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J Anal Toxicol. 2018 Mar 1;42(2):63-68. doi: 10.1093/jat/bkx082.

Recommendations for Toxicological Investigation of Drug-Impaired Driving and Motor Vehicle Fatalities-2017 Update.

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Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, 2300 Stratford Avenue, Willow Grove, PA 19090, USA.
NMS Labs, 3701 Welsh Road, Willow Grove, PA 19090, USA.
Arcadia University, 450 S Easton Road, Glenside, PA 19038, USA.
New York State Police Forensic Investigation Center, 1220 Washington Avenue, Building 30, Albany, NY 12226-3000, USA.
Wisconsin State Laboratory of Hygiene, 2601 Agriculture Drive, PO Box 7996, Madison, WI 53707-7996, USA.
New Hampshire Department of Safety, Division of State Police Forensic Laboratory, 33 Hazen Drive, Concord, NH 03305, USA.
Sam Houston State University, 1003 Bowers Boulevard, Huntsville, TX 77341, USA.
University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD 21201, USA.


This report describes the outcomes of a process undertaken to review and update the National Safety Council's Alcohol, Drugs and Impairment Division's recommendations for the toxicological investigation of suspected alcohol and drug-impaired driving cases and motor vehicle fatalities. The updates to the recommendations are made based on a survey of practices in laboratories in the USA and Canada performing testing in these cases, consideration of existing epidemiological crash and arrest data, current drug use patterns, and practical considerations of widely available technology platforms in laboratories performing this work. The final recommendations updates are derived from a consensus meeting of experts recruited from survey respondents and the membership of the National Safety Council's Alcohol, Drug and Impairment Division. The principal changes in this round of recommendations include removal of butalbital, phenobarbital, and phencyclidine from Tier I (mandatory) to Tier II (optional) due to changes in prevalence. In addition, buprenorphine, fentanyl, tramadol, and their metabolites were moved from Tier II to Tier I due to increased prevalence and concerns about their potential for causing impairment. In addition, screening and confirmatory cutoffs for the oral fluid scope were further refined. Other additions were made to the list of Tier II compounds including fentanyl analogs (e.g., acetylfentanyl, butyrylfentanyl, furanylfentanyl, etc), mitragynine, novel opioids (e.g., MT-45, U-47700), atypical antipsychotics, and novel benzodiazepines (e.g., clonazolam, flubromazolam, etc).

[Indexed for MEDLINE]

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