Unauthorized Drug Use in the US Army Based on Medical Review Officer Evaluations

Platteborze, Peter L.; Kippenberger, Donald J.; Martin, Thomas M.

doi:10.1093/jat/bku079

Cited by 5 publications

(4 citation statements)

References 2 publications

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“…While heroin was included on drug testing panels prior to 1999, prescription opioids were not included on drug testing panels until 2005, well after the onset of the opioid epidemic began. Oxycodone and oxymorphone were the first prescription opioids to be added to the drug test panel in 2005 (Platteborze et al 2014). However, servicemembers with prescriptions were not subject to disciplinary action if drug testing reflected the prescribed dosage over the relevant time periods (Platteborze et al 2014).…”

Section: Drug Testing For Opioids In the Us Militarymentioning

confidence: 99%

“…Oxycodone and oxymorphone were the first prescription opioids to be added to the drug test panel in 2005 (Platteborze et al 2014). However, servicemembers with prescriptions were not subject to disciplinary action if drug testing reflected the prescribed dosage over the relevant time periods (Platteborze et al 2014). Hydrocodone and hydromorphone were not added to the drug testing panel until 2012 (Rooney 2012), the year which also saw VA-issued opioid prescriptions beginning a steep decline.…”

Section: Drug Testing For Opioids In the Us Militarymentioning

confidence: 99%

See 1 more Smart Citation

Did the War on Terror Ignite an Opioid Epidemic?

Cesur

Sabia

Bradford

2019

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Grim national statistics about the U.S. opioid crisis are increasingly well known to the American public. Far less well known is that U.S. war veterans are at ground zero of the epidemic, facing an overdose rate twice that of civilians. Post-9/11 deployments to Afghanistan and Iraq have exposed servicemembers to injury-related chronic pain, psychological trauma, and cheap opium supplies, each of which may fuel opioid addiction. This study is the first to estimate the causal impact of combat deployments in the Global War on Terrorism on opioid abuse. We exploit a natural experiment in overseas deployment assignments and find that combat service substantially increased the risk of prescription painkiller abuse and illicit heroin use among active duty servicemen. War-related physical injuries, death-related battlefield trauma, and Post-Traumatic Stress Disorder emerge as primary mechanisms. The magnitudes of our estimates imply lowerbound combat exposure-induced health care costs of $1.04 billion per year for prescription painkiller abuse and $470 million per year for heroin use.

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Section: Drug Testing For Opioids In the Us Militarymentioning

confidence: 99%

Section: Drug Testing For Opioids In the Us Militarymentioning

confidence: 99%

Did the War on Terror Ignite an Opioid Epidemic?

Cesur

Sabia

Bradford

2019

View full text Add to dashboard Cite

show abstract

“…Heroin was the chief opioid included on drug testing panels prior to 1999; however, prescription opioids were not included on drug testing panels until 2005, well after the onset of the opioid epidemic began. Oxycodone and oxymorphone were the first prescription opioids to be added to the drug test panel in 2005 (Platteborze et al., 2014). However, servicemembers with prescriptions were not subject to disciplinary action if drug testing reflected the prescribed dosage over the relevant time periods (Platteborze et al., 2014).…”

Section: Introductionmentioning

confidence: 99%

“…Oxycodone and oxymorphone were the first prescription opioids to be added to the drug test panel in 2005 (Platteborze et al., 2014). However, servicemembers with prescriptions were not subject to disciplinary action if drug testing reflected the prescribed dosage over the relevant time periods (Platteborze et al., 2014). Hydrocodone and hydromorphone were not added to the drug testing panel until 2012 (Rooney, 2012), the year that also saw VA‐issued opioid prescriptions beginning a steep decline.…”

Section: Introductionmentioning

confidence: 99%

The effect of combat deployments on veteran opioid abuse

Cesur,

Sabia,

Bradford

2024

Health Economics

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Grim national statistics about the U.S. opioid crisis are increasingly well known to the American public. Far less well known is that U.S. servicemembers are at ground zero of the epidemic, with veterans facing an overdose death rate of up to twice that of civilians. Exploiting a quasi‐experiment in overseas deployment assignment, this study estimates the causal impact of combat exposure among the deployed in the Global War on Terrorism on opioid abuse. We find that exposure to war theater substantially increased the risk of prescription painkiller abuse and illicit heroin use among active duty servicemen. The magnitudes of our estimates imply lower‐bound combat exposure‐induced healthcare costs of $1.04 billion per year for prescription painkiller abuse and $470 million per year for heroin use.

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Prescription Opioids. V. Metabolism and Excretion of Oxymorphone in Urine Following Controlled Single Dose Administration

DePriest¹,

Heltsley²,

Black³

et al. 2016

J Anal Toxicol

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Oxymorphone (OM), a prescription opioid and metabolite of oxycodone, was included in the recently published proposed revisions to the Mandatory Guidelines for Federal Workplace Drug Testing Programs. To facilitate toxicological interpretation, this study characterized the time course of OM and its metabolite, noroxymorphone (NOM), in hydrolyzed and non-hydrolyzed urine specimens. Twelve healthy subjects were administered a single 10 mg controlled-release OM dose, followed by a periodic collection of pooled urine specimens for 54 h following administration. Analysis for free and total OM and NOM was conducted by liquid chromatography tandem mass spectrometry (LC-MS-MS), at a 50 ng/mL limit of quantitation (LOQ). Following enzymatic hydrolysis, OM and NOM were detected in 89.9% and 13.5% specimens, respectively. Without hydrolysis, OM was detected in 8.1% specimens, and NOM was not detected. The mean ratio of hydrolyzed OM to NOM was 41.6. OM was frequently detected in the first pooled collection 0-2 h post-dose, appearing at a mean of 2.4 h. NOM appeared at a mean of 8.3 h. The period of detection at the 50 ng/mL threshold averaged 50.7 h for OM and 11.0 h for NOM. These data support that OM analysis conducted using a 50 ng/mL threshold should include hydrolysis or optimize sensitivity for conjugated OM.

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Unauthorized Drug Use in the US Army Based on Medical Review Officer Evaluations

Cited by 5 publications

References 2 publications

Did the War on Terror Ignite an Opioid Epidemic?

Did the War on Terror Ignite an Opioid Epidemic?

The effect of combat deployments on veteran opioid abuse

Prescription Opioids. V. Metabolism and Excretion of Oxymorphone in Urine Following Controlled Single Dose Administration

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