Workshop #1: Benzodiazepines for DummiesAnd Smarties, Too! · 2019. 9. 16. · benzodiazepine...
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Workshop #1: Benzodiazepines for Dummies...And Smarties, Too! Date Monday, October 14, 2019 Time 8:00 am- 12:00 pm Cost Member Rates Early Bird Registration May 1- Aug 22 Late Registration Aug 23-Sept 29 On-site Registration Sept 30-Oct 15 $125 $150 $175 Non-member Rates Early Bird Registration May 1- Aug 22 Late Registration Aug 23-Sept 29 On-site Registration Sept 30-Oct 15 $175 $200 $225 Chairs Marc A. LeBeau Senior Scientist FBI Laboratory [email protected] Jeri Ropero-Miller Chief Scientist RTI International [email protected] Abstract While the U.S. opioid epidemic has garnered the country’s attention, the abuse of benzodiazepines has also skyrocketed but stayed under the radar. From 1996 to 2013, the number of adults filling a benzodiazepine prescription increased from 8.1 million to 13.5 million – a 67% increase! And while opioid prescriptions peaked in 2012, they have decreased by nearly 20% since then. Meanwhile, benzodiazepine prescriptions continue to rise. A study released earlier this year in the Journal of the American Medical Association showed that the percentage of outpatient medical visits that resulted in a prescription for a benzodiazepine doubled from 2003 to 2015. About half of those prescriptions came from primary care physicians. And with the upsurge in prescriptions there has been a sevenfold increase in overdose deaths involving benzodiazepines in the last 20 years. This workshop is designed as a refresher course on benzodiazepines. It will cover the history of their development and use, the chemistry and pharmacology of the different drugs within this class, analytical approaches, and interpretation of findings in biological specimens. While the course will include introductory concepts for those new to the field, it will also be of use to the more experienced toxicologists looking to refresh their knowledge of this important class of drugs. By the end of the workshop, we’ll all be “smarties” about benzodiazepines.
Transcript of Workshop #1: Benzodiazepines for DummiesAnd Smarties, Too! · 2019. 9. 16. · benzodiazepine...
Workshop #1: Benzodiazepines for Dummies...And Smarties, Too!
Date Monday, October 14, 2019
Time 8:00 am- 12:00 pm
Cost
Member Rates Early Bird Registration
May 1- Aug 22 Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$125 $150 $175 Non-member Rates
Early Bird Registration May 1- Aug 22
Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$175 $200 $225
Chairs Marc A. LeBeau Senior Scientist FBI Laboratory [email protected] Jeri Ropero-Miller Chief Scientist RTI International [email protected]
Abstract While the U.S. opioid epidemic has garnered the country’s attention, the abuse of benzodiazepines has also skyrocketed but stayed under the radar. From 1996 to 2013, the number of adults filling a benzodiazepine prescription increased from 8.1 million to 13.5 million – a 67% increase! And while opioid prescriptions peaked in 2012, they have decreased by nearly 20% since then. Meanwhile, benzodiazepine prescriptions continue to rise. A study released earlier this year in the Journal of the American Medical Association showed that the percentage of outpatient medical visits that resulted in a prescription for a benzodiazepine doubled from 2003 to 2015. About half of those prescriptions came from primary care physicians. And with the upsurge in prescriptions there has been a sevenfold increase in overdose deaths involving benzodiazepines in the last 20 years. This workshop is designed as a refresher course on benzodiazepines. It will cover the history of their development and use, the chemistry and pharmacology of the different drugs within this class, analytical approaches, and interpretation of findings in biological specimens. While the course will include introductory concepts for those new to the field, it will also be of use to the more experienced toxicologists looking to refresh their knowledge of this important class of drugs. By the end of the workshop, we’ll all be “smarties” about benzodiazepines.
Learning Objectives
1. Review the history of benzodiazepine use 2. Review the pharmacology of benzodiazepines 3. Review analysis for benzodiazepines and interpretation of results
Faculty Marc A. LeBeau. Senior Scientist FBI Laboratory Sarah Kerrigan Department Chair Sam Houston State University Lionel Raymon Becker Professional Education / Devry Jeri Ropero-Miller Chief Scientist RTI International Nikolas Lemos Professor UCSF - School of Medicine Robert Middleberg Laboratory Director NMS Labs Josef Witt-Doerring MD Janssen Pharmaceuticals / Drexel University College of Medicine Audience Knowledge Level Basic - suitable for individuals new to the field, requires little prior knowledge to the subject matter Workshop Agenda 8:00-8:05 am: Welcome Remarks Jeri Ropero-Miller 8:05-8:30 am: History of Benzodiazepines / Medical and Recreational Use of Benzodiazepines
Marc LeBeau 8:30-8:50 am: Chemistry of Benzodiazepines
Sarah Kerrigan 8:50-9:30 am: Pharmacology of Benzodiazepines
Lionel Raymon 10:00-10:30 am: Break 10:30-11:00 am: Analysis of Benzodiazepines
Nikolas Lemos 11:00-11:45 am: Interpretation of Benzodiazepine Results
Robert Middleberg 11:45-12:00 pm: Facilitated Discussion /Questions / Closing Remarks
Jeri Ropero-Miller/Panel
Workshop # 2: Breaking Down Silos - Forensic Toxicology and Public Health Labs Working Together
Date Monday, October 14, 2019
Time 8:00 am-12:00 pm
Cost
Member Rates Early Bird Registration
May 1- Aug 22 Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$125 $150 $175 Non-member Rates
Early Bird Registration May 1- Aug 22
Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$175 $200 $225
Chairs
Amy Miles Director of Forensic Toxicology Wisconsin State Lab of Hygiene [email protected] Ewa King Associate Director of Health Rhode Island Dept of Health [email protected] Abstract
This half day workshop will cover the role of the Public Health Laboratories in the various states and how they intersect with the Forensic Laboratories. An overview of a Public Health Lab will be described and how its mission is similar to a Forensic Lab. The workshop will provide the attendees with information on how to connect with each State's Public Health Epidemiologists to provide better data for public health and potential funding partnerships.
Learning Objectives
1. Inform the audience about the role of Public Health Labs 2. Provide information on resources in their state 3. Explain potential funding opportunities that exist in Public Health Labs for Forensic Labs
Faculty
Amy Miles Director of Forensic Toxicology Wisconsin State Lab of Hygiene
Ewa King Associate Director of Health Rhode Island Dept of Health Jason Peterson Chemical Threat Preparedness Coordinator Minnesota Dept of Health Julie Nassif Director, Environmental Health Association of Public Health Laboratories Nate Wright Lead Drug Overdose Epidemiologist Minnesota Department of Health Audience Knowledge Level Basic - suitable for individuals new to the field, requires little prior knowledge to the subject matter Workshop Agenda 8:00 - 8:45 am: Overview of the Association of Public Health Julie Nassif, MS 8:45 - 9:30 am: A look inside a Public Health Lab Ewa King, PhD 9:30 - 10:00 am: The Mission of the Public Health Lab vs. the Forensic Lab Jason Peterson, MS 10:00 - 10:30 am: Break 10:30 - 11:00 am: Testing Paradigm in Forensic Labs and Public Health Labs Jason Peterson, MS 11:00 - 11:30 am: How to connect Epidemiologists with Forensic Agencies Nate Wright 11:30 am - 12:00 pm: Using Forensic Lab Data for Public Health and Funding Opportunities Amy Miles, BS
Workshop # 3: Best Practices for Investigation of Overdose Deaths
Date Monday, October 14, 2019
Time 8:00 am-12:00 pm
Cost
Member Rates Early Bird Registration
May 1- Aug 22 Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$125 $150 $175 Non-member Rates
Early Bird Registration May 1- Aug 22
Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$175 $200 $225
Chairs Lorrine D. Edwards Advanced Chemist Wisconsin State Laboratory of Hygiene [email protected] Ruth Winecker Director, National Laboratory Certification Program RTI, International [email protected] Abstract The number of overdose deaths attributed to opioids and other drugs continues unabated in the United States, straining both financial and personnel resources in Coroner and Medical Examiner Offices. The Center for Disease Control and Prevention (CDC) reported that over 70,000 overdose deaths occurred in the United States in 2017, with approximately 68% related to opioids. Rates of deaths attributed to overdoses are likely underestimated due to inadequate training, resources and inconsistencies in the death investigation system. For example, coroners in some states may be elected officials with little to no experience in the medical field or death investigation process. Autopsies and toxicological testing are not always performed and requirements for training vary from county to county and state to state. The number of certified forensic pathologists in the United States is limited, thus autopsy services are often shared by multiple jurisdictions. The Organization of Scientific Area Committees (OSAC) medicolegal investigation subcommittee has recognized the variability and inconsistencies that exist in an overdose death investigation. The importance of the medicolegal death investigation community in providing accurate and timely, evidence based information cannot be underestimated to improve the quality of death surveillance data. This workshop will focus on Best Practices for postmortem investigation of suspected overdoses, with special emphasis on opioids. Guidelines and recommendations will emphasize those proposed by the National Association of Medical Examiners and the CDC for improving content and quality of death certification data in a multidisciplinary manner and improving accuracy of public health and safety monitoring of the opioid/drug overdose epidemic. Students in this workshop will receive training from
leading experts on forensic pathology, medicolegal death scene investigation, and toxicological analyses and interpretation. Determining and documenting causality on Death Certificates, in additional to challenging case examples will be included.
Learning Objectives 1. Attendees of this workshop will be able to cite best practices for the investigation of a
suspected overdose including scene investigation, autopsy, preferred forensic specimens, and recommended scope of toxicological analyses
2. Attendees of this workshop will appreciate that interpretation of toxicological analytical results obtained in a suspected overdose case must be evaluated in context of autopsy findings, and patient history
3. Attendees of this workshop will be able to compare and contrast the various levels of practice (best and minimum) in investigation and certification of overdose deaths and cite current gaps and opportunities for improvement in the area of medico-legal death investigation
Faculty Lorrine D. Edwards Advanced Chemist Wisconsin State Laboratory of Hygiene Gregory Davis Professor of Pathology, Director of Forensic Division University of Alabama at Birmingham Patricia Fore Medical Examiner and Death Investigator Trainer North Carolina Office of the Chief Medical Examiner Robert Johnson Chief Toxicologist Tarrant County Office of the Medical Examiner Audience Knowledge Level Basic - suitable for individuals new to the field, requires little prior knowledge to the subject matter Intermediate - Involves more advanced concepts requiring some technical working knowledge or prior exposure to the subject matter Workshop Agenda 8:00-8:20 am: Introduction-History of Standard Setting in Medico-Legal Death Investigations Lorrine (Lori) Edwards 8:20-9:10 am: The NAME position paper on Recommendations for the Investigation, Diagnosis, and Certification of Deaths Related to Opioid Drugs- Lessons Learned from Leading a Panel of Experts to Write and Update the NAME position paper. Dr. Gregory Davis 9:10-10:00 am: Lessons Learned from a Medical Examiner-Death Investigation Training Program Patricia Fore 10:00-10:30 am: Morning Break 10:30-11:20 am: Setting a Minimum Standard of Practice for Testing in Postmortem Forensic Toxicology Laboratories -Gap analysis current, minimum and best practices
Dr. Robert Johnson 11:20-11:45 am: Turning Horror Stories in Best Practices Dr. Ruth Winecker 11:45 am-12:00 pm: Panel Discussion
Workshop #4: Cannabidiol and Hemp - Separating Fact from Fiction
Date Monday, October 14, 2019
Time 1:30-5:30 pm
Cost
Member Rates Early Bird Registration
May 1- Aug 22 Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$125 $150 $175 Non-member Rates
Early Bird Registration May 1- Aug 22
Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$175 $200 $225
Chairs Nathalie A. Desrosiers Forensic Toxicologist [email protected] Sarah Urfer, M.S. Laboratory Director Chematox [email protected]
Abstract With the increasing decriminalization and legalization of cannabis, misconceptions about high cannabidiol (CBD) cannabis strains have also increased. This workshop will provide forensic toxicologists with an introduction to hemp and high CBD cannabis strains. The production and manufacture of high CBD strains will be covered. The legal status of hemp will be discussed. Finally, the pharmacokinetics and pharmacodynamics of CBD, including as it relates to THC, will be discussed.
Learning Objectives 1. After attending this workshop, participants will be able to understand the differences between
hemp (CBD-rich strains) and recreational cannabis 2. After attending this workshop, participants will have greater knowledge of the production,
manufacture, and legality of hemp 3. After attending this workshop, participants will gather knowledge about the pharmacokinetics
and pharmacodynamics of cannabidiol
Faculty Sarah Urfer Laboratory Director Chematox Nathalie A. Desrosiers Forensic Toxicologist
Audience Knowledge Level Basic - suitable for individuals new to the field, requires little prior knowledge to the subject matter
Workshop Agenda 1:30-1:35 pm: Introduction Nathalie Desrosiers 1:35-2:30 pm: What’s the difference between hemp and marijuana, anyways? Sarah Urfer 2:30-3:30 pm: What’s in this bottle? Production, Manufacture, and legality Sarah Urfer 3:30-4:00 pm: Break 4:00-4:20 pm: Cannabidiol pharmacokinetics Nathalie Desrosiers 4:20-5:00 pm: Cannabidiol mechanism of action and effects Nathalie Desrosiers 5:00-5:30 pm: Panel Discussion and Q&A period
Workshop #5: Driving Under the Influence: The NPS Edition (Sponsored by SOFT Designer Drug Committee)
Date Monday, October 14, 2019
Time 1:30-5:30 pm
Cost
Member Rates Early Bird Registration
May 1- Aug 22 Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$125 $150 $175 Non-member Rates
Early Bird Registration May 1- Aug 22
Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$175 $200 $225
Chairs Dani C. Mata Senior Forensic Scientist Orange County Crime Lab [email protected] Kevin G. Shanks Senior Forensic Toxicologist Axis Forensic Toxicology [email protected]
Abstract Novel psychoactive substances (NPS) have not waned in popularity over the years as forensic toxicology laboratories are detecting them in ever increasing numbers. More drug classes are being detected as analytical instrumentation has evolved and improved. Interpretation still causes immense struggle as forensic toxicologists are appearing in courts of law to discuss their findings in relation to driving under the influence of NPS with scant published literature detailing specific NPS drugs and their effects on the human body. In addition to the lack of case reports published in scientific journals, mono-intoxication cases are rare, so in poly-drug intoxications, drug-drug interactions must also be considered when interpreting the importance of a toxicological finding in the overall context of a human performance toxicology case. The SOFT Designer Drug Committee brings to you a workshop on driving under the influence of NPS, where we will discuss national and international NPS trends, as well as the general physiological and behavioral effects caused by the different NPS classes, which will be presented through case reports, to include behavior observed and documented by drug recognition experts and law enforcement officials, in conjunction with confirmed analytical toxicology results. A representative of the United Nations Office on Drugs and Crime (UNODC) will also present on their work and the trends they have seen internationally.
Learning Objectives 1. Inform attendees about the NPS trends seen in the United States for the past ten (10) years. 2. Provide attendees with driving under the influence of drugs case studies for each NPS class. 3. Discuss the difficulties in interpreting NPS in driving under the influence of drug cases.
Faculty Simon Elliot Consultant Forensic Toxicologist and Director Elliot Forensic Consulting Ltd Donna Papsun Toxicologist III NMS Labs Amy Miles Forensic Toxicology Section Director Wisconsin State Laboratory of Hygiene, UW School of Medicine and Public Health Liz Kiely Forensic Toxicologist Montgomery County, OH Coroner’s Office – Miami Valley Regional Crime Laboratory Tate Yeatman Crime Lab Director Palm Beach County, FL Sheriff’s Office Dani C. Mata Senior Forensic Scientist Orange County Crime Lab Audience Knowledge Level Intermediate - Involves more advanced concepts requiring some technical working knowledge or prior exposure to the subject matter Workshop Agenda 1:30 – 2:15 pm: International NPS Drug Trends and UNODC Simon Elliot 2:15 – 2:45 pm: US NPS Drug Trends Donna Papsun 2:45 – 3:00 pm: Synthetic Cannabinoids Amy Miles 3:00 – 3:30 pm: Opioids Liz Kiely 3:30 – 4:00 pm: BREAK 4:00 – 4:30 pm: Stimulants and Hallucinogens Tate Yeatman 4:30 – 5:30 pm: Benzodiazepines Dani Mata
Workshop # 6: ANAB ISO 17025:2017 & ABFT Accreditation - Bridging the Gaps
Date Monday, October 14, 2019
Time 1:30-5:30 pm
Cost
Member Rates Early Bird Registration
May 1- Aug 22 Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$125 $150 $175 Non-member Rates
Early Bird Registration May 1- Aug 22
Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$175 $200 $225
Chairs Jennifer F. Limoges Associate Director of Forensic Science/Toxicology New York State Police Forensic Investigation Center [email protected] Sue Pearring Forensic Toxicologist Supervisor San Francisco Office of the Chief Medical Examiner [email protected] Abstract This workshop is designed to assist laboratories in achieving or maintaining ISO 17025:2017 accreditation through the ANSI National Accreditation Board (ANAB), including the American Board of Forensic Toxicology (ABFT) option. The ABFT is phasing out their independent laboratory accreditation program, so many labs will need to move to an ISO based program. Additionally, the ANAB accredited laboratories now have the option to add the ABFT Laboratory Accreditation Standard to their scope. The workshop will compare and contrast the programs, as well as assist labs in identifying and addressing gaps. Topics include measurement traceability, nonconforming work, training and competency, impartiality, and risk assessment. Group discussions and sharing of best practices will allow labs to obtain practical mechanisms to achieve conformance in both programs.
Learning Objectives 1. To provide attendees with an understanding of the ANAB ISO 17025:2017 accreditation
program, including the ABFT add on option. 2. To prepare laboratories to meet ANAB and/or ABFT accreditation criteria. 3. To share best practices among laboratories for achieving conformance.
Faculty Laurel Farrell Senior Director of Accreditation-Forensics ANSI National Accreditation Board Graham Jones Forensic Toxicologist American Board of Forensic Toxicology Daniel Anderson Laboratory Manager - Toxicology & Drug Chemistry Colorado Bureau of Investigation Sue Pearring Forensic Toxicologist Supervisor San Francisco Office of the Chief Medical Examiner Jennifer F. Limoges Associate Director of Forensic Science/Toxicology New York State Police Forensic Investigation Center Audience Knowledge Level Intermediate - Involves more advanced concepts requiring some technical working knowledge or prior exposure to the subject matter Workshop Agenda 1:30-2:30 pm: ANAB ISO 17025 and ABFT Overview and Comparison Laurel Farrell, Graham Jones 2:30-3:30 pm: Evaluating Current Practices for Conformance Dan Anderson, Jennifer Limoges, Sue Pearring 3:30-4:00 pm: Break 4:00-5:30 pm: Group Exercises & Discussion – How to Reach Conformance Participants & Faculty
Workshop # 7: Clean Samples and Rugged Methods - Strategies for Method Development from Specimen Tube to Mass Spectrometer
Date Tuesday, October 15, 2019
Time 8:00 am-5:30 pm
Cost Member Rates
Early Bird Registration Late Registration On-site Registration May 1- Aug 22 Aug 23-Sept 29 Sept 30-Oct 15
$250 $275 $300 Non-member Rates
Early Bird Registration Late Registration On-site Registration May 1- Aug 22 Aug 23-Sept 29 Sept 30-Oct 15
$350 $375 $400 Chairs Jillian Neifeld Applications Chemist Biotage [email protected] Stephanie J. Marin Senior Applications Chemist Biotage [email protected] Abstract Development and validation of sensitive, robust methods for toxicology laboratories using GC-MS or LC-MS/MS can be challenging. Development of analytical methods requires knowledge of chromatography and mass spectrometry. Once the MS platform and chromatography are established, a proper sample preparation method must be developed. Together the overall method development process should yield a selective, sensitive, rugged and robust method for quantitation of desired analytes with minimal interferences and matrix effects. This workshop will provide training on principles of GC-MS and LC-MS/MS, selection of chromatography columns for both platforms, and systematic sample preparation method development. Hardware and options for automation for high throughput labs will also be discussed. A hands-on session with equipment and consumables will take place at the end of the workshop. Learning Objectives
1. Describe the principles of GC-MS and LC-MS/MS necessary for development of toxicology assays
2. Identify sample preparation and chromatography options for toxicology specimens 3. Classify hardware and automation choices for processing of specimens for analysis
Faculty Matthew West Technical Support Specialist (GC/GC-MS) Shimadzu Sarah Olive MS Technical Support Specialist (LC/LC-MS) Shimadzu Frances Carroll Business Development Manager Restek Victor Vandell Staff Scientist, Toxicology and PDM Quest Diagnostics Jillian Neifeld Applications Chemist Biotage Amy Patton Laboratory Manager PinPoint Testing, LLC Audience Knowledge Level Basic - suitable for individuals new to the field, requires little prior knowledge to the subject matter Intermediate - Involves more advanced concepts requiring some technical working knowledge or prior exposure to the subject matter
Workshop Agenda 8:00 – 8:30 am: Introduction and Opening Remarks Jillian Neifeld 8:30 – 9:15 am: Fundamentals of GC-MS Matthew West 9:15 – 10:00 am: Fundamentals of LC-MS/MS Sarah Olive 10:00 – 10:30 am: Break 10:30 – 11:15 am: Selecting LC and GC Columns Frances Carroll 11:15 – 12:00 pm: Practical Ways to Develop High Complexity Testing Methods”. Victor Vandell 12:00 – 1:30 pm: Lunch 1:30 – 2:00 pm: Analysis of Fentanyl Analogs Jillian Neifeld 2:00 – 2:30 pm: High-throughput sample preparation for the screening and confirmation of 140+ drugs in urine and blood using LC-/”MS”
Amy Patton 2:30 – 3:30 pm: Hands on session with hardware, consumables and automation platforms 3:30 – 4:00 pm: Break 4:00 – 5:00 pm: Continuation of hands on session 5:00 – 5:30 pm: Wrap up
Workshop # 8: The Basics, Mechanisms, and Drugs Involved in Cardiotoxicity
Date Tuesday, October 15, 2019
Time 8:00 am-12:00 pm
Cost
Member Rates Early Bird Registration
May 1- Aug 22 Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$125 $150 $175 Non-member Rates
Early Bird Registration May 1- Aug 22
Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$175 $200 $225
Chairs Nathalie A. Desrosiers Forensic Toxicologist [email protected]
Aaron Shapiro Associate Scientific Director BC Provincial Toxicology Centre [email protected]
Abstract As forensic toxicologists, we are frequently asked to consider the central nervous system depressant or stimulant effects of drugs as it relates to toxicity. Seldom do we consider the potential impact of drugs on the heart, whether along, in combination with other drugs, or in an individual who has cardiovascular disease. This workshop will begin with an introduction of the cardiovascular system and cardiovascular pathology. After attendees have gained or reviewed this knowledge, an in-depth overview of drugs that impact the heart, drug-drug interactions, and mechanisms of cardiotoxicity will be provided. Specific forensic case examples will be provided. This workshop will aid forensic toxicologists in interpreting postmortem drug findings in a broader context.
Learning Objectives 1. After attending this workshop, participants will have a fundamental understanding of the
anatomy and physiology of the cardiac system. 2. After attending this workshop, participants will gain understanding in cardiac pathology,
including QT prolongation, torsades de pointes, and gross pathology. 3. After attending this workshop, participants will understand which drugs target the heart, drug-
drug interactions that could impact the heart, and the mechanisms of cardiotoxicity.
Faculty Lauren Edelman
Deputy Medical Examiner Travis County Medical Examiner's Office Regina Koshy Cardiologist Veteran's Affair Clinic Kris Cunningham Deputy Director Ontario Forensic Pathology Service
Audience Knowledge Level Intermediate - Involves more advanced concepts requiring some technical working knowledge or prior exposure to the subject matter
Workshop Agenda 8:00-8:15 am: Introduction Dr. Aaron Shapiro 8:15-9:00 am: Anatomy and Physiology of the Heart Dr. Lauren A. Edelman 9:00-10:00 am: Cardiac Pathology and Cardiovascular Disease Dr. Regina Koshy 10:00-10:30 am: Break 10:30-11:30 am: Cardiotoxicity – Mechanisms and Forensic Examples Dr. Kris Cunningham 11:30 am -12:00 pm: Panel Discussion
Workshop # 9: Recommended Specimens, Scope, Cutoffs, and Strategies for DUI/D Testing & the Impact of Stop Limit Tests (Workshop is sponsored by the SOFT/AAFS Drugs and Driving Committee)
Date Tuesday, October 15, 2019
Time 8:00 am-12:00 pm
Cost
Member Rates Early Bird Registration
May 1- Aug 22 Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$125 $150 $175 Non-member Rates
Early Bird Registration May 1- Aug 22
Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$175 $200 $225
Chairs Curt E. Harper Chief Toxicologist Alabama Department of Forensic Sciences [email protected] Timothy Rohrig Director Sedgwick County Regional Forensic Science Center [email protected]
Abstract An appropriate scope of analysis is the foundation for comprehensive Driving under the Influence of drugs (DUI/D) testing. The Recommendations for Toxicological Investigation of Drug-Impaired Driving will be reviewed. Topics discussed will include recommended compounds (i.e. Tier I, II), appropriate cutoffs, preferred specimens (e.g. blood, oral fluid), and case management practices. The advantages and disadvantages of so-called “Stop Limit Testing” will be objectively presented and debated. Stop Limit Testing is a case management protocol used by some toxicology laboratories to triage DUI/D cases. When using this protocol drug analysis is only routinely pursued in cases when blood alcohol concentrations are less than 0.08-0.10%. We will also explore questions about the pros and cons of quantitative versus qualitative testing in DUID. This workshop will explore strategies for DUI/D testing to include immunoassay and mass spectrometry drug screening and how these approaches may complement each other. Methods and workflows to test for Tier I & II compounds as well as approaches to monitor and qualitatively identify novel psychoactive substances will be described. Extraction automation techniques will be highlighted as a mechanism to streamline efficiency and cost.
Learning Objectives
1. Understand recommended DUI/D specimens, scope of analysis, and cutoffs 2. Examine the impact of Stop Limit Testing in DUI/D investigations 3. Apply analytical strategies and workflows for desired scope of analyses
Faculty Barry Logan Chief Scientist NMS Labs Nicholas Tiscione Toxicology Unit Manager Palm Beach County Sheriff's Office Curt E. Harper Chief Toxicologist Alabama Department of Forensic Sciences Hui Yong Forensic Toxicology Alabama Department of Forensic Science Sarah Guertin Forensic Toxicology Alabama Department of Forensic Science
Audience Knowledge Level Basic - suitable for individuals new to the field, requires little prior knowledge to the subject matter Intermediate - Involves more advanced concepts requiring some technical working knowledge or prior exposure to the subject matter
Workshop Agenda 8:00-8:45 am: Recommendations for DUI/D Testing: Scope, Cutoffs, Specimens Barry Logan 8:45-9:15 am: Prevalence of Drugs in Cases with BAC> 0.08% Curt Harper 9:15-10:00 am: Cost Benefit Analysis & Impact of Stop Limit Testing Nicholas Tiscione 10:00-10:30 am: Break 10:30-11:30 am: Strategies for DUI/D Testing: Screening and Confirmation Approaches using Immunoassay and/or Mass Spectrometry (e.g. QQQ, Q-TOF) Hui Yong and Sarah Guertin 11:30 am-12:00 pm: DUI/D Extraction Automation Techniques Using the Hamilton Starlet: Oral Fluid Drug Screening and Opioid Quantitation as Examples Curt Harper
Workshop # 10: Poisonous Plants: Pharmacology, Toxicology, and Murder!
Date Tuesday, October 15, 2019
Time 1:30 am-5:30 pm
Cost
Member Rates Early Bird Registration
May 1- Aug 22 Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$125 $150 $175 Non-member Rates
Early Bird Registration May 1- Aug 22
Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$175 $200 $225
Chairs Justin O. Brower Assoc. Chief Toxicologist NC OCME [email protected] Kevin Shanks Senior Forensic Toxicologist Axis Forensic Toxicology [email protected] Abstract The beauty of nature surrounds us, as evidenced by the cherry blossom harbingers of Spring and the golden blaze of aspen leaves heralding Fall, but nature has an equally sinister side…poison. While toxicologists are all too familiar with cocaine from coca leaves, morphine from the opium poppy, and mitragynine from kratom, there exists a realm of less familiar, yet often deadlier, plant-based poisons. Cardiac glycosides like cerberin and digoxin will literally break your heart and glycine-receptor antagonists tutin and strychnine will leave you seizing on the floor. Dermal applications of phorbol esters from the Manchineel tree will leave you wishing for death and sanguinarine from Bloodroot will melt your face. Ingestion of plant-based poisons are relatively rare nowadays, but it is important for every forensic toxicologist to understand the history of such compounds, their mechanism of action and clinical signs of toxicity, and how they can be detected using today’s advanced analytical techniques. And while most intoxications are accidental, a small percentage of them are homicidal in nature, posing challenges for investigators and toxicologists alike. This workshop aims to educate and entertain the attendee on the history and pharmacology of a vast array of plant-based poisons and the analytical toxicology necessary to detect them. The murderous applications of these poisons will be highlighted by special guest Dr. Raychelle Burks (Asst. Prof. St. Edwards Univ., as seen on Science Channel’s Outrageous Acts of Science, and author of Chemistry World’s Trace Analysis.)
Learning Objectives 1. Expose the attendee to the history and wide distribution of plant-based poisons throughout
the world. 2. The attendee will understand the pharmacology and clinical symptoms of intoxication of a wide
variety of drug classes. 3. The attendee will be able to implement and develop methods for screening or confirming
plant-based poisons in their own laboratories.
Faculty Justin O. Brower Assoc. Chief Toxicologist NC OCME Kevin Shanks, MS Senior Forensic Toxicologist Axis Forensic Toxicology Raychelle Burks Asst. Professor St. Edwards University Audience Knowledge Level Basic - suitable for individuals new to the field, requires little prior knowledge to the subject matter Intermediate - Involves more advanced concepts requiring some technical working knowledge or prior exposure to the subject matter Workshop Agenda 1:30-1:35 pm: Welcome and Introduction 1:35-2:45 pm: Pharmacology Justin Brower 2:45-3:30 pm: Toxicology Kevin Shanks 3:30-4:00 pm: Break 4:00-5:30 pm: Murder! Raychelle Burks
Workshop #11: Application of QTOF techniques: Approaches and Workflows
Date Tuesday, October 15, 2019
Time 1:30-5:30 pm
Cost
Member Rates Early Bird Registration
May 1- Aug 22 Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$125 $150 $175 Non-member Rates
Early Bird Registration May 1- Aug 22
Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$175 $200 $225 Chairs Luke N. Rodda Chief Forensic Toxicologist and Director Forensic Laboratory Division, Office of the Chief Medical Examiner, City and County of San Francisco [email protected] Dani C. Mata. Senior Forensic Scientist Orange County, CA Crime Lab [email protected] Abstract Quadropole Time-of-Flight (QTOF) instrumentation has the potential to be the most versatile and pivotal High Resolution Mass Spectrometry (HRMS) technique in the modern forensic toxicology laboratory. Although, commercially available from many manufacturers and commonly used in other laboratory settings, implementation can be troublesome. Depending on the intended use, method development can be arduous with no current governing body guidelines to help with high resolution mass spectrometry. Once validated, the QTOF can either completely change or replace your laboratory workflow that has been in use years or even decades, or it may work in parallel to current workflows. Establishing a systematic toxicological approach with the inclusion of a new QTOF methods into established laboratory protocols can be just as daunting as the validation. This workshop will examine these three challenges and provide examples and provoke discussion of attendees currently faced issues.
Learning Objectives 1. Inform attendees about the benefits of QTOF works and possible instrumental parameters that
can be used in different workflows. 2. Provide attendees the pros and cons of different workflows when using a QTOF in human
performance and death investigation laboratory settings. 3. Discuss the difficulties of implementing a QTOF workflow into an existing forensic toxicology
laboratory.
Faculty Dani C. Mata Senior Forensic Scientist Orange County Crime Lab Luke N. Rodda Chief Forensic Toxicologist and Director Forensic Laboratory Division, Office of the Chief Medical Examiner, City and County of San Francisco Laura Huppertz Forensic Toxicologist Department of Forensic Toxicology, Institute of Forensic Medicine, University of Freiburg, Germany Jennifer Colby Medical Director of Toxicology, Assistant Professor of Pathology, Microbiology and Immunology Vanderbilt University Medical Center Jason Hudson Toxicology Section Chief Alabama Department of Forensic Science Anna Kelly Deputy Chief Toxicologist Harris County Institute of Forensic Sciences Audience Knowledge Level Intermediate - Involves more advanced concepts requiring some technical working knowledge or prior exposure to the subject matter Workshop Agenda 1:30 – 2:00 pm: Introduction to Time of Flight Mass Spectrometry Laura Huppertz 2:00 – 2:30 pm: Implementation, Workflows and Quantitative use of QTOF with Validation, Accreditation and Standards Consideration Luke Rodda 2:30 – 3:00 pm: It’s All About Data: Designing a Framework and Mining Your Data Jennifer Colby 3:00 – 3:30 pm: Qualitative Screening for 300 Drugs in DUID and Postmortem Casework Dani Mata 3:30 – 4:00 pm: BREAK 4:00 – 4:30 pm: Filling the Gaps: QTOF Screening for Novel Psychoactive Substances Jason Hudson 4:30 – 5:00 pm: Targeted & Retrospective Analysis utilizing TOF Anna Kelly 5:00 – 5:30 pm: Question Session with All Speakers including challenges facing the attendees.
Workshop #12: Oral Fluid Toxicology: Workplace Testing, Pain Management, and DUID (Sponsored by the SOFT/AAFS Oral Fluid Committee)
Date Tuesday, October 15, 2019
Time 1:30-5:30 pm
Cost
Member Rates Early Bird Registration
May 1- Aug 22 Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$125 $150 $175 Non-member Rates
Early Bird Registration May 1- Aug 22
Late Registration Aug 23-Sept 29
On-site Registration Sept 30-Oct 15
$175 $200 $225
Chairs Madeline J. Swortwood Assistant Professor, Director of Graduate Programs Sam Houston State University, Department of Forensic Science [email protected] Timothy Rohrig Director Sedgwick County Regional Forensic Science Center [email protected] Abstract Oral Fluid (OF) drug testing is a valuable tool in toxicology. OF may indicate recent drug use, is obtained non-invasively, and does not require collection from a trained professional. For these reasons, OF testing is amenable to roadside and point-of-care testing with direct application to pain management monitoring, workplace drug testing, and driving under the influence of drugs (DUID). This workshop will explore oral fluid as an alternative toxicological specimen with respect to pain management, workplace, and DUID testing. Analytical methodologies will be discussed in addition to current and proposed regulations for OF testing.
Learning Objectives 1. Understand the role of OF testing in pain management/compliance. 2. Examine new regulations for the federal workplace OF drug testing program. 3. Review DUID legislation and investigate implementing OF testing program.
Faculty Jarrad Wagner Professor Forensic Sciences, Oklahoma State University
Marilyn Huestis Professor The Lambert Center for the Study of Medicinal Cannabis and Hemp, Institute for Emerging Health Professions, Thomas Jefferson University Charles LoDico Senior Chemist/Toxicologist Division of Workplace Programs, SAMHSA Curt Harper Toxicology Discipline Chief Alabama Department of Forensic Science Audience Knowledge Level Basic - suitable for individuals new to the field, requires little prior knowledge to the subject matter Workshop Agenda 1:30-1:40 pm: Welcome Madeline Swortwood, Timothy Rohrig 1:40-2:00 pm: Introduction to Oral Fluid Jarrad Wagner 2:00-2:45 pm: OF and Pain Management Marilyn Huestis 2:45-3:30 pm: Federal Workplace Drug Testing Program using OF Charles LoDico 3:30-4:00 pm: Break 4:00-5:00 pm: OF and DUI/D + Survey of US Crime Labs Curt Harper 5:00-5:30 pm: Panel Discussion
