Is 1971 ng/mL amp consistent with one dose of Adderall?

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lrowe

Is 1971 ng/mL amp consistent with one dose of Adderall?

Post by lrowe » Thu Jun 17, 2010 2:38 pm

DOT urine drug test positive for amphetamine at level of 1,971 ng/mL. Donor could not provide medical explanation but stated that his wife accidentally put his son's Adderall tablet in his meds which were taken approximately 24 hrs before collection. I told him that this would not be considered a legitimate medical explanation so the report was verified as positive. He is challenging the test result and I will be asked to testify whether or not taking one dose of Adderall 24 hours prior to collection would account for a level of 1,971. Could this level be consistent with a single dose taken 24 hours prior to collection?



DrSteve

Re: Is 1971 ng/mL amp consistent with one dose of Adderall?

Post by DrSteve » Thu Jun 17, 2010 2:53 pm

It is not your job as an MRO to determine whether or not this level is consistant with the level at the time of the test. The simple answer is that it is possible, but without more information (like regular Adderall, Adderal XR, the dose, the urine creatinine level, etc., it would be harder.

You have determined that the + drug test was because he does not have a legit medical explanation. You have no factual knowledge that he took his son's Adderall by mistake. I suspect that this "story" may not be plausible. And the DOT regs do not allow you to even consider this.

You stated you will be "asked to testify whether or not taking one dose of Adderall 24 hours prior to collection would account for a level of 1,971" Who is asking for your testimony. and Why?

Steven Herbets, M.D.

lrowe wrote:DOT urine drug test positive for amphetamine at level of 1,971 ng/mL. Donor could not provide medical explanation but stated that his wife accidentally put his son's Adderall tablet in his meds which were taken approximately 24 hrs before collection. I told him that this would not be considered a legitimate medical explanation so the report was verified as positive. He is challenging the test result and I will be asked to testify whether or not taking one dose of Adderall 24 hours prior to collection would account for a level of 1,971. Could this level be consistent with a single dose taken 24 hours prior to collection?

lrowe

Re: Is 1971 ng/mL amp consistent with one dose of Adderall?

Post by lrowe » Thu Jun 17, 2010 5:08 pm

I am scheduled to testify in a termination hearing with the employer and the employee's union. The employer's attorney will be asking the question. I realize that while wearing my MRO hat I offer no opinion and my only duty is verification of the test result. However, I am anticipating a request to render an opinion while wearing my toxicologist hat.

Robert Swotinsky MD
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Re: Is 1971 ng/mL amp consistent with one dose of Adderall?

Post by Robert Swotinsky MD » Thu Jun 17, 2010 5:46 pm

Yes, 1971 ng/mL is consistent with taking one Adderall tablet the day before.

Adderall is available in dosages ranging from 5 to 30 mg amphetamine. A 20 mg dose is typical. Urine amphetamine concentrations are usually less than 4500 ng/mL in adults given a single 20 mg oral dose and peak at 2-18 hours post-administration [A Poklis. Urinary dextroamphetamine in adult attention deficit/hyperactivity disorder. JAT 21:176-177, 1997, http://www.ncbi.nlm.nih.gov/pubmed/9788523]. Bring the abstract with you to court. Better yet, purchase the article on line and use it to support your opinion.

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