This page contains a Flash digital edition of a book.

FRA Issues Final Rule on Post Accident Drug Testing Te Federal Railroad Administration

(FR) issued a final rule that requires post accident testing for certain over-the-coun- ter and prescription drugs. Te Rule was ef- fective May 6, 2013. On May 17, 2012, the FR proposed to add routine post-accident tests for certain non-controlled substances with potentially impairing side effects (77 FR 29307). As discussed in the NPRM, studies have shown a significant increase in the daily use of prescription drugs, over the counter (OTC) drugs, vitamins, and herbal and dietary supplements by both railroad workers and the general popula- tion. Although most prescription drugs and all OTC drugs are non-controlled substances, many commonly used ones, such as antihistamines and muscle relax- ants (e.g., tramadol), carry warning labels against driving or moving heavy machinery because of their potential sedating effects. Furthermore, even prescription and OTC drugs that do not carry such warnings can have unintended side effects when taken in combination with other drugs, when not used in accordance with directions, or when a user has an unusual reaction. Te FR established this rule for the sake of safety and the full notice can be viewed at htp:// 03-05/html/2013-05010.htm

Reporting Positive 6-Acetylmorphine (6-AM) Results Te National Laboratory Certification

Program (NLCP) issued a notice to pro- vide guidance for MROs reviewing positive 6-AM results reported by laboratories certified by the Department of Health and Human Services (HHS) under the NLCP. Recent discussion concerning result

interpretation and the source of 6-AM in urine specimens prompted HHS to send the notice. It continues to be the position of HHS that when a laboratory reports a specimen as positive for the heroin metabolite (6-AM), this is proof of heroin use. Tere is no legiti- mate medical explanation for a 6-AM positive result (see HHS Mandatory Guidelines, Sec- tion 13.4(d), effective October 1, 2010). HHS also noted that in 2010, HHS and

RTI International conducted a scientifically valid study of Department of Transporta- tion (DOT) specimens reported as con- firmed positive for 6-AM and negative for morphine. Te study found “no evidence indicating that the 6-AM originated from a source other than heroin.” [See Interim Final Rule dated May 2012]. Terefore, MROs will continue to

report laboratory-confirmed 6-AM posi- tive results as verified positive drug tests, in accordance with the HHS Mandatory Guidelines and DOT Regulations (See 49 CFR Part 40 at 40.139.a).

DEA Continues to Act Against Synthetic Drugs On April 12, 2013 the United States Drug

Enforcement Administration (DEA) pub- lished a Final Rule to permanently control 3,4-methylenedioxy-N-methylcathinone (methylone), a synthetic stimulant drug that has been encountered in falsely marketed “bath salt” products, into Schedule I under the Controlled Substances Act, the most restrictive category that is reserved for unsafe, highly abused substances with no accepted medical use. Methylone is abused

26 datia focus

by individuals for its psychoactive effects, and this abuse has had an adverse effect on public health and safety, including death. Te DEA temporarily scheduled methylone on October 21, 2011 upon finding it posed an imminent hazard to public safety. In addi- tion the United States Department of Health and Human Services concluded that it should be controlled. On October 17, 2012, the DEA proposed to make its Schedule I status permanent, taking steps that conclude with this Final Rule. Over the past two years, synthetic stimulants sold under the guise of “bath salts” or “plant food” has become in- creasingly popular, particularly among teens and young adults, and is sold at a variety of retail outlets and over the Internet. However, they have not been approved by the FDA for human consumption or for medical use. Marketed under names such as “Ivory Wave”, “Purple Wave”, “Vanilla Sky” or “Bliss,” these products are comprised of sub- stances perceived as mimics of cocaine, LSD, MDMA, and/or methamphetamine. Users have reported impaired perception, reduced motor control, disorientation, extreme para- noia, and violent episodes. Te long-term physical and psychological effects of these substances and their associated products are unknown but potentially severe. On May 16, 2013 the United States

Drug Enforcement Administration (DEA) made the synthetic cannabinoids UR-144, XLR11, and AKB48 Schedule I, illegal drugs under the Controlled Substances Act (CSA) for the next two years. Tese cannabinoids are oſten seen in so-called “fake pot” products that are falsely marketed and sold as “herbal incense” or “potpourri” products on the Internet and by a variety of retail stores. Synthetic cannabinoids refer to a family of substances that act on the brain similar to delta-9 THC, the main psychoactive constituent of cannabis. Te actual chemical names of these controlled cannabinoids are: (1-pentyl-1H-indol-3-yl) (2,2,3,3-tetramethylcyclopropyl) methanone (UR-144);[1-(5-fluoro-pentyl)-1H- indol-

summer 2013

Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66