Test ID: OPATU
Opiates, Urine
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Detecting the presence of opiates in the urine
Additional Tests Lists test(s) that are always performed, at an additional charge, with the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ADULT | Adulterants Survey, U | No | Yes |
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
An evaluation to detect the presence of adulterants will be performed and reported at no additional charge.
See Adulterant Survey Algorithm in Special Instructions.
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
OPATU/8473: Immunoassay/Gas Chromatography-Mass Spectrometry (GC-MS) Confirmation with Quantitation
ADULT/29345: Spectrophotometry (SP)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Dilaudid (Hydromorphone)
Heroin (as Morphine)
Hycodan (Hydrocodone)
Hydrocodone (Hycodan, Vicodin)
Hydromorphone (Dilaudid, Vicodin)
Lortab (Hydromorphone)
Morphine
Opiates
Oxycodone (Oxycontin, Percodan)
Oxycontin (Oxycodone)
Percodan (Oxycodone)
Vicodin (Hydrocodone)
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube: Plastic, 60-mL urine bottle
Specimen Volume: 20 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
Additional Information: 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.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerated (preferred) | 14 days |
| Frozen | 14 days | |
| Ambient | 72 hours |
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).(1)
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.
Negative
Positives are reported with a quantitative GC-MS result.
Cutoff concentrations
Immunoassay screen: <300 ng/mL
Codeine by GC-MS: <100 ng/mL
Hydrocodone by GC-MS: <100 ng/mL
Hydromorphone by GC-MS: <100 ng/mL
Oxycodone by GC-MS: <100 ng/mL
Morphine by GC-MS: <100 ng/mL
Interpretation Provides information to assist in interpretation of the test results
This procedure reports the total urine concentration; this is the sum of the unconjugated and conjugated forms of the parent drug.
Heroin (diacetylmorphine) is rarely detectable in body fluids. It has a half-life of a few minutes. Heroin undergoes rapid deacetylation to 6-monoacetylmorphine (6-MAM), which is about 6 times more potent than morphine. 6-MAM is further deacetylated to morphine; the effects of heroin are attributed to the combined effect of heroin, 6-MAM, and morphine. The presence of 6-MAM is conclusive evidence of prior heroin use. However, due to its short half-life, it is only detectable in urine for about 8 hours after administration.(2)
Codeine is also metabolized to morphine. The presence of morphine in urine can indicate exposure to morphine, heroin, or codeine within 2 to 3 days.(2)
Illicit heroin often contains small amounts of codeine. The presence of both codeine and morphine in urine does not rule out the use of heroin; however, the ratio of morphine to codeine can be helpful in discriminating between heroin and codeine use.(2)
Ingestion of bakery products containing poppy seeds can also cause morphine to be excreted in urine. If excessively large amounts are consumed, this can result in urine morphine concentrations up to 2,000 ng/mL for a period of 6 to 12 hours after ingestion.
The presence of hydrocodone >lower limit of quantitation (LOQ) indicates exposure within 2 to 3 days prior to specimen collection.(2)
The presence of hydromorphone >LOQ indicates exposure within 2 to 3 days prior to specimen collection. Hydromorphone is also a metabolite of hydrocodone, therefore the presence of hydromorphone could also indicate exposure to hydrocodone.(2)
The presence of oxycodone >LOQ indicates exposure to oxycodone within 2 to 3 days prior to specimen collection.(2)
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
This test detects drugs structurally similar to morphine. Other drugs in the opioid class, such as fentanyl, meperidine, methadone, and opiate antagonists such as naloxone, are not detected.
The presence of meperidine in a very high concentration (overdose proportions) will result in a positive screen report. The gas chromatography/mass spectrometry (GC-MS) report will be negative for opiates.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Gutstein HB, Akil H: Chapter 21: Opioid Analgesics. In Goodman and Gilman's The Pharmacological Basis of Therapeutics. Eleventh edition. Edited by LL Brunton, JS Lazo, KL Parker. New York, McGraw-Hill Companies Inc, 2006. Available at: http://www.accessmedicine.com/content.aspx?aID=940653
2. Dispositition of Toxic Drugs and Chemical in Man. Eighth edition. Edited by RC Baselt. Foster City, CA, Biomedical Publications, 2008, pp 355-360, 745-746, 750-752, 1057-1061, 1166-1168
Method Description Describes how the test is performed and provides a method-specific reference
Immunoassay and confirmation with quantification by gas chromatography/mass spectrometry (GC-MS).(Unpublished Mayo method)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
83925
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 6541 | Immunoassay Screen | 19295-5 |
| 6543 | Codeine-by GC/MS | 3508-9 |
| 21177 | Hydrocodone-by GC/MS | 3681-4 |
| 21179 | Hydromorphone-by GC/MS | 9835-0 |
| 21178 | Oxycodone-by GC/MS | 11246-6 |
| 6542 | Morphine-by GC/MS | 3831-5 |
| 21180 | Interpretation | 69050-3 |
| 21181 | Chain of Custody | In Process |
External
link
PDF
document
Excel
document
Word
document