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Medical Review Officer Manual
Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Substance Abuse Prevention Medical Review Officer Manual for Federal Agency Workplace Drug Testing Programs EFFECTIVE OCTOBER 1, 2010 Note: This manual applies to Federal agency drug testing programs that come under Executive Order 12564 dated September 15, 1986, section 503 of Public Law 100-71, 5 U.S.C. section 7301 note dated July 11, 1987, and the Department of Health and Human Services Mandatory Guidelines for Federal Workplace Drug Testing Programs (73 FR 71858) dated November 25, 2008 (effective October 1, 2010). This manual does not apply to specimens submitted for testing under U.S. Department of Transportation (DOT) Procedures for Transportation Workplace Drug and Alcohol Testing Programs (49 CFR Part 40). The current version of this manual and other information including MRO Case Studies are available on the Drug Testing page under Medical Review Officer (MRO) Resources on the SAMHSA website: http://www.workplace.samhsa.gov Previous Versions of this Manual are Obsolete 3 Table of Contents Chapter 1. The Medical Review Officer (MRO)........................................................................... 6 Chapter 2. The Federal Drug Testing Custody and Control Form ................................................ 7 Chapter 3. Urine Drug Testing ...................................................................................................... 9 A. Federal Workplace Drug Testing Overview.................................................................. -
IOC Doping Control Guide For
Doping Control Guide Version 1.0 | February 2016 CONTENTS 1 | ! GENERAL INFORMATION ...................................................... 2! 2 | ! DOPING CONTROL ............................................................. 2! 3 | ! DOPING CONTROL STEP-BY-STEP ........................................... 3! 4 | ! LABORATORY ................................................................... 4! 5 | ! MEDICATIONS USE ............................................................. 4! 6 | ! SUPPLEMENT USE .............................................................. 4! 7 | ! THERAPEUTIC USE EXEMPTIONS ............................................. 5! 8 | ! WHEREABOUTS INFORMATION ............................................... 5! 9 | ! RESOLVING PENDING CASES INVOLVING POSSIBLE VIOLATIONS OF ANTI-DOPING RULES .......................................................... 6! 10 |!WADA INDEPENDENT OBSERVER PROGRAMME ............................. 6! 11 |!WADA OUTREACH PROGRAMME ............................................ 7! 12 |!SHARE OF INFORMATION THROUGH SECURE DATABASE ................. 7! 13 |!DOPING CONTROL TECHNICAL PROCEDURES FOR RIO 2016 OLYMPIC GAMES ............................................................... 7! APPENDICES .......................................................................... 8! A1| DOPING CONTROL STEP-BY-STEP POSTER .................................. 8! A2|THE 2016 PROHIBITED LIST .................................................... 9! SUBSTANCES & METHODS PROHIBITED AT ALL TIMES (IN AND OUT-OF-COMPETITION) ......................................................... -
Dexmethylphenidate Hydrochloride Extended-Release Capsules These
DEXMETHYLPHENIDATE HYDROCHLORIDE- dexmethylphenidate hydrochloride capsule, extended release Granules Pharmaceuticals Inc. ---------- HIGHLIGHTS OF PRESCRIBING INFORMATION Dexmethylphenidate hydrochloride extended-release capsules These highlights do not include all the information needed to use DEXMETHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE CAPSULES safely and effectively. See full prescribing information for DEXMETHYLPHENIDATE HYDROCHLORIDE EXTENDED RELEASE CAPSULES. DEXMETHYLPHENIDATE HYDROCHLORIDE extended-release capsules, for oral use, CII Initial U.S. Approval: 2005 WARNING: ABUSE AND DEPENDENCE See full prescribing information for complete boxed warning. • CNS stimulants, including dexmethylphenidate hydrochloride extended-release, other methylphenidate-containing products, and amphetamines, have a high potential for abuse and dependence( 5.1, 9.2, 9.3). • Assess the risk of abuse prior to prescribing and monitor for signs of abuse and dependence while on therapy ( 5.1, 9.2). INDICATIONS AND USAGE Dexmethylphenidate hydrochloride extended-release capsules are a central nervous system (CNS) stimulant indicated for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) ( 1) DOSAGE AND ADMINISTRATION • Patients new to methylphenidate: Recommended starting dose is 5 mg once daily for pediatric patients and 10 mg once daily for adults with or without food in the morning ( 2.2) • Patients currently on methylphenidate: Dexmethylphenidate hydrochloride extended-release dosage is half the current total daily dosage of methylphenidate -
(19) United States (12) Patent Application Publication (10) Pub
US 20130289061A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2013/0289061 A1 Bhide et al. (43) Pub. Date: Oct. 31, 2013 (54) METHODS AND COMPOSITIONS TO Publication Classi?cation PREVENT ADDICTION (51) Int. Cl. (71) Applicant: The General Hospital Corporation, A61K 31/485 (2006-01) Boston’ MA (Us) A61K 31/4458 (2006.01) (52) U.S. Cl. (72) Inventors: Pradeep G. Bhide; Peabody, MA (US); CPC """"" " A61K31/485 (201301); ‘4161223011? Jmm‘“ Zhu’ Ansm’ MA. (Us); USPC ......... .. 514/282; 514/317; 514/654; 514/618; Thomas J. Spencer; Carhsle; MA (US); 514/279 Joseph Biederman; Brookline; MA (Us) (57) ABSTRACT Disclosed herein is a method of reducing or preventing the development of aversion to a CNS stimulant in a subject (21) App1_ NO_; 13/924,815 comprising; administering a therapeutic amount of the neu rological stimulant and administering an antagonist of the kappa opioid receptor; to thereby reduce or prevent the devel - . opment of aversion to the CNS stimulant in the subject. Also (22) Flled' Jun‘ 24’ 2013 disclosed is a method of reducing or preventing the develop ment of addiction to a CNS stimulant in a subj ect; comprising; _ _ administering the CNS stimulant and administering a mu Related U‘s‘ Apphcatlon Data opioid receptor antagonist to thereby reduce or prevent the (63) Continuation of application NO 13/389,959, ?led on development of addiction to the CNS stimulant in the subject. Apt 27’ 2012’ ?led as application NO_ PCT/US2010/ Also disclosed are pharmaceutical compositions comprising 045486 on Aug' 13 2010' a central nervous system stimulant and an opioid receptor ’ antagonist. -
UFC PROHIBITED LIST Effective June 1, 2021 the UFC PROHIBITED LIST
UFC PROHIBITED LIST Effective June 1, 2021 THE UFC PROHIBITED LIST UFC PROHIBITED LIST Effective June 1, 2021 PART 1. Except as provided otherwise in PART 2 below, the UFC Prohibited List shall incorporate the most current Prohibited List published by WADA, as well as any WADA Technical Documents establishing decision limits or reporting levels, and, unless otherwise modified by the UFC Prohibited List or the UFC Anti-Doping Policy, Prohibited Substances, Prohibited Methods, Specified or Non-Specified Substances and Specified or Non-Specified Methods shall be as identified as such on the WADA Prohibited List or WADA Technical Documents. PART 2. Notwithstanding the WADA Prohibited List and any otherwise applicable WADA Technical Documents, the following modifications shall be in full force and effect: 1. Decision Concentration Levels. Adverse Analytical Findings reported at a concentration below the following Decision Concentration Levels shall be managed by USADA as Atypical Findings. • Cannabinoids: natural or synthetic delta-9-tetrahydrocannabinol (THC) or Cannabimimetics (e.g., “Spice,” JWH-018, JWH-073, HU-210): any level • Clomiphene: 0.1 ng/mL1 • Dehydrochloromethyltestosterone (DHCMT) long-term metabolite (M3): 0.1 ng/mL • Selective Androgen Receptor Modulators (SARMs): 0.1 ng/mL2 • GW-1516 (GW-501516) metabolites: 0.1 ng/mL • Epitrenbolone (Trenbolone metabolite): 0.2 ng/mL 2. SARMs/GW-1516: Adverse Analytical Findings reported at a concentration at or above the applicable Decision Concentration Level but under 1 ng/mL shall be managed by USADA as Specified Substances. 3. Higenamine: Higenamine shall be a Prohibited Substance under the UFC Anti-Doping Policy only In-Competition (and not Out-of- Competition). -
MRO Manual Before 2004
Note: This manual is essentially the same as the 1997 HHS Medical Review Officer (MRO) Manual except for changes related to the new Federal Custody and Control Form (CCF). The appendix has also been deleted since the new Federal Custody and Control Form is available as a separate file on the website. Medical Review Officer Manual for Federal Agency Workplace Drug Testing Programs for use with the new Federal Drug Testing Custody and Control Form (OMB Number 0930-0158, Exp Date: June 30, 2003) This manual applies to federal agency drug testing programs that come under Executive Order 12564 and the Department of Health and Human Services (HHS) Mandatory Guidelines. Table of Contents Chapter 1. The Medical Review Officer (MRO) ............................................................... 1 Chapter 2. Federal Drug Testing Custody and Control Form .......................................... 3 Chapter 3. The MRO Review Process ............................................................................ 3 A. Administrative Review of the CCF ........................................................................... 3 I. State Initiatives and Laws ....................................................................................... 15 Chapter 4. Specific Drug Class Issues .......................................................................... 15 A. Amphetamines ....................................................................................................... 15 B. Cocaine ................................................................................................................ -
Enantiomeric Profiling of Chiral Illicit Drugs in a Pan-European Study Erika Castrignanòa**, Zhugen Yanga,B, Richard Badec,D, J
This document is the accepted manuscript version of the following article: Castrignanò, E., Yang, Z., Bade, R., Baz-Lomba, J. A., Castiglioni, S., Causanilles, A., … Kasprzyk-Hordern, B. (2018). Enantiomeric profiling of chiral illicit drugs in a pan-European study. Water Research, 130, 151-160. https:// doi.org/10.1016/j.watres.2017.11.051 This manuscript version is made available under the CC-BY-NC-ND 4.0 license http:// creativecommons.org/licenses/by-nc-nd/4.0/ Enantiomeric profiling of chiral illicit drugs in a pan-European study Erika Castrignanòa**, Zhugen Yanga,b, Richard Badec,d, Jose A. Baz-Lombae, Sara Castiglionif, Ana Causanillesg, Adrian Covacih, Emma Gracia-Lorc,f, Felix Hernandezc, Juliet Kinyuah, Ann- Kathrin McCalli, Alexander L. N. van Nuijsh, Christoph Orti, Benedek G. Plószj,k, Pedram Raminj,l, Nikolaos I. Rousisf, Yeonsuk Ryue, Kevin V. Thomase,m, Pim de Voogtg,n, Ettore Zuccatof and Barbara Kasprzyk-Horderna* a Department of Chemistry, Faculty of Science, University of Bath, Bath, BA2 7AY, United Kingdom (UK) b Division of Biomedical Engineering, School of Engineering, University of Glasgow, Oakfield Road, Glasgow G12 8LT, UK c Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat s/n, E-12071, Castellón, Spain d School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia 5000, Australia e Norwegian Institute for Water Research (NIVA), Gaustadalleen 21, 0349, Oslo, Norway f IRCCS Istituto di Ricerche Farmacologiche “Mario Negri”, Department of Environmental Health Sciences, Via La Masa 19, 20156, Milan, Italy g KWR Watercycle Research Institute, Chemical Water Quality and Health, P.O. -
Selegiline) in Monkeys*
Intravenous self-administration studies with /-deprenyl (selegiline) in monkeys* /-Deprenyl and its stereoisomer d-deprenyl did not maintain intravenous self-administration behavior in rhesus monkeys. In contrast, /-methamphetamine, the major metabolite of /-deprenyl, as well as the baseline drug, cocaine, maintained high rates of intravenous self-administration behavior. Treatment with /-deprenyl doses up to 1.0 mg/kg before self-administration sessions failed to alter self-administra- tion of either cocaine or /-methamphetamine. Thus /-deprenyl did not appear to have cocaine- or meth- amphetamine-like reinforcing properties in monkeys and was ineffective in altering established patterns of psychomotor-stimulant self-administration behavior. These results support clinical findings that de- spite long-term use of /-deprenyl for the treatment of Parkinson's disease by large numbers of patients, no instances of abuse have been documented. /-Deprenyl has recently been suggested as a potential med- ication for the treatment of various types of drug abuse, including cocaine abuse, but its failure to pro- duce selective effects in decreasing cocaine or methamphetamine self-administration behavior in the present experiments makes such an application seem unlikely. (CLIN PHARMACOL THER 1994;56:774-80.) Gail D. Winger, PhD,a Sevil Yasar, MD,b'd'e S. Steven Negus, PhD,a and Steven R. Goldberg, pIli/i d'e Ann Arbor, Mich., and Baltimore, Md. From the 'Department of Pharmacology, University of Michigan /-Deprenyl (selegiline) has been known for several -
Recommended Methods for the Identification and Analysis Of
Vienna International Centre, P.O. Box 500, 1400 Vienna, Austria Tel: (+43-1) 26060-0, Fax: (+43-1) 26060-5866, www.unodc.org RECOMMENDED METHODS FOR THE IDENTIFICATION AND ANALYSIS OF AMPHETAMINE, METHAMPHETAMINE AND THEIR RING-SUBSTITUTED ANALOGUES IN SEIZED MATERIALS (revised and updated) MANUAL FOR USE BY NATIONAL DRUG TESTING LABORATORIES Laboratory and Scientific Section United Nations Office on Drugs and Crime Vienna RECOMMENDED METHODS FOR THE IDENTIFICATION AND ANALYSIS OF AMPHETAMINE, METHAMPHETAMINE AND THEIR RING-SUBSTITUTED ANALOGUES IN SEIZED MATERIALS (revised and updated) MANUAL FOR USE BY NATIONAL DRUG TESTING LABORATORIES UNITED NATIONS New York, 2006 Note Mention of company names and commercial products does not imply the endorse- ment of the United Nations. This publication has not been formally edited. ST/NAR/34 UNITED NATIONS PUBLICATION Sales No. E.06.XI.1 ISBN 92-1-148208-9 Acknowledgements UNODC’s Laboratory and Scientific Section wishes to express its thanks to the experts who participated in the Consultative Meeting on “The Review of Methods for the Identification and Analysis of Amphetamine-type Stimulants (ATS) and Their Ring-substituted Analogues in Seized Material” for their contribution to the contents of this manual. Ms. Rosa Alis Rodríguez, Laboratorio de Drogas y Sanidad de Baleares, Palma de Mallorca, Spain Dr. Hans Bergkvist, SKL—National Laboratory of Forensic Science, Linköping, Sweden Ms. Warank Boonchuay, Division of Narcotics Analysis, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand Dr. Rainer Dahlenburg, Bundeskriminalamt/KT34, Wiesbaden, Germany Mr. Adrian V. Kemmenoe, The Forensic Science Service, Birmingham Laboratory, Birmingham, United Kingdom Dr. Tohru Kishi, National Research Institute of Police Science, Chiba, Japan Dr. -
Serotonin Syndrome How to Avoid, Identify, &
Serotonin syndrome How to avoid, identify, & As the list of serotonergic agents grows, recognizing hyperthermic states and potentially dangerous drug combinations is critical to our patients’ safety. 14 Current VOL. 2, NO. 5 / MAY 2003 p SYCHIATRY Current p SYCHIATRY treat dangerous drug interactions Harvey Sternbach, MD Clinical professor of psychiatry UCLA Neuropsychiatric Institute Los Angeles, CA romptly identifying serotonin syn- drome and acting decisively can keep side effects at the mild end of the spec- Ptrum. Symptoms of this potentially dangerous syndrome range from minimal in patients starting selective serotonin reuptake inhibitors (SSRIs) to fatal in those combining monoamine oxidase inhibitors (MAOIs) with serotonergic agents. This article presents the latest evidence on how to: • reduce the risk of serotonin syndrome • recognize its symptoms • and treat patients with mild to life- threatening symptoms. WHAT IS SEROTONIN SYNDROME? Serotonin syndrome is characterized by changes in autonomic, neuromotor, and cognitive-behav- ioral function (Table 1) triggered by increased serotonergic stimulation. It typically results from pharmacodynamic and/or pharmacokinetic in- teractions between drugs that increase serotonin activity.1,2 continued VOL. 2, NO. 5 / MAY 2003 15 Serotonin Table 1 activity or reduced ability to How to recognize serotonin syndrome secrete endothelium-derived nitric oxide may diminish the System Clinical signs and symptoms ability to metabolize serotonin.2 Autonomic Diaphoresis, hyperthermia, hypertension, tachycardia, pupillary dilatation, nausea, POTENTIALLY DANGEROUS diarrhea, shivering COMBINATIONS Neuromotor Hyperreflexia, myoclonus, restlessness, MAOIs. Serotonin syndrome tremor, incoordination, rigidity, clonus, has been reported as a result of teeth chattering, trismus, seizures interactions between MAOIs— Cognitive-behavioral Confusion, agitation, anxiety, hypomania, including selegiline and insomnia, hallucinations, headache reversible MAO-A inhibitors (RIMAs)—and various sero- tonergic compounds. -
Evidence That Formulations of the Selective MAO-B Inhibitor, Selegiline, Which Bypass First-Pass Metabolism, Also Inhibit MAO-A in the Human Brain
BNL-107759-2015-JA Evidence that formulations of the selective MAO-B inhibitor, selegiline, which bypass first-pass metabolism, also inhibit MAO-A in the human brain Joanna S. Fowler1, Jean Logan2, Nora D. Volkow3,4, Elena Shumay4, Fred McCall-Perez5, Michelle Gilmor7, Millard Jayne4, Gene-Jack Wang4, David L. Alexoff1, Karen Apelskog-Torres4, Barbara Hubbard1, Pauline Carter1, Payton King1, Stanley Fahn6, Frank Telang4, Colleen Shea1, Youwen Xu1, Lisa Muench4 1Biosciences Department, Brookhaven National Laboratory, Upton, NY 11973, USA 2New York University Langone Medical Center, New York, NY 10016, USA 3National Institute on Drug Abuse, Bethesda, MD, USA 4National Institute on Alcohol Abuse and Alcoholism, Bethesda MD, USA 5Targeted Medical Pharma Inc, Los Angeles, CA 90077, USA 6Novartis Pharmaceuticals, East Hanover, NJ 07936, USA 7Neurological Institute, Columbia University, New York, NY, USA Submitted to Neuropsychopharmacology July 2014 Biological, Environmental and Climate Sciences Department Brookhaven National Laboratory U.S. Department of Energy Office of Science Office of Biological and Environmental Research Notice: This manuscript has been authored by employees of Brookhaven Science Associates, LLC under Contract No. DE-AC02-98CH10886 with the U.S. Department of Energy. The publisher by accepting the manuscript for publication acknowledges that the United States Government retains a non-exclusive, paid-up, irrevocable, world-wide license to publish or reproduce the published form of this manuscript, or allow others to do -
Predictable Increase of Central Nervous System Stimulation by a Pyrolysis Product in Smoking Dimethylamphetamine
264 Journal of Health Science, 50(3) 264–270 (2004) Predictable Increase of Central Nervous System Stimulation by a Pyrolysis Product in Smoking Dimethylamphetamine Motoyasu Sato,*, a Kenjiro Ito,a and Hisamitsu Nagaseb aScientific Investigation Research Laboratory, Aichi Pref. Police H.Q., 2–1–1 Sannomaru, Naka-ku, Nagoya 460–8502, Japan and bGifu Pharmaceutical University, 5–6–1 Mitahora-higashi, Gifu 502–8585, Japan (Received January 10, 2004; Accepted February 6, 2004) We carried out a dimethylamphetamine (DMA) smoking experiment that is closer to some real cases. In this study, we heated DMA hydrochloride (DMA-HCl) in the range of about 250°C to 350°C, in which demethylation reaction occurred mainly, with a smoke collection apparatus and gas lighter, and trapped the generating vapor with an adsorption cartridge. The eluate desorbed from the cartridge and residual materials inside the smoke collection apparatus were analyzed by gas chromatography-mass spectrometry and liquid chromatography-electrospray ion- ization-mass spectrometry. Methamphetamine (MA) and amphetamine (AM) were produced via demethylation from the dimethylamino group of DMA. Allylbenzene (AB), benzaldehyde (BA), cis-β-methylstyrene (cMS), benzyl chloride (BC) and trans-β-methylstyrene (tMS) in addition to MA and AM, were also formed as pyrolysis products. The molar percentages of a pyrolyzate MA and AM to the starting DMA were 21.4 and 1.8%, respectively, and the total molar percentage of AB, BA, cMS, BC and tMS was 2.9%. Taking into account the central nervous system stimulation by DMA and MA in humans, the total stimulant effects of the drugs that are ingested in a body can be calculatedly increased more than fourfold by smoking DMA.