":"Department of Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43440\u2010021\u201000232\u20104"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/eja.0000000000000638"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2023.4945"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2025.104825"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2025.101230"},{"key":"e_1_2_10_7_1","unstructured":"ARK Diagnostics I.ARK\u2122 ketamine assay.2023https:\/\/www.ark\u2010tdm.com\/products\/urine\u2010drug\u2010tests\/ketamine\/index.html."},{"key":"e_1_2_10_8_1","unstructured":"EvanCare.KET ketamine rapid test strip\/device (urine\/saliva).2025https:\/\/evancaremed.com\/KET\u2010Ketamine\u2010Rapid\u2010Test\u2010Strip\u2010Device\u2010Urine\u2010Saliva\u2010PG7239764."},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2018.03.004"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2024.112467"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2023.2273770"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2013.05.009"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/avj.12676"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2016.03.010"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forc.2019.100184"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2026.2640486"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm\u20102024\u20100242"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.26\u201000031"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2015.12.004"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2014.12.030"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchromb.2007.02.005"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/34.3.149"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bks006"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2004.11.024"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2006.09.001"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/1478601x.2019.1664506"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1875\u20109114.2011.01089.x"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.202000388"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2023.104001"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2021.2010253"},{"key":"e_1_2_10_31_1","volume-title":"Results from the 2022 National Survey on drug use and health: detailed tables","author":"Center for Behavioral Health Statistics and Quality","year":"2023"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12982"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007691\u2010200404000\u201000020"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchemneu.2017.06.001"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010024\u201018459\u20100"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/dta.1610"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2025.112792"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bkt054"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/1556\u20104029.14184"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(1950)3:1<32::aid\u2010cncr2820030106>3.0.co;2\u20103"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57050503"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1198\/106186006X133933"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.5555\/2789272.2912120"},{"issue":"3","key":"e_1_2_10_45_1","first-page":"18","article-title":"Classification and regression by randomForest","volume":"2","author":"Liaw A","year":"2002","journal-title":"R News"},{"key":"e_1_2_10_46_1","volume-title":"R: a language and environment for statistical computing","author":"R Core Team","year":"2025"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2011.05.012"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/fcp.13060"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11414\u2010018\u20109617\u20108"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/923290"},{"key":"e_1_2_10_51_1","unstructured":"Center for Forensic Science Research & Education.Saliva test results.2026https:\/\/www.cfsre.org\/nps\u2010discovery\/saliva\u2010test\u2010results."},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2023.2207716"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.70069"}],"container-title":["Journal of Forensic Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1556-4029.70391","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1556-4029.70391","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1556-4029.70391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:39:27Z","timestamp":1788327567000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1556-4029.70391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,19]]},"references-count":52,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/1556-4029.70391"],"URL":"https:\/\/doi.org\/10.1111\/1556-4029.70391","archive":["Portico"],"relation":{},"ISSN":["0022-1198","1556-4029"],"issn-type":[{"value":"0022-1198","type":"print"},{"value":"1556-4029","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,19]]},"assertion":[{"value":"2026-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}