title: Unauthorized drug use in the US Army based on medical review officer evaluations.
abstract: This article examines the US Army's Medical Review Officer (MRO) drug positive urinalysis evaluations from 2009 through 2012. We retrospectively analyzed nearly 70,000 MRO results by year, drug and Army component. Of the MRO reviewable positive results, the Army's unauthorized drug positive rate was 22.21%. The component rates were 20.81, 24.17 and 26.09% for the Active Duty, Reserve and National Guard, respectively. By drug, the average unauthorized rates over these 4 years were 13.78% for oxycodone, 24.62% oxymorphone, 18.56% d-amphetamine, 98.04% d-methamphetamine, 21.97% codeine, 45.21% morphine and 100% steroids. In 2012 testing began for hydrocodone and hydromorphone and their unauthorized rates were 12.32 and 15.04%, respectively. The Army's unauthorized drug positive rate peaked in 2012 when it increased over 44% from the previous year. The 2012 rates in decreasing order were steroids > D-methamphetamine > morphine > oxymorphone > oxycodone > codeine > D-amphetamine > hydromorphone > hydrocodone. This comprehensive analysis showed that the majority of the Army's MRO reviews were associated with the use of authorized prescriptions; however, there appears to be significant abuse of oxycodone and D-amphetamine.
authors.affiliation: Brooke Army Medical Center-DPALS, JBSA, Fort Sam Houston, TX, USA peter.platteborze@us.army.mil.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Platteborze
authors.affiliation: USAMEDCOM, JPSA, Fort Sam Houston, TX, USA.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Kippenberger
authors.affiliation: Pentagon Office of the Under Secretary of Defense (Personnel and Readiness), Personnel Risk Reduction, Washington, DC, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Martin
mesh_terms: D000661:Amphetamine / Q000652:urine; D003061:Codeine / Q000652:urine; D006801:Humans; D006853:Hydrocodone / Q000652:urine; D004091:Hydromorphone / Q000652:urine; D008694:Methamphetamine / Q000652:urine; D008889:Military Personnel; D009020:Morphine / Q000652:urine; D010098:Oxycodone / Q000652:urine; D010111:Oxymorphone / Q000652:urine; D012189:Retrospective Studies; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis*; D014481:United States; D016482:Urinalysis
chemical_list: D008694:Methamphetamine; D006853:Hydrocodone; D009020:Morphine; D010111:Oxymorphone; D010098:Oxycodone; D000661:Amphetamine; D004091:Hydromorphone; D003061:Codeine