{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:40:14Z","timestamp":1786977614134,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["analyticalsciencejournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug Testing and Analysis"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This study evaluated an alternative routine for reporting urinary chiral amphetamine results in assessment of attention\u2010deficit\/hyperactivity disorder (ADHD) treatment with amphetamine medications and for detecting side\u2010use of illicit racemic amphetamine. Currently in Sweden, only enantiopure\n                    <jats:italic>d\u2010<\/jats:italic>\n                    amphetamine\u2010based ADHD medications (lisdexamphetamine dimesylate and dexamphetamine sulfate) are approved. It is therefore unsuitable to express the chiral result as the\n                    <jats:italic>l<\/jats:italic>\n                    \/\n                    <jats:italic>d\u2010<\/jats:italic>\n                    ratio, as before, because\n                    <jats:italic>l\u2010<\/jats:italic>\n                    amphetamine should not be present provided treatment compliance. A new routine for LC\u2010MS\/MS chiral amphetamine testing was therefore introduced in 2020, whereby the relative proportion (%) of\n                    <jats:italic>l\u2010<\/jats:italic>\n                    amphetamine and the total amphetamine and creatinine concentrations are reported. Evaluation of the new routine on 24,354 results from 2013 to 2023 revealed that it was useful to distinguish ADHD medication adherence from illicit drug use as the source for a positive test. The\n                    <jats:italic>l\u2010<\/jats:italic>\n                    amphetamine proportion also reflected the enantiomeric content of the medications used. Overall, most results confirmed adherence to ADHD medication, as the\n                    <jats:italic>l\u2010<\/jats:italic>\n                    amphetamine percentage was &lt;1% in 76% of samples (2023) which is the recommended cutoff with enantiopure\n                    <jats:italic>d\u2010<\/jats:italic>\n                    amphetamine medications. However, in all years, illicit drug use was indicated (&gt;40%\n                    <jats:italic>l\u2010<\/jats:italic>\n                    amphetamine) in 8.3%\u201314.5% of cases. In conclusion, this study demonstrated the clinical value and utility of a new routine for reporting urinary chiral amphetamine results to differentiate adherence to ADHD medication from illicit drug use. Unlike the\n                    <jats:italic>l\/d\u2010<\/jats:italic>\n                    amphetamine ratio, it considers differences in total amphetamine concentration and urine dilution, factors that can affect the interpretation.\n                  <\/jats:p>","DOI":"10.1002\/dta.3690","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:15:30Z","timestamp":1712794530000},"page":"163-169","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Alternative routine for reporting chiral amphetamine test results in assessment of attention\u2010deficit\/hyperactivity disorder medication: experiences from 2013 to 2023"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7480-8078","authenticated-orcid":false,"given":"Anders","family":"Helander","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Clinical Chemistry Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Vill\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.1471"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787\u2010022\u201002034\u20102"},{"key":"e_1_2_6_4_1","unstructured":"The Swedish National Board of Health and Welfare. [The prescription of ADHD drugs continues to increase].https:\/\/www.socialstyrelsen.se\/globalassets\/sharepoint-dokument\/artikelkatalog\/ovrigt\/2021-6-7436.pdf"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/17512433.2023.2249414"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/life13112180"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2014.09.2801"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2013.09.005"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2010.01.2112"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchromb.2011.11.007"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269881113482532"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2017.0071"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/000456329603300107"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/29.7.682"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinms.2019.04.002"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/dta.2208"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/27.7.485"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/24.3.223"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.2165\/0044011\u2010200828120\u201000002"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40261\u2010015\u20100354\u2010y"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2016.0121"},{"issue":"24","key":"e_1_2_6_22_1","first-page":"1311","article-title":"Creatinine concentration in urine should be measured in drug testing. Guidelines for decision limits and interpretation are necessary, at least for legal rights","volume":"108","author":"Helander A","year":"2011","journal-title":"Lakartidningen"},{"key":"e_1_2_6_23_1","article-title":"Harmonized measurement and reporting of chiral amphetamine in the follow\u2010up of ADHD treatment","volume":"117","author":"Helander A","year":"2020","journal-title":"Lakartidningen"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/28.7.563"},{"issue":"11","key":"e_1_2_6_25_1","first-page":"1369","article-title":"The amphetamines: clinical and pharmacokinetic implications of recent studies of an assay procedure and urinary excretion in man","volume":"16","author":"Rowland M","year":"1966","journal-title":"Arzneimittelforschung"},{"key":"e_1_2_6_26_1","unstructured":"The Swedish Medical Products Agency. [Medicines for ADHD \u2010 treatment recommendation: information from the Swedish medical products agency 2016;27(2):13\u201324].https:\/\/www.lakemedelsverket.se\/globalassets\/dokument\/behandling-och-forskrivning\/behandlingsrekommendationer\/behandlingsrekommendation\/behandlingsrekommendation-lakemedel-adhd.pdf"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1081\/dmr\u2010100100562"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2023.166910"},{"key":"e_1_2_6_29_1","article-title":"Drug use and drug trends in Sweden 2010\u20102020 \u2010 results from urine drug testing in the workplace","volume":"118","author":"Helander A","year":"2021","journal-title":"Lakartidningen"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043764\u2010200205000\u201000012"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bkaa058"}],"container-title":["Drug Testing and Analysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/analyticalsciencejournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dta.3690","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T20:29:45Z","timestamp":1760387385000},"score":1,"resource":{"primary":{"URL":"https:\/\/analyticalsciencejournals.onlinelibrary.wiley.com\/doi\/10.1002\/dta.3690"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,10]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/dta.3690"],"URL":"https:\/\/doi.org\/10.1002\/dta.3690","archive":["Portico"],"relation":{},"ISSN":["1942-7603","1942-7611"],"issn-type":[{"value":"1942-7603","type":"print"},{"value":"1942-7611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,10]]},"assertion":[{"value":"2024-02-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}