Test ID: PCDS
Pain Clinic Drug Screen, Urine

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.

Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography-flame ionization detector for ethanol; gas chromatography-mass spectrometry for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, methadone, opiates, phencyclidine, propoxyphene, and tetrahydrocannabinol metabolite) at an additional charge.

The drug screen, prescription/OTC will be performed by gas chromatography-mass spectrometry. Qualitative results will be reported.

An evaluation to detect the presence of adulterants will be performed and reported at no additional charge.

See Adulterant Survey Algorithm in Special Instructions.

• Adulterant Survey Algorithm

CDAU7/81410: Alcohol Screened by an Enzymatic Assay/All Others Screened by Immunoassay
ADULT/29345: Spectrophotometry (SP)

AMPHU/8257, BARBU/80372, BENZU/80370, COKEU/9286, MTDNU/83129, MSPR/500373, OPATU/8473, PCPU/80371, THCU/8898, PDSU/88760: Gas Chromatography-Mass Spectrometry (GC-MS)

ETOH/24007: Gas Chromatography-Flame Ionization Detector (GC-FID)

Collection Container/Tube: Plastic urine container

Submission Container/Tube: Plastic, 60-mL urine bottle

Specimen Volume: 30 mL

Collection Instructions:

1. Collect a random urine specimen.

2. Submit 30 mL in 1 plastic bottle.

3. No preservative.

Additional Information:

1. No specimen substitutions.

2. No STATS are accepted for this procedure.

3. For situations where chain-of-custody is required, a Chain-of-Custody Kit (Supply T282) is available. For chain-of-custody information, see COCH/9426 Chain-of-Custody Processing.

4. Additional drug panels and specific requests are available. Call Mayo Medical Laboratories at 800-533-1710 or 507-266-5700.

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:

-Amphetamines

-Barbiturates

-Benzodiazepines

-Cocaine

-Ethanol

-Methadone

-Phencyclidine

-Propoxyphene

-Opiates

-Tetrahydrocannabinol

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.

Negative

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.

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

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.

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

Drug classes are screened by an immunoassay technique. All positive screening results are confirmed by gas chromatography-mass spectrometry or gas chromatography-flame ionization detector.(Unpublished Mayo method)

Monday through Sunday

80100-Drug Screen, prescription/OTC

80104-Drug screen, qualitative, each procedure

83925-Opiates

G0431-Drug screen, qualitative, each specimen-government payers (if appropriate)

80154-Benzodiazepines (if appropriate)

80299-Tetrahydrocannabinol carboxylic acid (if appropriate)

80299 x 2-Propoxyphene (if appropriate)

82055-Ethanol (if appropriate)

82145 x 2-Amphetamines (if appropriate)

82205-Barbiturates (if appropriate)

82520-Cocaine (if appropriate)

83840-Methadone (if appropriate)

83992-Phencyclidine (if appropriate)