title: Retrospective study of urinalysis for dl-amphetamine and dl-methamphetamine analysis under current Department of Defense guidelines.
abstract: Under current Department of Defense (DOD) directive, the laboratories certified to conduct urinalyis testing in support of the DOD Drug Deterrence Program are required to conduct dl-isomer analysis on all specimens that confirm at a concentration greater than 500 ng/mL methamphetamine (METH). Although the same cutoff concentration is required for amphetamine (AMP) reporting, there is no requirement for dl-isomer analysis of AMP-positive specimens. Of the 894,823 specimens screened by the Army Drug Testing Laboratory at Ft. Meade, MD during a 19-month period, 339 confirmed positive for METH. From this positive population, seven specimens failed to confirm at or above the DOD cutoff of > 20% d-isomer. One of the seven specimens contained 534 ng/mL l-AMP and was reported positive for AMP. Although 100% of the AMP was the l-isomer, under current DOD directive, this information was not passed along to the Medical Review Officers (MRO) to assist them during the interview process. Although this situation appears to be a rare event, consideration should be given to requiring dl-isomer analysis of AMP-positive specimens and forwarding this information to the MRO.
authors.affiliation: U.S. Army Forensic Toxicology Drug Testing Laboratory, Fort Meade, Maryland 20755, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Shippee
authors.forename: D J
authors.initials: DJ
authors.lastname: Kippenberger
mesh_terms: D000661:Amphetamine / Q000652:urine*; D006077:Government Agencies; D017408:Guidelines as Topic; D006801:Humans; D008694:Methamphetamine / Q000652:urine*; D012189:Retrospective Studies; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D008694:Methamphetamine; D000661:Amphetamine