DOCSLIB.ORG

Prevalence of Fentanyl and Its Analogs in Court-Ordered Mandatory Drug Testing in Hair 2020 Internship Showcase

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Prevalence of Fentanyl and Its Analogs in Court-Ordered Mandatory Drug Testing in Hair 2020 Internship Showcase Prevalence of Fentanyl and Its Analogs in Court-Ordered Mandatory Drug Testing in Hair 2020 Internship Showcase Jessica Bunn Virginia Commonwealth [email protected] www.rti.org RTI International is a trade name of Research Triangle Institute. RTI and the RTI logo are U.S. registered trademarks of Research Triangle Institute. Fentanyl Laboratory Drug Seizures of Fentanyl Top five drug 60000 seizures in 2018: 50000 1. Methamphetamine 40000 2. Cannabis/THC 30000 3. Cocaine 4. Heroin 20000 5. Fentanyl 10000 0 2 (Drug Enforcement Administration, 2019) Current Methods for Analysis o Current methods focus on heroin, codeine, and morphine targets. o Historically, fentanyl exposure comes from fentanyl-containing heroin. o Now, fentanyl and its analogs are used on their own​. o Many samples potentially could be falsely reported as negative if fentanyl and its analogs are not included in the testing. How many fentanyl and analog users are being missed? 3 Fentanyl and Analog Use • Because of changes in legal status, fentanyl analogs often change in popularity. • These changes increase the difficulty for analysis because new analogs are constantly being developed. What analogs are new and popular, so testing is accurate? 500 Prominent Opioids 400 300 200 100 0 Acetyl Fentanyl 2-Furanyl Fentanyl 4-FiBF Carfentanil 2016 2017 2018 2019 4 (Special Testing and Research Laboratory, n.d.b) Acetylfentanyl Fentanyl Analog Trends 4-ANPP Carfentanil *Furanylfentanyl 2-furanylfentanyl Valerylfentanyl Acetylfentanyl 4-FiBF *U-47700 U-47700 butyrylfentanyl 4-ANPP methoxyacetylfentanyl benzylfentanyl *4-FiBF 2016 2-furanylbenzylfentanyl 2019 Carfentanil Cyclopropylfentanyl NPP *Acrylfentanyl Acrylfentanyl Butyrylfentanyl *p-flourofuranylfentanyl U-48800 valerylfentanyl benzoylfentanyl *o-desmethyl-cis-tramadol *o-flourofentanyl *1-benzyl-4-piperidone *benzylfentanyl 2-thiofuranylfentanyl 3-methylfentanyl *p-fluorobutyrylfentanyl 4-piperidone *Despropionyl o-fluorofentanyl *3-methylfentanyl *o-fluorofuranyl fentanyl 0 50 100 150 0 50 100 150 200 250 300 350 400 * Reported for the first time in that year 5 (Special Testing and Research Laboratory, n.d.a and b) Decontamination of Hair o Decontamination is necessary to remove external contamination. o Specific washes remove different types of contamination. o Fentanyl and its analogs are normally decontaminated with a variation of • Organic: Dichloromethane • Aqueous: Water 6 Extraction of Fentanyl from Hair o Used to pull drug out of the hair matrix o Liquid-liquid o Solid phase • In general, lower limits of • Requires less time and detection and technical skill quantification • Less need for solvent • Uses more organic solvent Analytical methods must be improved because fentanyl and its analogs are used at lower doses. 7 References o Drug Enforcement Administration, U.S. Department of Justice. (2019, December). 2019 Drug Enforcement Administration national drug threat assessment (DEA- DCT-DIR-007-20). Retrieved from https://www.dea.gov/sites/default/files/2020- 01/2019-NDTA-final-01-14-2020_Low_Web-DIR-007-20_2019.pdf o Special Testing and Research Laboratory, Drug Enforcement Administration, U.S. Department of Justice. (n.d.a). Emerging threat report annual 2016. Retrieved from https://ndews.umd.edu/sites/ndews.umd.edu/files/emerging-threat-report-2016- annual.pdf o Special Testing and Research Laboratory, Drug Enforcement Administration, U.S. Department of Justice. (n.d.b). Emerging threat report annual 2019 (DEA PRB 03- 09-20-09). Retrieved from https://ndews.umd.edu/sites/ndews.umd.edu/files/DEA- Emerging-Threat-Report-2019-Annual.pdf 8 Acknowledgments o Katherine Bollinger, MS o Megan Grabenauer, PhD o University Collaboration Office o RTI International 9 Thank you Contact: Jessica Bunn| email: [email protected] 10.
Load more

Recommended publications
  • A Review of Synthetic Fentanyl Metabolism and the Metabolism of Select Synthetic Fentanyl Analogues
    A review of synthetic fentanyl metabolism and the metabolism of select synthetic fentanyl analogues Gerard Lee A thesis submitted for the completion of a degree in Master of Forensic Science (Professional Practice) in The School of Veterinary and Life Sciences Murdoch University Supervisors: Associate Professor James Speers (Murdoch) Associate Professor Bob Mead (Murdoch) Semester 1, 2019 i Declaration I declare that this thesis does not contain any material submitted previously for the award of any other degree or diploma at any university or other tertiary institution. Furthermore, to the best of my knowledge, it does not contain any material previously published or written by another individual, except where due reference has been made in the text. Finally, I declare that all reported experimentations performed in this research were carried out by myself, except that any contribution by others, with whom I have worked is explicitly acknowledged. ii Acknowledgements I would like to thank my supervisor Bob Mead for his time guiding me and providing feedback on this endeavour. He has been a great help providing insights and advice from when I started university at Murdoch until now for which I am extremely grateful. To James Speers, thank you for helping me find a direction for this project when I started out. And finally, to my family and friends for their encouragement and support. iii Table of Contents Title page. ...............................................................................................................................I
    [Show full text]
  • 18 December 2020 – to Date)
    (18 December 2020 – to date) MEDICINES AND RELATED SUBSTANCES ACT 101 OF 1965 (Gazette No. 1171, Notice No. 1002 dated 7 July 1965. Commencement date: 1 April 1966 [Proc. No. 94, Gazette No. 1413] SCHEDULES Government Notice 935 in Government Gazette 31387 dated 5 September 2008. Commencement date: 5 September 2008. As amended by: Government Notice R1230 in Government Gazette 32838 dated 31 December 2009. Commencement date: 31 December 2009. Government Notice R227 in Government Gazette 35149 dated 15 March 2012. Commencement date: 15 March 2012. Government Notice R674 in Government Gazette 36827 dated 13 September 2013. Commencement date: 13 September 2013. Government Notice R690 in Government Gazette 36850 dated 20 September 2013. Commencement date: 20 September 2013. Government Notice R104 in Government Gazette 37318 dated 11 February 2014. Commencement date: 11 February 2014. Government Notice R352 in Government Gazette 37622 dated 8 May 2014. Commencement date: 8 May 2014. Government Notice R234 in Government Gazette 38586 dated 20 March 2015. Commencement date: 20 March 2015. Government Notice 254 in Government Gazette 39815 dated 15 March 2016. Commencement date: 15 March 2016. Government Notice 620 in Government Gazette 40041 dated 3 June 2016. Commencement date: 3 June 2016. Prepared by: Page 2 of 199 Government Notice 748 in Government Gazette 41009 dated 28 July 2017. Commencement date: 28 July 2017. Government Notice 1261 in Government Gazette 41256 dated 17 November 2017. Commencement date: 17 November 2017. Government Notice R1098 in Government Gazette 41971 dated 12 October 2018. Commencement date: 12 October 2018. Government Notice R1262 in Government Gazette 42052 dated 23 November 2018.
    [Show full text]
  • Analysis of Synthetic Opioids in Postmortem Blood, Vitreous Humor, and Brain Tissue
    City University of New York (CUNY) CUNY Academic Works Student Theses John Jay College of Criminal Justice Fall 12-2018 Analysis of synthetic opioids in postmortem blood, vitreous humor, and brain tissue Rachel K. Chesser CUNY John Jay College, [email protected] How does access to this work benefit ou?y Let us know! More information about this work at: https://academicworks.cuny.edu/jj_etds/88 Discover additional works at: https://academicworks.cuny.edu This work is made publicly available by the City University of New York (CUNY). Contact: [email protected] i Analysis of synthetic opioids in postmortem blood, vitreous humor, and brain tissue A thesis presented in partial fulfillment of the requirements for the degree of Master of Science in Forensic Science John Jay College of Criminal Justice City University of New York Rachel Chesser December 2018 ii Analysis of synthetic opioids in postmortem blood, vitreous humor, and brain tissue Rachel Chesser This thesis has been presented to and accepted by the Office of Graduate Studies, John Jay College of Criminal Justice in partial fulfillment of the requirements for the degree of Master of Science in Forensic Science. Thesis Committee Thesis Advisor: Dr. Marta Concheiro-Guisan Second Reader: Dr. Gail Cooper External Reader: Dr. Luke N. Rodda iii Acknowledgements I would like to express my sincerest gratitude to Dr. Marta Concheiro, my advisor, for providing her guidance towards my thesis research and providing me with a strong background on forensic toxicology that allowed me to complete my project. She has been so patient and helpful with me in putting my thesis together and helping me make sense of it for parts I did not understand.
    [Show full text]
  • Swedish Code of Statutes
    1. ------IND- 2018 0506 S-- EN- ------ 20190508 --- --- FINAL Swedish Code of Statutes Ordinance amending the Ordinance (1999:58) banning certain products SFS 2018:1587 that are harmful to health Published Issued on 4 October 2018 on 9 October 2018 The Government hereby lays down1 that the annex to the Ordinance (1999:58) prohibiting certain products that are harmful to health shall read as set out below. ___________ This ordinance shall enter into force on 12 November 2018. On behalf of the government ANNIKA STRANDHÄLL Kjell Rempler (Ministry of Health and Social Affairs) 1 See Directive (EU) 2015/1535 of the European Parliament and of the Council of 9 September 2015 laying down a procedure for the provision of information in the field of technical regulations and of rules on Information Society services. 2 Annex SFS 2018:1587 List of products to be regarded as products that are harmful to health in accordance with the Ordinance prohibiting certain products that are harmful to health N-methyl-1-(3,4-methylenedioxyphenyl)-2-butylamine (MBDB) 1-(3,4-methylenedioxyphenyl)-2-butylamine (BDB) 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DiPT) 5-methoxy-alphamethyltryptamine (5-MeO-AMT) 2,5-dimethoxy-4-ethylphenethylamine (2C-E) alpha-methyltryptamine (AMT) 2,5-dimethoxy-4-chlorophenethylamine (2C-C) 2,5-dimethoxy-4-methylphenethylamine (2C-D) 4-acetoxy-N,N-diisopropyltryptamine (4-AcO-DiPT) 4-hydroxy-N,N-diisopropyltryptamine (4-HO-DiPT) gamma-butyrolactone (GBL) 1,4-butanediol (1,4-BD) 4-acetoxy-N,N-methylisopropyltryptamine
    [Show full text]
  • Recommended Methods for the Identification and Analysis of Fentanyl and Its Analogues in Biological Specimens
    Recommended methods for the Identification and Analysis of Fentanyl and its Analogues in Biological Specimens MANUAL FOR USE BY NATIONAL DRUG ANALYSIS LABORATORIES Laboratory and Scientific Section UNITED NATIONS OFFICE ON DRUGS AND CRIME Vienna Recommended Methods for the Identification and Analysis of Fentanyl and its Analogues in Biological Specimens MANUAL FOR USE BY NATIONAL DRUG ANALYSIS LABORATORIES UNITED NATIONS Vienna, 2017 Note Operating and experimental conditions are reproduced from the original reference materials, including unpublished methods, validated and used in selected national laboratories as per the list of references. A number of alternative conditions and substitution of named commercial products may provide comparable results in many cases. However, any modification has to be validated before it is integrated into laboratory routines. ST/NAR/53 Original language: English © United Nations, November 2017. All rights reserved. The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. Mention of names of firms and commercial products does not imply the endorse- ment of the United Nations. This publication has not been formally edited. Publishing production: English, Publishing and Library Section, United Nations Office at Vienna. Acknowledgements The Laboratory and Scientific Section of the UNODC (LSS, headed by Dr. Justice Tettey) wishes to express its appreciation and thanks to Dr. Barry Logan, Center for Forensic Science Research and Education, at the Fredric Rieders Family Founda- tion and NMS Labs, United States; Amanda L.A.
    [Show full text]
  • Understanding and Challenging the Drugs: Chemistry and Toxicology
    UNDERSTANDING AND CHALLENGING THE DRUGS: CHEMISTRY AND TOXICOLOGY Presenter: • Dr. Jasmine Drake, Graduate Program Director and Assistant Professor, Administration of Justice Department, Barbara Jordan-Mickey Leland School of Public Affairs, Texas Southern University NACDL Training Defending Drug Overdose Homicides in Pennsylvania Penn State Harrisburg, Middletown, PA November 6th, 2019 11:30- 12:45 p.m. Understanding & Challenging the Drugs: Chemistry & Toxicology Dr. Jasmine Drake, Forensic Science Learning Laboratory, Texas Southern University I. Opioid Drug Classifications A. Types of Opioids B. Classic vs. Synthetic C. Toxicology of Opioids 1) How opioids interact with the body 2) Addiction (psychological vs. physiological II. New Classes of Drugs A. Emerging Threats B. Potency III. National Trends in Opioid Overdose Deaths in the U.S. A. Based on State B. Ethnicity C. Drug-Type (prescription vs. fentanyl vs. heroin) IV. Trends of Opioid Overdose Deaths in Philadelphia A. Based on Ethnicity B. Drug Type (prescription vs. fentanyl vs. heroin) V. Legal Considerations to the Opioid Epidemic A. Punitive Measures vs. Rehabilitative Treatment B. Progressive Jurisdictions Nationwide C. New Legal Measures in Philadelphia VI. Toxicology Reports A. What’s in the report? B. Key Aspects of the Tox Report C. Terminology D. Evaluating and Interpreting the data? E. Questions and considerations. VII. Conclusion and Discussion A. Case Specific Examples B. Sample Toxicology Reports The Opioid Epidemic: What labs have to do with it? Ewa King, Ph.D. Associate Director of Health RIDOH State Health Laboratories Analysis. Answers. Action. www.aphl.org Overview • Overdose trends • Opioids and their effects • Analytical testing approaches • Toxicology laboratories Analysis. Answers. Action.
    [Show full text]
  • UNODC, Synthetic Drugs in East and Southeast Asia
    Synthetic Drugs in East and Southeast Asia Latest developments and challenges May 2020 Global SMART Programme Copyright © 2020, United Nations Office on Drugs and Crime (UNODC). This publication may be reproduced in whole or in part and in any form for educational or non-profit purposes without special permission from the copyright holder, provided acknowledgement of the source is made. UNODC would appreciate receiving a copy of any publication that uses this publication as a source. Acknowledgements This report was prepared by the Global Synthetic Monitoring: Analyses, Reporting and Trends (SMART) Programme, Laboratory and Scientific Section with the support of the UNODC Regional Office for Southeast Asia and the Pacific. Supervision, direction and review Justice Tettey, Chief, Laboratory and Scientific Section Jeremy Douglas, Regional Representative, Southeast Asia and the Pacific Research and drafting Martin Raithelhuber, Illicit Synthetic Drugs Expert Tun Nay Soe, Inter-regional Programme Coordinator Inshik Sim, Drug Programme Analyst, Southeast Asia and the Pacific Joey Yang Yi Tan, Junior Professional Officer in Drug Research Graphic design and layout Akara Umapornsakula, Graphic Designer Administrative support Jatupat Buasipreeda, Programme Assistant The present report also benefited from the expertise and valuable contributions of UNODC colleagues in the Laboratory and Scientific Section and the Regional Office for Southeast Asia and the Pacific, including Tsegahiwot Abebe Belachew, Rebecca Miller, Reiner Pungs, and John Wojcik. Disclaimer This report has not been formally edited. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of UNODC or the Secretariat of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
    [Show full text]
  • WHO Expert Committee on Drug Dependence
    WHO Technical Report Series 1034 This report presents the recommendations of the forty-third Expert Committee on Drug Dependence (ECDD). The ECDD is responsible for the assessment of psychoactive substances for possible scheduling under the International Drug Control Conventions. The ECDD reviews the therapeutic usefulness, the liability for abuse and dependence, and the public health and social harm of each substance. The ECDD advises the Director-General of WHO to reschedule or to amend the scheduling status of a substance. The Director-General will, as appropriate, communicate the recommendations to the Secretary-General of the United Nations, who will in turn communicate the advice to the Commission on Narcotic Drugs. This report summarizes the findings of the forty-third meeting at which the Committee reviewed 11 psychoactive substances: – 5-Methoxy-N,N-diallyltryptamine (5-MeO-DALT) WHO Expert Committee – 3-Fluorophenmetrazine (3-FPM) – 3-Methoxyphencyclidine (3-MeO-PCP) on Drug Dependence – Diphenidine – 2-Methoxydiphenidine (2-MeO-DIPHENIDINE) Forty-third report – Isotonitazene – MDMB-4en-PINACA – CUMYL-PEGACLONE – Flubromazolam – Clonazolam – Diclazepam The report also contains the critical review documents that informed recommendations made by the ECDD regarding international control of those substances. The World Health Organization was established in 1948 as a specialized agency of the United Nations serving as the directing and coordinating authority for international health matters and public health. One of WHO’s constitutional functions is to provide objective, reliable information and advice in the field of human health, a responsibility that it fulfils in part through its extensive programme of publications. The Organization seeks through its publications to support national health strategies and address the most pressing public health concerns of populations around the world.
    [Show full text]
  • CAS Number Index
    2334 CAS Number Index CAS # Page Name CAS # Page Name CAS # Page Name 50-00-0 905 Formaldehyde 56-81-5 967 Glycerol 61-90-5 1135 Leucine 50-02-2 596 Dexamethasone 56-85-9 963 Glutamine 62-44-2 1640 Phenacetin 50-06-6 1654 Phenobarbital 57-00-1 514 Creatine 62-46-4 1166 α-Lipoic acid 50-11-3 1288 Metharbital 57-22-7 2229 Vincristine 62-53-3 131 Aniline 50-12-4 1245 Mephenytoin 57-24-9 1950 Strychnine 62-73-7 626 Dichlorvos 50-23-7 1017 Hydrocortisone 57-27-2 1428 Morphine 63-05-8 127 Androstenedione 50-24-8 1739 Prednisolone 57-41-0 1672 Phenytoin 63-25-2 335 Carbaryl 50-29-3 569 DDT 57-42-1 1239 Meperidine 63-75-2 142 Arecoline 50-33-9 1666 Phenylbutazone 57-43-2 108 Amobarbital 64-04-0 1648 Phenethylamine 50-34-0 1770 Propantheline bromide 57-44-3 191 Barbital 64-13-1 1308 p-Methoxyamphetamine 50-35-1 2054 Thalidomide 57-47-6 1683 Physostigmine 64-17-5 784 Ethanol 50-36-2 497 Cocaine 57-53-4 1249 Meprobamate 64-18-6 909 Formic acid 50-37-3 1197 Lysergic acid diethylamide 57-55-6 1782 Propylene glycol 64-77-7 2104 Tolbutamide 50-44-2 1253 6-Mercaptopurine 57-66-9 1751 Probenecid 64-86-8 506 Colchicine 50-47-5 589 Desipramine 57-74-9 398 Chlordane 65-23-6 1802 Pyridoxine 50-48-6 103 Amitriptyline 57-92-1 1947 Streptomycin 65-29-2 931 Gallamine 50-49-7 1053 Imipramine 57-94-3 2179 Tubocurarine chloride 65-45-2 1888 Salicylamide 50-52-2 2071 Thioridazine 57-96-5 1966 Sulfinpyrazone 65-49-6 98 p-Aminosalicylic acid 50-53-3 426 Chlorpromazine 58-00-4 138 Apomorphine 66-76-2 632 Dicumarol 50-55-5 1841 Reserpine 58-05-9 1136 Leucovorin 66-79-5
    [Show full text]
  • Use of Fentanyl, Butyrfentanyl and Furanylfentanyl As Discussed on Polish Online Forums Devoted to ‘Designer Drugs’
    Psychiatr. Pol. ONLINE FIRST Nr 219: 1–18 Published ahead of print 12 March 2021 www.psychiatriapolska.pl ISSN 0033-2674 (PRINT), ISSN 2391-5854 (ONLINE) DOI: https://doi.org/10.12740/PP/OnlineFirst/128156 Use of fentanyl, butyrfentanyl and furanylfentanyl as discussed on Polish online forums devoted to ‘designer drugs’ Monika Kacela, Jakub Wojcieszak, Jolanta B. Zawilska Medical University of Lodz, Department of Pharmacodynamics Summary Aim. The study was aimed to analyze information posted by users of synthetic opioids on Polish online drug discussion forums. Special emphasis was given to sources of drugs and their availability, routes of administration, dosages, expected and toxic effects. Material and methods. 6,143 reports related to synthetic opioids, posted between 2005 and mid 2019 on three widely available popular Polish online forums devoted to psychoactive substances, i.e., https://hyperreal.info/talk, https://dopek.info and https://forum.dopalamy, were collected and analyzed. The article presents data on three most popular opioids, i.e., fentanyl, butyrfentanyl and furanylfentanyl. Results. Fentanyl was the most widely used and relatively easily accessible synthetic opioid in Poland. Butyrfentanyl and furanylfentanyl were far less popular. The main source of fentanyl was diversion of medicines, notably transdermal patches. Fentanyl, butyrfentanyl and furanylfentanyl are administered orally, buccally, sublingually, intranasally, by inhalation and intravenously. Concomitant use of fentanyl and its derivatives with other psychoactive compounds increases the risk of severe adverse effects. Conclusions. Our study contributed to a more comprehensive understanding of problems related to abuse of fentanyl, butyrfentanyl and furanylfentanyl in Poland. In the light of the relatively high popularity of pharmaceutical fentanyl used for non-medical purposes, there is an urgent need for more strict control over illegal sales of fentanyl transdermal preparations via the Internet, as well as disposal of used patches.
    [Show full text]
  • Comprehensive Multi-Analytical Screening Of
    COMPREHENSIVE MULTI-ANALYTICAL SCREENING OF DRUGS OF ABUSE, INCLUDING NEW PSYCHOACTIVE SUBSTANCES, IN URINE WITH BIOCHIP ARRAYS APPLIED TO THE EVIDENCE ANALYSER Darragh J., Keery L., Keenan R., Stevenson C., Norney G., Benchikh M.E., Rodríguez M.L., McConnell R. I., FitzGerald S.P. Randox Toxicology Ltd., Crumlin, United Kingdom e-mail: [email protected] Introduction Biochip array technology allows the simultaneous detection of multiple drugs from a single undivided sample, which This study summarises the analytical performance of three different biochip arrays applied to the screening of increases the screening capacity and the result output per sample. Polydrug consumption can be detected and by acetylfentanyl, AH-7921, amphetamine, barbiturates, benzodiazepines (including etizolam and clonazepam), incorporating new immunoassays on the biochip surface, this technology has the capacity to adapt to the new trends benzoylecgonine/cocaine, benzylpiperazines, buprenorphine, cannabinoids, carfentanil, dextromethorphan, fentanyl, in the drug market. furanylfentanyl, meprobamate, mescaline, methamphetamine, methadone, mitragynine, MT-45, naloxone, ocfentanyl, opioids, opiates, oxycodone, phencyclidine, phenylpiperazines, salvinorin, sufentanil, synthetic cannabinoids (JWH-018, UR-144, AB-PINACA, AB-CHMINACA), synthetic cathinones [mephedrone, methcathinone, alpha- pyrrolidinopentiophenone (alpha-PVP)], tramadol, tricyclic antidepressants, U-47700, W-19, zolpidem. Methodology Three different biochip arrays were used (DOA ULTRA,
    [Show full text]
  • Critical Review Report: CROTONYLFENTANYL
    Critical Review Report: CROTONYLFENTANYL Expert Committee on Drug Dependence Forty-second Meeting Geneva, 21-25 October 2019 This report contains the views of an international group of experts, and does not necessarily represent the decisions or the stated policy of the World Health Organization 42nd ECDD (2019): Crotonylfentanyl © World Health Organization 2019 All rights reserved. nd This is an advance copy distributed to the participants of the 42 Expert Committee on Drug Dependence, before it has been formally published by the World Health Organization. The document may not be reviewed, abstracted, quoted, reproduced, transmitted, distributed, translated or adapted, in part or in whole, in any form or by any means without the permission of the World Health Organization. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use.
    [Show full text]