Class of 2005 Abstract / Objectives: To determine the frequency with which students living in a dormitory at a large state university share prescription controlled substances. Methods: Questionnaires which collected information about sharing of controlled substances were administered outside Manzanita residence hall. The questionnaire consisted of 11 questions and included what medications were shared, the frequency and reasons for sharing, and effects experienced; data on gender and age were also collected. Results: Questionnaires were completed by 80 males and 46 females. Fifty-one percent of males and 35% of females reported sharing controlled substances. The most commonly shared medications were pain killers (26 males and 9 females) and amphetamines (21 males and 7 females), with benzodiazepines being the next most commonly shared category of controlled substances (10 males and 4 females). Most students reported sharing controlled substances for recreational purposes, with study aid purposes being the second most reported reason. Few students reported sharing controlled substances for medical purposes. Implications: Controlled substances are frequently shared among students living in Manzanita Hall at Arizona State University for both recreational use and as study aids. Few students share controlled substances for medical purposes.

Class of 2006 Abstract / Objectives: To determine the economic impact of controlled substance destruction in multiple long term care facilities in Southern Arizona and to identify related demographic characteristics of the patients and facilities. Methods: Subjects had controlled substance prescriptions destroyed at nursing homes serviced by a pharmacy nursing home provider in Tucson, Arizona. Controlled substances destruction records and existing prescription records were reviewed and data was collected on the name, strength, number of units destroyed, date of destruction and schedule of each controlled medication that was destroyed for a particular patient over the course of a year. Demographic data was collected on patient gender, age, type of insurance coverage and the size of the nursing home facilities. Results: A total of 1095 controlled substance prescriptions were destroyed during the time period of the study and the total cost of destroyed medication was $26,886.37. The average cost of destroyed medication per prescription was $24.55 ± 60.38 (mean ± SD). Schedule II controlled substances accounted for the highest total cost per prescription destroyed and destruction of unused controlled substances cost indigent insurance programs more than any of the other payers studied. There was no difference in mean cost per prescription destroyed by facility, therapeutic class or between women and men. Conclusions: The value of controlled substance destruction in long term care facilities is sizeable. To reduce waste, prescribers and pharmacy providers should initially dispense moderate quantities of controlled substances until it is apparent that the medication is tolerable and efficacious for the patient.

Indiana University-Purdue University Indianapolis (IUPUI) / Gas chromatography-mass spectrometry (GC-MS) is one of the most widely used instrumental techniques for chemical analyses in forensic science laboratories around the world due to its versatility and robustness. The most common type of chemical evidence submitted to forensic science laboratories is seized drug evidence, the analysis of which is largely dominated by GC-MS. Despite this, some drugs are difficult or impossible to analyze by GC-MS under normal circumstances. For these drugs, derivatization can be employed to make them more suitable for GC-MS. In Chapter 1, the derivatization of primary amino and zwitterionic drugs with three different derivatization agents, trifluoroacetic anhydride (TFAA); N,O-bis(trimethylsilyl)trifluoroacetamide + 1% trimethylchlorosilane (BSTFA + 1% TMCS); and dimethylformamide dimethylacetal (DMF-DMA), is discussed. The chromatographic performance was quantified for comparison between the derivatives and their parent drugs. Peak symmetry was compared using the asymmetry factor (As), separation efficiency was measured by the number of theoretical plates (N), and sensitivity was compared by measuring the peak areas. In Chapter 2, derivatization techniques were adapted for an automated on-fiber derivatization procedure using a technique called total vaporization solid phase microextraction (TV-SPME). TV-SPME is a variation of SPME in which a small volume of sample solution is used which can be totally vaporized, removing the need to consider the equilibrium between analytes in the solution and analytes in the headspace. By allowing derivatization agent to adsorb to the SPME fiber prior to introduction to the sample vial, the entire derivatization process can take place on the fiber or in the headspace surrounding it. The use of a robotic sampler made the derivatization procedure completely automated. In Chapter 3, this on-fiber derivatization technique was tested on standards of 14 controlled substances as well as on realistic samples including simulated “street meth”, gamma-hydroxybutyric acid (GHB) in mixed drinks, and hallucinogenic mushrooms, and was also tested on several controlled substances as solid powders. Future work in this area is discussed in Chapter 4, including adapting the method to toxicological analyses both in biological fluids and in hair. Some of the expected difficulties in doing so are discussed, including the endogenous nature of GHB in the human body. The presence of natural GHB in beverages is also discussed, which highlights the need for a quantitative addition to the method. Additional method improvements are also discussed, including proposed solutions for complete derivatization of more of the analytes, and for decreasing analysis time.

OBJECTIVE: To review existing PDMP statutes, and to provide recommendations for good legislative drafting that will create effective statutory components that will enhance the function and increase the use of PDMPs. METHODS: This policy review was conducted from July 2014 to December 2014, using articles dated January 01, 2004 to July 01, 2014. All PubMed searches were artificially limited to peer reviewed articles that were available as “free full text.” To ensure a comprehensive review of the policies, statutes from all fifty states were surveyed using the legal database, Westlaw Next. The search used terms associated with PDMPs. Each statute was reviewed by title and content to determine applicability to the study. The list of statutes compiled from Westlaw Next was compared with existing publications that survey PDMP statutes. The recommendations are based on the investigator’s experience and training in law and public health in consultation with a legislative expert, and supported by peer reviewed articles and legislative drafting guides. RESULTS: There are twelve main topical components that are addressed in existing state PDMP statutes. The policy brief’s primary three recommendations are to implement an advisory committee with an outlined membership, impose a duty for the committee to routinely review database information and to report on the findings, mandate practitioners to consult the database prior to administering controlled substances, and enact a PDMP educational component for practitioners. Appendix A of this policy review (attached) provides a full list of the recommendations for effective legislation on all twelve topical components.

No description available.

Prescription drug use is a growing public health concern and studies show it is a contributing risk to motor vehicle collisions. The Appalachian region is also known to have an ever-increasing number of patients on controlled substances. This retrospective study of patients from the years 2011-2015 on controlled substances presenting to an Appalachian Level 1 trauma center after a motor vehicle or motorcycle collision was analyzed in order to determine the rate of opioid use among victims of motor vehicle collisions in the system, as well as evaluate for any differences in resource utilization between these patients and patients not using controlled substances. A total of 2,570 patients were included in the study. Seven-hundred sixty-eight (29.9%) individuals were found to be on a controlled substance. There was a similar mortality rate in both groups (2.8% vs 3.6%). There was no significant difference in hospital length of stay (LOS), intensive care unit (ICU) LOS, ventilator days, or injury severity score. Statistically significant findings include the type of crash (motor vehicle crash vs motorcycle crash) (p=0.003) and position in the vehicle (driver vs passenger) (p<0.001). Motor vehicle crashes and driver position were significantly associated with the presence of a controlled substance.

Abstract available through the Journal of Pharmacy Practice.

Forensic science has a significant historical and contemporary relationship with the criminal justice system. It is a relationship between two disciplines whose origins stem from different backgrounds. It is trite that effective communication assist in resolving underlying problems in any given context. However, a lack of communication continues to characterise the intersection between law and science. As recently as 2019, a six-part symposium on the use of forensic science in the criminal justice system again posed the question on how the justice system could ensure the reliability of forensic science evidence presented during trials. As the law demands finality, science is always evolving and can never be considered finite or final. Legal systems do not always adapt to the nature of scientific knowledge, and are not willing to abandon finality when that scientific knowledge shifts. Advocacy plays an important role in the promotion of forensic science, particularly advocacy to the broader scientific community for financial support, much needed research and more testing. However, despite its important function, advocacy should not be conflated with science. The foundation of advocacy is a cause; whereas the foundation of science is fact. The objective of this research was to conduct a qualitative literature review of the field of forensic science; to identify gaps in the knowledge of forensic science and its integration in the criminal justice system. The literature review will provide researchers within the field of forensic science with suggested research topics requiring further examination and research. To achieve its objective, the study critically analysed the historical development of, and evaluated the use of forensic science evidence in legal systems generally, including its role regarding the admissibility or inadmissibility of the evidence in the courtroom. In conclusion, it was determined that the breadth of forensic scientific knowledge is comprehensive but scattered. The foundational underpinning of the four disciplines, discussed in this dissertation, has been put to the legal test on countless occasions. Some gaps still remain that require further research in order to strengthen the foundation of the disciplines. Human influence will always be present in examinations and interpretations and will lean towards subjective decision making. / Jurisprudence / D. Phil.