Pain Clinic Drug Screen, Urine
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
This panel was designed to screen for and confirm by gas chromatography-mass spectrometry (GC-MS) or gas chromatography-flame ionization detection (GC-FID) the following drugs:
This panel uses the screening technique described under IDOAU/8248 Drug Abuse Survey, Urine, which involves immunoassay testing for drugs by class. Since oxycodone is not detected well with the opiate screening assay, OPATU/8473 Opiates, Urine is included to detect this drug. All positive screening results are confirmed by GC-MS or GC-FID, and quantitated, before a positive result is reported.
The panel includes PDSU/88760 Drug Screen, Prescription/OTC, Urine, which looks for a broad spectrum of prescription and over-the-counter drugs. It is designed to detect drugs that have toxic effects, as well as known antidotes or active therapies that a clinician can initiate to treat the toxic effect. The test is intended to help physicians manage an apparent overdose or intoxicated patient, to determine if a specific set of symptoms might be due to the presence of drugs, or to evaluate a patient who might be abusing these drugs intermittently. The test is not designed to screen for intermittent use of illicit drugs.
Detecting drug abuse involving amphetamines, barbiturates, benzodiazepines, cocaine, ethanol, methadone, opiates, phencyclidine, propoxyphene, and tetrahydrocannabinol
Detection and identification of prescription or over-the-counter drugs frequently found in drug overdose or used with a suicidal intent
This test is intended to be used in a setting where the identification of the drug is required.
A positive result indicates that the patient has used the drugs detected in the recent past. See individual tests (eg, AMPHU/8257 Amphetamines, Urine) for more information.
For information about drug testing, including estimated detection times, see Drugs of Abuse Testing at http://www.mayomedicallaboratories.com/articles/drug-book/index.html
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Not intended for use in employment-related testing.
For situations where chain-of-custody is required, a Chain-of-Custody Kit (Supply T282) is available. See COCH/9426 Chain-of-Custody-Processing.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Screening cutoff concentrations
Alcohol: 30 mg/dL
Amphetamines: 500 ng/mL
Barbiturates: 200 ng/mL
Benzodiazepines: 200 ng/mL
Cocaine (benzoylecgonine-cocaine metabolite): 150 ng/mL
Ethanol: 30 mg/dL
Methadone: 300 ng/mL
Opiates: 300 ng/mL
Phencyclidine: 25 ng/mL
Propoxyphene: 300 ng/mL
Tetrahydrocannabinol carboxylic acid: 20 ng/mL
This report is intended for use in clinical monitoring or management of patients. It is not intended for use in employment-related testing.
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Physician's Desk Reference. 61st edition. Montvale, NJ. Thomson PDR, 2007
2. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 10th edition. New York, NY. McGraw-Hill Professional, 2001
3. Langman LJ, Bechtel L, Holstege CP: Chapter 35. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Edited by CA Burtis, ER Ashwood, DE Bruns. WB Saunders Company, 2011, pp 1109-1188
4. Principles of Forensic Toxicology. Second edition. Washington DC. AACC Press, 2003, p 385