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J Anal Toxicol. 2014 Jul 6. pii: bku079. [Epub ahead of print]  Unauthorized Drug Use in the US Army Based on Medical Review Officer Evaluations.  Platteborze PL1, Kippenberger DJ2, Martin TM3.  Brooke Army Medical Center-DPALS, JBSA, Fort Sam Houston, TX, USA; USAMEDCOM, JPSA, Fort Sam Houston, TX, USA;  Pentagon Office of the Under Secretary of Defense (Personnel and Readiness), Personnel Risk Reduction, Washington, DC, USA.

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.

Published by Oxford University Press 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

PMID: 25002456