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Rockville, MD, United States

Wish E.D.,University of Maryland College Park | Artigiani E.,University of Maryland College Park | Billing A.,University of Maryland College Park | Hauser W.,University of Maryland College Park | And 3 more authors.
Journal of Addictive Diseases | Year: 2012

The authors sampled for expanded drug testing of 1,061 urine specimens collected by Maryland Division of Parole and Probation staff. They found an increase in the percentage of individuals testing positive for buprenorphine and found that these specimens often contained other drugs, suggesting misuse. Subsequent interviews with 15 probationers and parolees in Baltimore, Maryland, showed wide-scale availability of buprenorphine on the street and in prisons. Medical examiners and drug testing programs should immediately initiate routine testing for buprenorphine to track a possible outbreak of buprenorphine diversion and misuse. Physician education programs should redouble their efforts to teach strategies to deter diversion and misuse of the drug. Copyright © Taylor & Francis Group, LLC. Source

Logan B.K.,The Center for Forensic Science Research and Education | Logan B.K.,Grove Labs | Mohr A.L.A.,The Center for Forensic Science Research and Education | Talpins S.K.,Institute for Behavior and Health Inc.
Journal of Analytical Toxicology | Year: 2014

The use of oral fluid (OF) drug testing devices offers the ability to rapidly obtain a drug screening result at the time of a traffic stop. We describe an evaluation of two such devices, the Dräger Drug Test 5000 and the Affiniton DrugWipe, to detect drug use in a cohort of drivers arrested from an investigation of drug impaired driving (n 5 92). Overall, 41% of these drivers were ultimately confirmed positive by mass spectrometry for the presence of one or more drugs. The most frequently detected drugs were cannabinoids (30%), benzodiazepines (11%) and cocaine (10%). Thirty-nine percent of drivers with blood alcohol concentrations >0.08 g/100 mL were found to be drug positive. Field test results obtained from OF samples were compared with collected OF and urine samples subsequently analyzed in the laboratory by gas or liquid chromatography-mass spectrometry. The Dräger Drug Test 5000 (DDT5000) and DrugWipe returned overall sensitivities of 51 and 53%, and positive predictive values of 93 and 63%, respectively. The most notable difference in performance was the DDT5000's better sensitivity in detecting marijuana use. Both devices failed to detect benzodiazepine use. Oral fluid proved to be a more effective confirmatory specimen, with more drugs being confirmed in OF than urine. © The Author 2014. Published by Oxford University Press. All rights reserved. Source

Reisfield G.M.,Florida College | Goldberger B.A.,Florida College | Gold M.S.,Florida College | DuPont R.L.,Institute for Behavior and Health Inc.
Journal of Analytical Toxicology | Year: 2012

Motor vehicle crashes are a leading cause of morbidity and mortality in the United States. Drivers with measurable quantities of potentially impairing illicit or prescription drugs in their body fluids are multiple times more likely to be involved in motor vehicle crashes than those without such drugs in their bodies. Drug-related impairment, however, cannot be inferred solely on the basis of the presence of drugs in biological fluids. Thus, for more than a quarter century, there has been a search for drug blood concentrations that are the equivalent of the 0.08 g/dL threshold for alcohol-impaired driving in the United States. We suggest that such equivalents are a mirage, and cannot be determined due to variable drug tolerance, lack of consistent relationships between drug blood concentrations and impairment, innumerable drug combinations and multiple other factors. Thus, while the idea of determining impairing drug concentrations is attractive, it is ultimately unattainable, and withholding drugged driving legislation pending the acquisition of such data is tantamount to a plan for inaction with regard to an important and growing public health and safety problem. We propose specific legislation to address alcohol- and drug-impaired driving in the United States. © The Author [2012]. Published by Oxford University Press. All rights reserved. Source

DuPont R.L.,Institute for Behavior and Health Inc. | Skipper G.E.,Promises Treatment Centers
Journal of Psychoactive Drugs | Year: 2012

The success of the nation's state physician health programs (PHPs) provides important new evidence on the potential for dramatically reducing relapse and promoting long-term recovery from substance use disorders. This article summarizes the findings of the first national PHP study and outlines six lessons learned from this model of care management: (1) zero tolerance for any use of alcohol and other drugs; (2) thorough evaluation and patient-focused care; (3) prolonged, frequent random testing for both alcohol and other drugs; (4) effective use of leverage; (5) defining and managing relapses; and (6) the goal of lifelong recovery rooted in the 12-Step fellowships. PHPs are a part of a new paradigm of care management that includes the programs developed for commercial pilots (HIMS) and for attorneys (CoLAP). Elements of this model of care have been used with a dramatically different patient population, and with similar success, in the criminal justice system in HOPE Probation and 24/7 Sobriety. The authors review these programs and discuss implications for extending elements of the new paradigm more widely. © Taylor & Francis Group, LLC. Source

Coleman J.J.,Prescription Drug Research Center | Schuster C.R.,Wayne State University | Schuster C.R.,CRS Associates LLC | DuPont R.L.,Institute for Behavior and Health Inc.
Pharmaceutical Medicine | Year: 2010

Prescription drugs, principally opioid analgesics, now account for more fatal drug overdoses in the US than heroin and cocaine. Experts offer several theories for this, including the introduction within the past decade of high dosage, extended-release drug formulations that have proven easy to manipulate for abuse purposes. At the same time, the prescribing of immediate- and extended-release pain relievers the most highly abused category of prescription drugs has increased significantly. Regulatory agencies, in turn, have increased their oversight of prescribers, dispensers and manufacturers of controlled substances. For its part, the pharmaceutical industry has shown a modest but growing interest in developing abuse-deterrent drugs. In this article, we review the progress being made through the use of technology and design in mitigating the abuse potential of currently marketed and newly approved drugs, as well as several pipeline candidates. We discuss obstacles facing the future of this novel approach to reducing prescription drug abuse and conclude with policy recommendations intended to encourage the development of abuse-deterrent drugs. © 2010 Adis Data Information BV. All rights reserved. Source

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