DoD adds fentanyl to drug testing panel
By Staff Sgt. Nicole Leidholm, Armed Forces Medical Examiner System
/ Published November 22, 2019
DOVER AIR FORCE BASE, Del. -- The Department of Defense implemented new policy in March 2019 to direct all service Drug Demand Reduction Program labs to test for fentanyl and norfentanyl.
The DoD has a zero tolerance policy for the illegal or improper use of drugs by service members. Because of this, all U.S. service members are subject to random urinalysis testing.
When trends start to be seen in society, the DoD looks at the potency and lethality of the drug, before being considered for additional testing on the panel, said U.S. Navy Capt. Eric R. Welsh, Office of Drug Demand Reduction director.
Fentanyl is an opioid, similar to heroin. It is 50 times more potent than heroin and 100 times more potent than morphine.
“Fentanyl and its metabolite, norfentanyl, have garnered national attention lately because of fentanyl’s growing popularity and potential lethality,” said U.S. Navy Lt. Cmdr. Katherine Dozier, Armed Forces Medical Examiner System Special Forensic Toxicology Drug Testing Laboratory chief. “This, combined with the emergence of fentanyl and norfentanyl in SFTDTL’s DoD surveillance testing, led the Office of Drug Demand Reduction to petition for fentanyl’s addition to the standard DDRP drug testing panel.”
The five service branch DDRPs and the AFMES SFTDTL began fentanyl screening in June 2019.
“Very small quantities of fentanyl can have significant effects,” said Dozier. “The illicit drug trade is aware of this, and has used fentanyl to cheaply adulterate heroin, cocaine, and other illicit drugs to enhance effects.”
The SFDTL at AFMES provides surveillance testing for the DoD, as well as civilian populations through approved collaborations.
“The SFDTL determines current drug trends and confirmation testing for the five service DDRP labs,” said Dozier. “We confirm fentanyl and its metabolite, norfentanyl, as well as synthetic cannabinoids, commonly called Spice or K2.”
According to the National Institute of Drug Abuse, Spice and K2 are often called marijuana or “fake weed” because some of its chemicals are like those in marijuana, however, the effects can be unpredictable and in some cases, severe or even life-threatening.
“Robust, frequent and random drug testing of our personnel is one of our greatest weapons against drug use,” said Welsh. “Even though the Department tests for more drugs than ever before, the positive rate was the lowest observed in 20 years at 0.84 percent.”
According to DoD instruction 1010.16, drug testing is used to permit commanders to assess the security, military fitness, readiness, good order and discipline of their commands and allow commanders to take disciplinary or administrative action as appropriate.
“Illicit drug use by service members is a national security threat and a health and safety concern,” said Dozier. “Many of these drugs have been shown to affect decision-making, risk-taking, and levels of consciousness. For the well-being of every service member and every U.S. citizen they defend, illicit drug use in the military must be taken seriously.”
When a service member is asked to submit a urine sample for testing, it is done at their location’s DDRP. The sample is then shipped to the one of the five service branch FTDTLs, where it is tested via immunoassay, the same scientific technique used in pregnancy tests that allows for an answer of either negative or presumptive positive.
“If a specimen tests presumptively positive on the immunoassay for synthetic cannabinoids or fentanyl, it is sent to SFTDTL for confirmation,” said Dozier. “We confirm these specimens using Liquid Chromatography Tandem Mass Spectrometry.”
The spectrometer is able to positively identify and measure the amount of fentanyl or norfentanyl in urine specimens, which leads to a positive result reported.
“If there is a positive result for a prescription drug, such as fentanyl, the result will be forwarded to the medical review officer to determine if the use of the prescription is legitimate,” said Pamela Iseminger, 436th Air Wing DDRP manager. “If there is no medical documentation in the members file to substantiate the positive test, the unit commander will meet with the member to provide written notice of the positive result.”
Then, the member is provided 30 calendar days to produce any medical records or other documentation which may justify the positive result, said Iseminger.
“The DDRP directly impacts mission readiness,” said Iseminger. “It acts as the focal point for installation level drug urinalysis testing and drug prevention programs and ensures a work place free of illicit drugs use and provides a mission-ready fighting force at all times.”