Detecting drug abuse involving alcohol, amphetamines, barbiturates, benzodiazepines, cocaine, methadone, opiates, phencyclidine, and tetrahydrocannabinol
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.
This test is not intended for use in employment-related testing.
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
THCX | Carboxy-THC Confirmation, CoC, U | Yes | No |
PCPX | Phencyclidine Confirmation, CoC, U | Yes | No |
MTDNX | Methadone Confirmation, CoC, U | Yes | No |
COKEX | Cocaine and metabolite Conf, CoC, U | Yes | No |
BNZX | Benzodiazepines Conf, CoC, U | Yes | No |
BARBX | Barbiturates Confirmation, CoC, U | Yes | No |
AMPHX | Amphetamines Confirmation, CoC, U | Yes | No |
OPATX | Opiate Confirmation, CoC, U | Yes | No |
ETOHX | Ethanol, CoC, U | No | No |
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
COCH | Chain of Custody Processing | No | Yes |
ADLTX | Adulterants Survey, CoC, U | Yes | Yes |
Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography with flame ionization detector for ethanol; gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry at an additional charge.
Adulterants testing will be performed on all chain-of-custody urine samples as per regulatory requirements.
Enzymatic Assay/Immunoassay
7-Amino Flunitrazepam (Metabolite of Flunitrazepam) (Rohypnol)
Alcohol
Alprazolam (Xanax)
Amobarbital (Amytal)
Amphetamines
Amytal (Amobarbital)
Angel Dust (Phencyclidine)
Ativan (Lorazepam)
Barbita (Phenobarbital)
Barbiturates
Benzodiazepines
Benzoylecgonine (Cocaine Metabolite)
Butabarbital (Butisol)
Butalbital (Fiorinal)
Butisol (Butabarbital)
Cannabinoids (Tetrahydrocannabinol)
Chlordiazepoxide (Librium)
Clorazepate (Tranxene)
Cocaine
Codeine
Coke (Cocaine)
Crack (Cocaine)
Dalmane (Flurazepam)
Date Rape Drug (Rohypnol: Flunitrazepam)
Desalkyl Flurazepam (Metabolite)
Desoxyn (Methamphetamines)
Diazepam (Valium)
Dilaudid (Hydromorphone)
Dolophine (Methadone)
Drugs of Abuse
Ecstasy
Ethanol
Ethyl Alcohol
ETOH (Ethanol)
Fiorinal (Butalbital)
Flunitrazepam (Rohypnol)
Flurazepam (Dalmane)
Halicon (Triazolam)
Heroin
Hycodan (Hydrocodone)
Hydrocodone (Hycodan, Vicodin)
Hydromorphone (Dilaudid, Vicodin)
Hydroxy-Ethyl Flurazepam (Metabolite of Flurazepam) (Dalmane)
Killer Weed (Phencyclidine)
Librium (Chlordiazepoxide)
Lorazepam (Ativan)
Lortab (Hydromorphone)
Luminal (Phenobarbital)
Marijuana (Tetrahydrocannabinol)
MDA (Methylenedioxyamphetamine) Metabolite for Methylenedioxyethylamphetamine (MDEA)
MDMA (Methylenedioxymethamphetamine)
Mebaral (Mephobarbital)
Mephobarbital (Mebaral)
Methadone (Dolophine)
Methamphetamines (Desoxyn)
Methylenedioxyamphetamine (MDA) Metabolite for Methylenedioxyethylamphetamine (MDEA)
Methylenedioxymethamphetamine (MDMA)
Morphine
Nembutal (Pentobarbital)
Nordizepam (Tranxene)
Opiates
Oxazepam (Serax)
Oxycodone (Oxycontin, Percodan)
Oxycontin (Oxycodone)
PCP (Phencyclidine)
Pentobarbital (Nembutal)
Pentothal (Thiopental)
Percodan (Oxycodone)
Phencyclidine (PCP)
Phenobarbital
Restoril (Temazepam)
Rocket Fuel (Phencyclidine)
Rohypnol (Flunitrazepam)
Secobarbital (Seconal)
Seconal (Secobarbital)
Serax (Oxazepam)
Solfoton (Phenobarbital)
Speed (Amphetamines)
TCP (Phencyclidine)
Temazepam (Restoril)
Tetrahydrocannabinol (THC)
THC (Tetrahydrocannabinol)
Thiopental (Pentothal)
Toxicology Screen, Drugs
Tranxene (Clorazepate)
Triazolam (Halcion)
Tuinal (Amobarbital and Secobarbital)
Valium (Diazepam)
Vicodin (Hydrocodone)
Xanax (Alprazolam)
EDDP
Methadone metabolite
Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography with flame ionization detector for ethanol; gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry at an additional charge.
Adulterants testing will be performed on all chain-of-custody urine samples as per regulatory requirements.
Urine
Container/Tube: Chain-of-Custody Kit (T282) containing the specimen containers, seals, and documentation required
Specimen Volume: 30 mL
Collection Instructions: Collect specimen in the provided container, seal, and submit with the associated documentation to satisfy the legal requirements for chain-of-custody testing.
Additional Information: Submitting less than 30 mL will compromise our ability to perform all necessary testing.
1. Chain of Custody Request is included in the Chain-of-Custody Kit (T282).
2. If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
15 mL
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 7 days | |
Frozen | 14 days |
Detecting drug abuse involving alcohol, amphetamines, barbiturates, benzodiazepines, cocaine, methadone, opiates, phencyclidine, and tetrahydrocannabinol
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.
This test is not intended for use in employment-related testing.
Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography with flame ionization detector for ethanol; gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry at an additional charge.
Adulterants testing will be performed on all chain-of-custody urine samples as per regulatory requirements.
This assay was designed to test for and confirm the following drugs, by either gas chromatography-mass spectrometry (GC-MS), gas chromatography flame ionization detection (GC-FID), or liquid chromatography tandem mass spectrometry (LC-MS/MS):
-Amphetamines
-Barbiturates
-Benzodiazepines
-Cocaine
-Ethanol
-Opiates
-Methadone
-Phencyclidine
-Tetrahydrocannabinol
This test uses the simple screening technique which involves immunoassay testing for drugs by class. All positive immunoassay screening results will be confirmed by the definitive assay available and is described in each individual reflex test (eg, AMPHU / Amphetamines Confirmation, Random, Urine). All positive screening results are confirmed by either GC-MS, GC-FID, or LC-MS/MS and quantitated before a positive result is reported.
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.
Negative
Screening cutoff concentrations
Amphetamines: 500 ng/mL
Barbiturates: 200 ng/mL
Benzodiazepines: 100 ng/mL
Cocaine (benzoylecgonine-cocaine metabolite): 150 ng/mL
Ethanol: 10 mg/dL
Methadone metabolite: 300 ng/mL
Opiates: 300 ng/mL
Phencyclidine: 25 ng/mL
Tetrahydrocannabinol carboxylic acid: 50 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, AMPHX / Amphetamines Confirmation, Chain of Custody, Random, Urine) for more information.
For information about drug testing, including estimated detection times, see Drugs of Abuse Testing.
The test does not screen for drug classes other than those listed above. More comprehensive screening is available using the serum or urine drug screens (DSSX / Drug Screen, Prescription/Over the Counter, Chain of Custody, Serum or PDSUX / Drug Screen, Prescription/Over the Counter, Chain of Custody, Urine).
1. Physicians Desk Reference (PDR). 60th edition. Medical Economics Company; 2006
2. Bruntman LL. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. McGraw-Hill Book Company; 2006
3. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023: chap 43
The amphetamines, barbiturates, benzodiazepines, cocaine, methadone metabolite, opiates, phencyclidine, and tetrahydrocannabinol metabolite assays are based on the kinetic interaction of microparticles in a solution (KIMS) as measured by changes in light transmission. In the absence of sample drug, soluble drug conjugates bind to antibody-bound microparticles, causing the formation of particle aggregates. As the aggregation reaction proceeds in the absence of sample drug, the absorbance increases. When a urine sample contains the drug in question, this drug competes with the drug derivative conjugate for microparticle-bound antibody. Antibody bound to sample drug is no longer available to promote particle aggregation, and subsequent particle lattice formation is inhibited. The presence of sample drug diminishes the increasing absorbance in proportion to the concentration of drug in the sample. Sample drug content is determined relative to the value obtained for a known cutoff concentration of drug.(Package inserts: EDDP Specific Urine Enzyme Immunoassay. Immunalysis; 09/2018; AMPS2 cobas. Roche Diagnostics; V 10.0 09/2018; BARB cobas. Roche Diagnostics; V 13.0 09/2021; THC2 cobas. Roche Diagnostics; V 13.0 03/2022; BNZ2 cobas. Roche Diagnostics; V 2.0 04/2024; COC2 cobas. Roche Diagnostics; V 9.0 03/2019; ETOH2 cobas. Roche Diagnostics; V 16.0 06/2022; OPI2 cobas. Roche Diagnostics; V 16.0 01/2022; PCP cobas. Roche Diagnostics; V 13.0 09/2021)
ETOHX Confirmation
Specimens are analyzed and quantified by headspace gas chromatography with flame ionization detection.(Baselt RC. Disposition of Toxic Drugs and Chemicals in Man, 10th edition, Biomedical Publications; 2014:2211)
Monday through Saturday
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
80307
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
CDA7X | Confirmed Drug Abuse Panel9, CoC, U | 87428-9 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
36253 | Amphetamines | 43983-6 |
36254 | Cocaine | 43984-4 |
36255 | Opiates | 70151-6 |
36256 | Phencyclidine | 14310-7 |
36257 | Tetrahydrocannabinol | 14312-3 |
36261 | Chain of Custody | 77202-0 |
36262 | Alcohol | 42242-8 |
36258 | Barbiturates | 70155-7 |
36259 | Benzodiazepines | 14316-4 |
36260 | Methadone metabolite | 41858-2 |