[Federal Register Volume 89, Number 28 (Friday, February 9, 2024)]
[Notices]
[Pages 9166-9167]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-02640]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Notice of Meeting

    Pursuant to Public Law 92-463, notice is hereby given that the 
Substance Abuse and Mental Health Services Administration's (SAMHSA) 
Center for Substance Abuse Prevention's (CSAP) Drug Testing Advisory 
Board (DTAB) will convene via web conference on March 5, 2024, from 10 
a.m. EST to 12:45 p.m. EST.
    The board will meet in open-session March 5, 2024, from 10 a.m. EST 
to 12:45 p.m. EST to hear presentations regarding proposed changes to 
the analyte table including fentanyl prevalence, fentanyl immunoassay 
updates, cost and benefits analysis and a summary of public comments 
received regarding the proposed changes to the HHS Drug Testing Panels.
    Section 8105 of the Fighting Opioid Abuse in Transportation Act, 
included in the SUPPORT for Patients and Communities Act, required the 
Secretary to determine whether it is justified, based on the 
reliability and cost-effectiveness of testing, to revise the Mandatory 
Guidelines for Federal Workplace Drug Testing Programs to include 
fentanyl. Section 8105 additionally required the Secretary to consider 
whether to include any other drugs or other substances listed in 
Schedule I and II of Controlled Substances Act (CSA). Norfentanyl is a 
metabolite of fentanyl. Because it is also an immediate precursor used 
in the illicit manufacture of fentanyl, it is a Schedule II substance 
under the CSA.
    Fentanyl is involved in a large proportion of overdose deaths in 
the United States and is therefore an important public safety concern. 
Furthermore, fentanyl is increasingly used as a stand-alone substance, 
not in conjunction with heroin and other substances. According to the 
National Forensic Laboratory Information System (NFLIS) 2022 report, 
fentanyl was the 3rd most frequently identified drug and accounted for 
13.81% of all drugs reported by forensic laboratories.\1\ Norfentanyl 
is an important component of identifying people who use fentanyl when 
urine is the specimen matrix. Fentanyl has been detected in oral fluid 
in patients receiving pain management

[[Page 9167]]

services, overdose cases, and driving under the influence of drugs 
(DUID) cases. Information provided by HHS-certified laboratories in 
2023 indicated that a majority (84%) of the laboratories analyzed non-
regulated workplace specimens for fentanyl and/or norfentanyl, and that 
all had the ability to analyze urine specimens for fentanyl with 
sufficiently sensitive detection limits using commercially available 
immunoassay kits and confirmatory test instrumentation commonly used in 
HHS-certified laboratories.
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    \1\ National Forensic Laboratory Information System (NFLIS). 
(2022). NFLIS-Drug 2022 Annual Report. U.S. Department of Justice, 
Drug Enforcement Agency, Diversion Control Division. 2022 NFLIS-Drug 
Annual Report.pdf.
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    Proposed addition to HHS Drug Testing Panels as listed below:

------------------------------------------------------------------------
                                    Initial test
         Urine analyte                 cutoff        Confirmation cutoff
------------------------------------------------------------------------
Fentanyl.......................  1 ng/mL..........  1.0 ng/mL.
Norfentanyl....................  .................  1.0 ng/mL.
------------------------------------------------------------------------


------------------------------------------------------------------------
                                    Initial test
       Oral fluid analyte              cutoff        Confirmation cutoff
------------------------------------------------------------------------
Fentanyl.......................  1 ng/mL..........  1.0 ng/mL.
------------------------------------------------------------------------

    The Department plans to remove MDA and methylenedioxy- 
methamphetamine (MDMA) from the drug testing panel, because the number 
of positive specimens reported by HHS-certified laboratories does not 
support testing all specimens for MDA and MDMA in Federal workplace 
drug testing programs. Information provided to the Department through 
the NLCP in 2021 and 2022 shows the positivity rate for MDMA ranges 
from 0.001 to 0.003%, and a review of the results indicate that >25% of 
the positive specimens are likely agency blind samples. MDA has a lower 
positivity rate than MDMA and both have lower positivity rates than 
phencyclidine (PCP). SAMHSA also considered removing PCP but decided 
against this change. While PCP has an overall positivity rate nearly as 
low as MDMA, there are regional differences in positivity, with some 
areas of the country having much higher rates, so PCP remains a 
regulated test analyte. Because MDA and MDMA are Schedule I drugs, a 
Federal agency may test specimens for these analytes in accordance with 
Section 3.2 of the UrMG and OFMG (i.e., on a case-by-case basis for 
reasonable suspicion or post-accident testing, or routinely with a 
waiver from the Secretary).
    Meeting registration information can be completed at https://snacregister.samhsa.gov/. Web conference and call information will be 
sent after completing registration. Meeting information and a roster of 
DTAB members may be obtained by accessing the SAMHSA Advisory 
Committees website, https://www.samhsa.gov/about-us/advisory-councils/meetings, or by contacting the Designated Federal Officer, Lisa Davis.
    Committee Name: Substance Abuse and Mental Health Services 
Administration, Center for Substance Abuse Prevention, Drug Testing 
Advisory Board.
    Dates/Time/Type: March 5, 2024, from 10:00 a.m. EST to 12:45 p.m. 
EST: OPEN.
    Place: Virtual.
    To Submit Comments: Requests to make public comment during the 
public comment period of the March DTAB meeting must be made in writing 
at least 7 days prior to the meeting to the following email: 
[email protected].
    Contact: Lisa S. Davis, M.S, Social Science Analyst, Center for 
Substance Abuse Prevention, 5600 Fishers Lane, Rockville, Maryland 
20857, Telephone: (240) 276-1440, Email: [email protected].

Anastasia Flanagan,
Public Health Advisor, Division of Workplace Programs.
[FR Doc. 2024-02640 Filed 2-8-24; 8:45 am]
BILLING CODE 4162-20-P