Oxycodone Screen, Chain of Custody, Urine
Detection of oxycodone and oxymorphone in urine following chain-of-custody procedures
This chain-of-custody test is intended to be used in a setting where the test results can be used definitively to make a diagnosis.
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
Testing begins with screening assay. If oxycodone screen is positive, then the liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmation with quantification will be performed at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Opiates are the natural or synthetic drugs that have a morphine-like pharmacological action. Medically, opiates are used primarily for relief of pain. Opiates include morphine and drugs structurally similar to morphine (eg, codeine, hydrocodone, hydromorphone, oxycodone, oxymorphone).
Oxycodone is metabolized to noroxycodone, oxymorphone, and their glucuronides and is excreted primarily via the kidney. The presence of oxycodone greater than 100 ng/mL indicates exposure to oxycodone within 2 to 3 days prior to specimen collection.
Oxymorphone is metabolized in the liver and excreted via the kidney primarily as the glucuronide conjugates. Oxymorphone is also a metabolite of oxycodone and therefore the presence of oxymorphone could also indicate exposure to oxycodone.
Chain of custody is a record of the disposition of a specimen to document who collected it, who handled it, and who performed the analysis. When a specimen is submitted in this manner, analysis will be performed in such a way that it will withstand regular court scrutiny. Chain of custody is required whenever the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that it was under the control of personnel involved with testing the specimen at all times; this control implies that the opportunity for specimen tampering would be limited.
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 concentration:
Oxycodone: 100 ng/mL
A positive result indicates that the patient has used the drugs detected in the recent past. See individual tests (eg, OXYCU / Oxycodone with Metabolite Confirmation, Urine) for more information.
For information about drug testing, including estimated detection times, see Mayo Medical Laboratories Drugs of Abuse Testing Guide at http://www.mayomedicallaboratories.com/test-info/drug-book/index.html
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Other drugs in the opioid class, such as fentanyl, meperidine, methadone, and opiate antagonists such as naloxone, are not detected.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Anderson DT, Fritz KL, Muto JJ: Oxycontin: the concept of a "ghost pill" and the postmortem tissue distribution of oxycodone in 36 cases. J Anal Toxicol 2002;26:448-459
2. Jannetto PJ, Gock SG: Oxycodone: Recognition and Pharmacogenomics. Clinical and Forensic Toxicology News 2003 March
3. Cone EJ: Oxycodone Involvement in Drug Abuse Deaths: A DAWN-Based Classification Scheme applied to an Oxycodone Postmortem Database Containing over 1000 Cases. J Anal Toxicol 2003;27:57-67
4. Baselt RC, Cravey RH: Oxycodone. In Disposition of Toxic Drugs and Chemicals in Man. Fourth edition. Chemical Toxicology Institute, Foster City, CA. 1995;572-574