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ADCO Summit 30 August 2010

ADCO Summit 30 August 2010. The Navy Drug Testing Program and Navy Drug Screening Laboratories (NDSLs). MISSION. To ensure scientifically valid , legally defensible (forensic) , and timely drug test results. NDSL GREAT LAKES. Customers: -All DoD military entrants (MEPS)

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ADCO Summit 30 August 2010

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  1. ADCO Summit30 August 2010 The Navy Drug Testing Program and Navy Drug Screening Laboratories (NDSLs)

  2. MISSION To ensure scientifically valid, legally defensible (forensic), and timely drug test results.

  3. NDSL GREAT LAKES Customers: -All DoD military entrants (MEPS) -Naval Service Training Commands -COMNAVSURFLANT (01Nov09) -600,000 samples tested annually

  4. NDSL JACKSONVILLE Customers: -Navy & Marine Corps Units located east of the Mississippi; except COMNAVSURFLANT -Army Units at Fort Benning, GA and Redstone Arsenal, AL -1,000,000 samples tested annually

  5. NDSL SAN DIEGO Customers: -Navy & Marine Corps Units located west of the Mississippi; except selected units in Hawaii (samples sent to Tripler Army Lab) -900,000 samples tested annually

  6. SAMPLE WORKLOAD projected

  7. LABORATORY SERVICES • Urine Drug Testing • Technical Consultation • Legal Support (testimony, affidavits, testing documents) • Laboratory Tours • Customer Training & Marketing • Development of New Procedures

  8. SAMPLE TESTING • 100% of Military Samples are Tested for: • Marijuana (THC) • Cocaine (Benzoylecgonine) • Amphetamines (Amph & Meth) • Designer Amphs (MDA & MDMA – Ecstasy) • Heroin (6-AM) • 20% - 50% of Military Samples are Tested for: • PCP (Phencyclidine) • Opiates (Codeine & Morphine) • Synthetic Opiates (Oxycodone & Oxymorphone)

  9. SPECIAL TESTING • Compounds not on the NDSL testing panel • Limited numbers of samples • Usually “probable cause” testing • Armed Forces Institute of Pathology • Ketamine, GHB, Psilocin (Magic Mushrooms), Salvia, LSD, etc. • Prescription Drugs - Barbiturates, Vicodin, Benzodiazepines (Valium, Xanax, Librium), etc. • Steroids • Navy & Marine Corps samples must be sent to NDSL San Diego • Testing at UCLA Olympic Testing Lab

  10. TESTING PROCEDURES • SCREEN • IMMUNOASSAY • CONFIRMATION • GC/MS

  11. INITIAL SCREEN All samples are screened by immunoassay Allows the laboratory to process 4,000-5,000 samples / day and identify those that likely contain drugs Samples that test negative are discarded

  12. RESCREEN Samples that test positive on the initial screen may be tested again by immunoassay for the specific drug(s) for which they initially screened positive Samples that test negative are discarded

  13. CONFIRMATION Samples that test positive on the screen are analyzed by gas chromatography-mass spectrometry (GC-MS) to confirm the presence and the amount of drug in the sample A new sample is poured from the bottle for this test GC-MS gives a “fingerprint” of the drug, which is unique to that drug for positive identification

  14. CONFIRMATION

  15. TEST RESULTS • Samples must be positive on the screen and confirmation tests to be reported positive • Negative results reported 1-3 days after samples received • Positive results reported 3-5 days after samples received • Positive samples retained in frozen storage 1 year

  16. REPORTING RESULTS • Results posted on a secure web portal • iFTDTL • Commands must have iFTDTL access: Drug Labs can not provide message results after 30Sep10 • Better than Message System or Email • secure / can’t be edited or deleted • reliable / minimal downtime • timely / daily downloads • archived / data driven reports

  17. CUTOFF LEVELS • Administrative Cutoff: The concentration (ng/ml) of drug in urine that serves as a breakpoint for identifying a result as positive or negative. • Eliminate non-abuse exposure • Passive inhalation of THC • Poppy seed ingestion • Consider analytical & instrument capabilities

  18. DETECTION TIME Detection GC-MS Drug (days) (ng/mL) Marijuana (THC) 5* 15 Cocaine (BZE) 3 100 D-Amph/D-Meth 3 100 MDA/MDMA 3 500 Heroin (6AM) ~1 10 Codeine 2 2000 Morphine 2 4000 Oxycodone 3 100 Oxymorphone 3 100 PCP 3 25 *longer with chronic/daily use

  19. DRUG CONCENTRATION High dose – used 3 days ago Low dose – used yesterday Used Today DrugConcentration * Cutoff Conc Urine collection Time

  20. DRUG USE AMONGHIGH SCHOOL SENIORS Any illicit drug Past year 36.5% Past month 23.3% Marijuana Past year 32.8% Past month 20.6% Daily 5.2% Amphetamines Past year 6.6% Past month 3.0% Cocaine Past year 3.4% Past month 1.3% Oxycontin Past year 4.9% Source: 2009 Monitoring the Future Study – Univ. of Michigan

  21. THE TRUTH ABOUT THE MYTHS Passive inhalation of marijuana smoke (under real world conditions) will not cause a positive THC result.

  22. THE TRUTH ABOUT THE MYTHS Taking large amounts of niacin (vitamin B3) will not mask a positive result.

  23. THE TRUTH ABOUT THE MYTHS Novocaine, Lidocaine/Xylocaine will not cause a positive cocaine result.

  24. THE TRUTH ABOUT THE MYTHS Vicks Inhaler will not cause a positive methamphetamine result: The laboratories distinguish between the different forms (d and l) of methamphetamine.

  25. THE TRUTH ABOUT THE MYTHS Over the counter cold medications, weight loss products, performance enhancers (i.e., ephedra, ephedrine, pseudoephedrine) will not cause a positive amphetamine result.

  26. THE TRUTH ABOUT THE MYTHS Over-the-counter herbal nutritional supplements (manfactured and sold in the US) will not cause a positive THC result. THC levels in hemp seed oil products have been significantly reduced through DEA regulation.

  27. THE TRUTH ABOUT THE MYTHS It is not likely that ingestion of large concentrations of poppy seeds will cause a positive morphine result.

  28. SPICE - LIKE PRODUCTS

  29. SPICE-LIKE PRODUCTS • Sold as herbal incense / potpourri – not for human consumption • Different products contain various synthetic cannabinoid (marijuana-like) compounds producing different effects (some much more potent than marijuana) – most are not scheduled in the US (only HU-210) • Smoked for marijuana-like effects (euphoria, altered consciousness) • Compounds will not be detected during urinalysis at drug labs • Chasing a moving target – underground chemists can design new synthetic compounds to • Optimize physical & psychological effects • Improve marketability by advertising lack of detectability

  30. DEVIL TRACKS • Sold as plant food – not for human consumption • Allegedly contains Mephedrone • (4-methylmethcathinone) • Chemically related to Ecstasy • Effects similar to Ecstasy have been reported - euphoria, well-being, increased alertness • Not scheduled in the US

  31. METHYLENEDIOXYPYROVALERONE(MDPV) Sold as bath salts – not for human consumption Stimulant - increased alertness, awareness, and wakefulness, euphoria, anxiety, agitation, and perception of a diminished requirement for food and sleep, tachycardia, hypertension Instructions warn about using too much and combining with alcohol

  32. CONTROLLED SUBSTANCE ANALOGUES • Many of these “designer drugs” are not scheduled / listed in the Controlled Substances Act • Federal Analogue Act - allows any chemical "substantially similar" to an illegal drug (in Schedule I or II) to be treated as if it were also in Schedule I or II, but only if it is intended for human consumption.

  33. NAVY POLICY • Issue must be addressed by through policy vice urinalysis • Use of controlled substance analogues, such as designer drugs, and consumption of substances for other than their intended use (intoxication / stupefaction) is PROHIBITED • SECNAV 5300.28D • OPNAV 5350.4D • CNO NAVADMIN 108/10 (also prohibits possession) • Violators subject to UCMJ Article 92 (violation of a lawful order) and adverse administrative action • For more information on Spice / herbal incense visit: www.npc.navy.mil/CommandSupport/NADAP/WhatsNew

  34. Maté de Coca (Coca Tea) Leaves from the coca plant (Erythroxylum coca) De-cocainized tea is legally sold in the US

  35. COMMAND URINALYSISPROGRAM Frequent Unannounced Random Small groups Attentive observers Senior staff supported Complete chain of custody documentation 4 collections each month 15% of assigned personnel each month

  36. ATTEMPTING TO DEFEAT A DRUG TEST Hydration - Drinking fluids to dilute the urine followed by urination so the concentration of drug drops below the administrative cutoff

  37. ATTEMPTING TO DEFEAT A DRUG TEST Detoxification – Using agents to assist in the removal of substances from the body

  38. ATTEMPTING TO DEFEAT A DRUG TEST Dilution - Adding another liquid (i.e., water) to the urine in the bottle to lower the drug concentration

  39. ATTEMPTING TO DEFEAT A DRUG TEST Adulteration - Adding something to the urine in the bottle that destroys the drug or interferes with the testing process

  40. ATTEMPTING TO DEFEAT A DRUG TEST Substitution - Replacing the urine in the bottle with known negative/synthetic urine or another liquid (i.e., water, apple juice, Gatorade, Mountain Dew)

  41. TALK TO THE NDSL TECHNICAL EXPERTS testing procedures at the NDSLs concentration of drug in urine (ng/mL) window of detection whether an over the counter or prescription medication can cause a positive result to validate/invalidate the credibility of a member’s story unknowing ingestion (“someone put something in my drink”) innocent ingestion (“I had a poppyseed bagel for breakfast”) passive inhalation (“I was at a concert where people were smoking marijuana”)

  42. NDSL GREAT LAKESPOINTS OF CONTACT CO’s Secretary: DSN 792, (847) 688-2045, ext 112 FAX (847) 688-5513 Admin Services: (847) 688-2045, ext 110 Expert Witnesses: Dr. Jacob Snyder, ext 113 Dr. Robert Romberg, ext 124 Mr. Charles Kazarian, ext 126

  43. NDSL JACKSONVILLEPOINTS OF CONTACT CO’s Secretary: DSN 942, (904) 542-7755, ext 100 FAX (904) 542-7761 Admin Services: (904) 542-7755, ext 130, 131 Expert Witnesses: Mr. Robert Sroka Mr. Al Marinari Dr. Rick Bateh

  44. NDSL SAN DIEGOPOINTS OF CONTACT CO’s Secretary: DSN 522, (619) 532-7141 FAX (619) 532-7337 Admin Services: (619) 532-5174 Expert Witnesses: Dr. Paul Robandt Dr. Jim Callies

  45. QUESTIONS CDR Lisa McWhorter, MSC, USN Program Manager (757) 953-0750 / DSN 377 lisa.mcwhorter@med.navy.mil Cheri Baird Deputy, Program Manager (757) 953-0751 / DSN 377 cheri.baird@med.navy.mil Navy and Marine Corps Public Health Center Portsmouth, VA

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