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Test Update Immediate Action Notification
Effective Date: Monday, April 27, 2020 Test Updates Immediate Action In our continuing effort to provide you with the highest quality toxicology laboratory services available, we have compiled important changes regarding a number of tests we perform. Listed below are the types of changes that may be included in this notification, effective Monday, April 27, 2020 Test Changes - Tests that have had changes to the method/ CPT code, units of measurement, scope of analysis, reference comments, or specimen requirements. Discontinued Tests - Tests being discontinued with alternate testing suggestions. Please use this information to update your computer systems/records. These changes are important to ensure standardization of our mutual laboratory databases. If you have any questions about the information contained in this notification, please call our Client Support Department at (866) 522-2206. Thank you for your continued support of NMS Labs and your assistance in implementing these changes. The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. NMS Labs does not assume responsibility for billing errors due to reliance on the CPT Codes listed in this document. NMS Labs 200 Welsh Rd. Horsham, PA 19044-2208 [email protected] Page 1 of 6 Effective Date: Monday, April 27, 2020 Test Updates Test Test Name Test Method / Specimen Stability Scope Units Reference Discontinue Code Name CPT Code Req. Comments Designer Benzodiazepines (Qualitative), 0570U • Urine (Forensic) Designer Benzodiazepines Confirmation 52487U • (Qualitative), Urine Designer Benzodiazepines Confirmation, 52487B • Blood Designer Benzodiazepines Confirmation, 52487SP • Serum/Plasma Designer Benzodiazepines, Blood 0570B • (Forensic) Designer Benzodiazepines, 0570SP • Serum/Plasma (Forensic) NMS Labs 200 Welsh Rd. -
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. -
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 -
Boendedok 2020 Manual För Intervjuformulären
BoendeDOK 2020 Manual för intervjuformulären Mikael Dahlberg Mats Anderberg Helen Falck Innehållsförteckning Introduktion ___________________________________________________ 4 BoendeDOK __________________________________________________ 6 Inskrivningsintervju __________________________________________ 6 Avstämningsintervju __________________________________________ 7 Utskrivningsintervju __________________________________________ 7 Frågeområden i BoendeDOK ___________________________________ 7 Hantering och förvaring av DOK-material _________________________ 8 Kontaktpersonens roll _________________________________________ 8 Kodning i BoendeDOK ________________________________________ 9 Tidsintervaller ______________________________________________ 10 Frågor om förändring ________________________________________ 10 Att i efterhand ändra intervjusvar _______________________________ 11 Inför intervjun - Klientens samtycke ____________________________ 11 Under intervjun _____________________________________________ 12 Återkoppling av Inskrivningsintervjun ___________________________ 12 BoendeDOK Inskrivningsformulär ________________________________ 16 Intervjuinformation __________________________________________ 16 A. Administrativa uppgifter ___________________________________ 16 B. Bakgrundsinformation _____________________________________ 17 C. Boende _________________________________________________ 17 D. Relationer _______________________________________________ 20 E. Myndighets- och vårdkontakter ______________________________ 21 -
1 'New/Designer Benzodiazepines'
1 ‘New/Designer Benzodiazepines’: an analysis of the literature and psychonauts’ trip reports 2 Laura Orsolini*1,2,3, John M. Corkery1, Stefania Chiappini1, Amira Guirguis1, Alessandro Vento4,5,6,7, 3 Domenico De Berardis3,8,9, Duccio Papanti1, and Fabrizio Schifano1 4 5 1 Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical 6 Sciences, University of Hertfordshire, Hatfield, AL10 9AB, Herts, UK. 7 2 Neomesia Mental Health, Villa Jolanda Hospital, Jesi, Italy. 8 3 Polyedra, Teramo, Italy. 9 4 NESMOS Department (Neurosciences, Mental Health and Sensory Organs), Sapienza University – Rome, School of 10 Medicine and Psychology; Sant’Andrea Hospital, Rome, Italy 11 5 School of psychology - G. Marconi Telematic University, Rome, Italy 12 6 Addictions Observatory (ODDPSS), Rome, Italy 13 7 Mental Health Department - ASL Roma 2, Rome, Italy 14 8 Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of “G. D’Annunzio”, Chieti, 15 Italy. 16 9 NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, ASL 4 17 Teramo, Italy. 18 19 Corresponding author: 20 Laura Orsolini, Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life 21 and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, Herts, UK; Villa Jolanda Hospital, Neomesia 22 Mental Health, Villa Jolanda, Italy; Polyedra, Teramo, Italy; E-mail address: [email protected]. Tel.: (+39) 392 23 3244643. 24 25 Conflicts of Interest 26 The authors declare that this research was conducted in the absence of any commercial or financial relationships 27 that could be construed as a potential conflict of interest. -
The Emergence of New Psychoactive Substance (NPS) Benzodiazepines
Issue: Ir Med J; Vol 112; No. 7; P970 The Emergence of New Psychoactive Substance (NPS) Benzodiazepines. A Survey of their Prevalence in Opioid Substitution Patients using LC-MS S. Mc Namara, S. Stokes, J. Nolan HSE National Drug Treatment Centre Abstract Benzodiazepines have a wide range of clinical uses being among the most commonly prescribed medicines globally. The EU Early Warning System on new psychoactive substances (NPS) has over recent years detected new illicit benzodiazepines in Europe’s drug market1. Additional reference standards were obtained and a multi-residue LC- MS method was developed to test for 31 benzodiazepines or metabolites in urine including some new benzodiazepines which have been classified as New Psychoactive Substances (NPS) which comprise a range of substances, including synthetic cannabinoids, opioids, cathinones and benzodiazepines not covered by international drug controls. 200 urine samples from patients attending the HSE National Drug Treatment Centre (NDTC) who are monitored on a regular basis for drug and alcohol use and which tested positive for benzodiazepine class drugs by immunoassay screening were subjected to confirmatory analysis to determine what Benzodiazepine drugs were present and to see if etizolam or other new benzodiazepines are being used in the addiction population currently. Benzodiazepine prescription and use is common in the addiction population. Of significance we found evidence of consumption of an illicit new psychoactive benzodiazepine, Etizolam. Introduction Benzodiazepines are useful in the short-term treatment of anxiety and insomnia, and in managing alcohol withdrawal. 1 According to the EMCDDA report on the misuse of benzodiazepines among high-risk opioid users in Europe1, benzodiazepines, especially when injected, can prolong the intensity and duration of opioid effects. -
Förordning Om Ändring I Förordningen (1992:1554) Om Kontroll Av Narkotika;
Príloha 11 k rozhodnutiu švédskych úradov vlády 22. februára 2018 § 79 1. ------IND- 2018 0079 S-- SK- ------ 20180302 --- --- PROJET Zbierka zákonov Švédska SFS Published on issued on 1 March 2018. The government hereby lays down1 that Annex 1 to the Ordinance (1992:1554) on the control of narcotic drugs2 shall read as set out below. This ordinance shall enter into force on 10 April 2018. On behalf of the Government ANNIKA STRANDHÄLL Lars Hedengran (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 Ordinance reprinted as 1993:784. 1 SFS Annex 13 List of substances to be considered narcotic drugs according to the Narcotic Drugs Punishments Act Stimulants of the central nervous system ethylamphetamine (2-ethylamino-1-phenylpropane) fenethylline [1-phenyl-1-piperidyl-(2)-methyl]acetate 1-phenyl-2-butylamine N-hydroxyamphetamine propylhexedrine 4-methylthioamphetamine (4-MTA) modafinil 4-methoxy-N-methylamphetamine (PMMA, 4-MMA) 2,5-dimethoxy-4-ethylthiophenethylamine (2C-T-2) 2,5-dimethoxy-4-(n)-propylthiophenethylamine (2C-T-7) 4-iodo-2,5-dimethoxyphenethylamine (2C-I) 2,4,5-trimethoxyamphetamine (TMA-2) 4-methylmethcathinone (mephedrone) 4-fluoramphetamine 1-(4-methoxyphenyl)-2-(methylamino)propan-1-one (methedrone) 1-(1,3-benzodioxol-5-yl)-2-pyrrolidin-1-yl-pentan-1-one (MDPV) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)butan-1-one -
Agressions Sexuelles Et Toxicologie
Agressions Sexuelles et Toxicologie Service de Toxicologie du Laboratoire de Sciences Judiciaires et de Médecine Légale (LSJML) Présenté par : Anne-Marie Faucher et Pascal Mireault Avec la participation de: Ariane Adam-Poupart Définitions AGRESSION SEXUELLE AVEC SOUMISSION CHIMIQUE: Le terme soumission chimique s’applique lorsqu’une drogue/substance est administrée dans le but d’altérer le comportement d’une victime en la rendant passive, soumise. LES DROGUES DU VIOL : Substance qui invalide un individu pour un certain laps de temps et peut causer une perte de mémoire. Ces drogues augmentent la vulnérabilité d’une personne à une agression sexuelle. Définitions BLACK-OUT: Épisode d’amnésie qui n’est pas accompagné d’une perte de conscience. L’individu expérimentant un black-out peut s’exprimer de façon rationnelle et semble avoir des comportements normaux; toutefois, il est incapable d’enregistrer des informations . Prédisposition variable d’une personne à l’autre. INTOXICATION: Épisode suivant l’administration d’une substance qui résulte en des perturbations graves du comportement. À titre d’exemple, une intoxication à l’alcool peut induire une perte des fonctions motrices, une baisse évidente des réponses aux stimuli, des vomissements, de l’incontinence et peut entraîner un coma. PRINCIPAUX AMNÉSIANTS, SÉDATIFS OU HYPNOTIQUES* Durée Détection Drogue Présentation Dose (mg) d’action Sang Urine Éthanol Liquide (Bière, Vin, etc.) >1ml/Kg Variable Variable Variable GHB (gamma Poudre ou comprimé blanc, >500 mg 15 min- 4 h 8 h 12-48 h hydroxybutyrique) -
Bioanalytical Studies of Designer Benzodiazepines
From DEPARTMENT OF LABORATORY MEDICINE Karolinska Institutet, Stockholm, Sweden BIOANALYTICAL STUDIES OF DESIGNER BENZODIAZEPINES Madeleine Pettersson Bergstrand Stockholm 2018 All previously published papers were reproduced with permission from the publisher. Published by Karolinska Institutet. Printed by Eprint AB © Madeleine Pettersson Bergstrand, 2018 ISBN 978-91-7831-063-0 Front page illustration: Sandra Eriksson Bioanalytical studies of designer benzodiazepines THESIS FOR DOCTORAL DEGREE (Ph.D.) The thesis will be defended at 4X, Alfred Nobels allé 8, Huddinge Friday, May 25, 2018 at 09.00 a.m. By Madeleine Pettersson Bergstrand Principal Supervisor: Opponent: Prof. Anders Helander Ass. Prof. Elisabeth Leere Øiestad Karolinska Institutet Oslo University Hospital Department of Laboratory Medicine Department of Forensic Sciences Division of Clinical Chemistry Clinic for Laboratory medicine Co-supervisor: Examination Board: Prof. Olof Beck Prof. Åsa Emmer Karolinska Institutet KTH Royal Institute of Technology Department of Laboratory Medicine Department of Chemistry Division of Clinical Pharmacology Division of Applied Physical Chemistry Docent Stefan Borg Karolinska Institutet Department of Clinical Neuroscience Docent Pierre Lafolie Karolinska Institutet Department of Medicine Division of Clinical Epidemiology ABSTRACT The fast appearance of benzodiazepine analogues, referred to as new psychoactive substance (NPS) or designer benzodiazepines, requires the continuous update of detection methods in order to keep up with the latest drugs on the recreational drug market. Moreover, as usually only limited information on toxicity and excretion patterns of these new drugs exists, this needs to be evaluated to report on adverse effects and to determine suitable targets for drug testing. Urine drug testing usually involves screening using immunoassay followed by confirmation of positive screening results using mass spectrometric (MS) methods. -
Current Awareness in Clinical Toxicology Editors: Damian Ballam Msc and Allister Vale MD
Current Awareness in Clinical Toxicology Editors: Damian Ballam MSc and Allister Vale MD May 2016 CONTENTS General Toxicology 8 Metals 33 Management 16 Pesticides 35 Drugs 19 Chemical Warfare 37 Chemical Incidents & 28 Plants 37 Pollution Chemicals 29 Animals 38 CURRENT AWARENESS PAPERS OF THE MONTH Efficacy and effectiveness of anti-digoxin antibodies in chronic digoxin poisonings from the DORA study (ATOM-1) Chan BS, Isbister GK, O'Leary M, Chiew A, Buckley NA. Clin Toxicol 2016; online early: doi: 10.1080/15563650.2016.1175620: Context We hypothesized that in chronic digoxin toxicity, anti-digoxin antibodies (Fab) would be efficacious in binding digoxin, but this may not translate into improved clinical outcomes. Objective This study aims to investigate changes in free digoxin concentrations and clinical effects on heart rate and potassium concentrations in chronic digoxin poisoning when anti-digoxin Fab are given. Materials and methods This is a prospective observational study. Patients were recruited if they have been treated with anti-digoxin Fab for chronic digoxin poisoning. Data was entered into a standardised prospective form, supplemented with medical records. Their serum or plasma was collected, analysed for free and bound digoxin and free anti-digoxin Fab concentrations. Results From September 2013 to February 2015, 36 patients (median age, 78 years; 22 females) Current Awareness in Clinical Toxicology is produced monthly for the American Academy of Clinical Toxicology by the Birmingham Unit of the UK National Poisons Information Service, with contributions from the Cardiff, Edinburgh, and Newcastle Units. The NPIS is commissioned by Public Health England 2 were recruited from 18 hospitals. -
A Review of the Evidence of Use and Harms of Novel Benzodiazepines
ACMD Advisory Council on the Misuse of Drugs Novel Benzodiazepines A review of the evidence of use and harms of Novel Benzodiazepines April 2020 1 Contents 1. Introduction ................................................................................................................................. 4 2. Legal control of benzodiazepines .......................................................................................... 4 3. Benzodiazepine chemistry and pharmacology .................................................................. 6 4. Benzodiazepine misuse............................................................................................................ 7 Benzodiazepine use with opioids ................................................................................................... 9 Social harms of benzodiazepine use .......................................................................................... 10 Suicide ............................................................................................................................................. 11 5. Prevalence and harm summaries of Novel Benzodiazepines ...................................... 11 1. Flualprazolam ......................................................................................................................... 11 2. Norfludiazepam ....................................................................................................................... 13 3. Flunitrazolam .......................................................................................................................... -
HSE Update August 2020
An Oifig Náisiúnta don Chuimsiú Sóisialta Lána an Mhuilinn, Baile Pharma, Baile Átha Cliath 20, D20 KH63 Tel: 01 6201703 National Social Inclusion Office Mill Lane, Palmerstown, Dublin 20, D20 KH63 Tel: 01 6201703 HSE update August 2020 The Changing Nature of the Benzodiazepine Market Benzodiazepines Benzodiazepines are a widely prescribed group of medicines with a range of clinical uses that include treating anxiety, insomnia, acute muscle spasms and managing alcohol withdrawal. However, this group of medicines are often used outside of prescribing recommendations. They can be used by people, including those accessing addiction and homeless services as part of a poly drug use culture in Ireland. Like all medicines, benzodiazepines can produce side effects. They are also dangerous if mixed with other substances, particularly depressant type drugs such as opioids or alcohol. There are many different types of benzodiazepines that range from short, medium and long lasting. Some well-known types of benzodiazepines are Diazepam (Valium,D5/D10), Alprzolam (Xanax, Tranex), Lorazepam (Ativan), Triazolam (Halcion), Flurazepam (Dalmane), Chlordiazepoxide (Librium). Benzodiazepines are commonly known as: ‘Benzo’, ‘Xanax’, ‘Sticks’, ‘Street tablets’, ‘Xan’, ‘Up John’, ‘D5’s’, ‘D 10’s. In the past, much attention has been on the diversion of medicinal benzodiazepines. However, there has been an increase in the manufacturing and supply of illicitly produced benzodiazepines. We are aware that tablets sold by dealers or online may not be genuine prescription medication and are ‘fake’ copies of pharmaceutically made tablets. Some can contain what are considered new benzodiazepine-type substances or combinations of different substances. What are new benzodiazepine-type substances? New benzodiazepines are sometimes called ‘novel’, ‘designer’ or ‘new psychoactive substances’.