Download Drugs of Abuse - ASAP-NJ

Opiate Related
Opiates:
• The screen is most specific to codeine and morphine and shows some reactivity to hydrocodone and
hydromorphone. Morphine can be detected in urine
up to 72 hours after the last dosage; codeine within
48 hours.
• High levels of oxycodone and certain drugs can
cross react with the opiate screen, yielding a falsepositive result.
Oxycodone:
• Our oxycodone screen is sensitive to oxycodone
and oxymorphone. Oxycodone is detected up to 3
days after last use and oxymorphone is detected up
to 4 days after last use. Oxymorphone is a metabolite
of oxycodone, so oxycodone use could potentially
screen ‘positive’ for up to a week after last use.
• The oxycodone screen is very specific with no
known cross reactants.
Buprenorphine:
• Buprenorphine screening is conducted to ensure
that the client is adhering to a proper dosage regimen
• Buprenorphine confirmation testing is strongly encouraged to accurately measure the bup/norbup ratio
for prescription monitoring purposes.
Methadone:
• Methadone can be detected up to 11 days after last
usage (at maintenance level dosage).
EDDP (Methadone Metabolite):
• EDDP is the primary metabolite of methadone. The
absence of EDDP can indicate possible tampering of
the specimen or very recent ingestion of the parent
drug (methadone). Methadone dosages can be monitored by evaluating the methadone:eddp ratio (using
confirmation values).
EtG/Alcohol Metabolite
• The purpose of EtG (Ethyl Glucuronide) testing is to
provide a means to monitor abstinence from alcohol.
• EtG can also be produced when exposed to extraneous alcohol, such as hand sanitizers, mouth
wash, hair products, or cooking wine, etc. It is
recommended that treatment professionals develop
policies in response to extraneous alcohol exposure
resulting in positive EtG results. Treatment professionals are encouraged to educate clients on the risk
and consequences of extraneous alcohol exposure.
• EtG can be detected by EIA screening up to 80
hours in urine. Confirmation testing is highly recommended with all positive results as the EtG screen is
susceptible to problems due to poor specimen quality, such as concentrated or color urine.
• Below you will find helpful SAMHSA guidelines in
regards to interpreting EtG results. (Please note:
these levels are from confirmation testing - not the
screening results produced by Burlington Labs.)
“High” Positives (e.g., >1,000 ng/mL) may indicate:
• Heavy drinking on the same day or previously
(e.g., previous day or two).
• Light drinking the same day
“Low” Positives (e.g., 500–1,000 ng/mL) may indicate:
• Previous heavy drinking (previous 1–3 days).
• Recent light drinking (e.g., past 24 hours).
• Recent intense “extraneous exposure” (within 24
hours or less).
“Very Low” Positives (100–500 ng/mL) may indicate:
• Previous heavy drinking (1–3 days).
• Previous light drinking (12–36 hours).
• Recent “extraneous” exposure.
Drugs
of Abuse
Windows of
Detection &
Contributing
Factors
Common Drugs of Abuse
Cannabinoids (THC):
• THC detection times vary greatly depending on the
Client’s pattern of use. For a single use, detection
time is up to 3 days. After moderate use, THC can be
detected up to 4 days. Heavy use can produce a result 10 days after stopping and with chronic use, THC
can take up to 30-36 days to pass completely through
the system.
• Often, the goal of treatment is to monitor the decrease in THC levels. It is recommended that positive
specimens receive confirmation testing to provide an
exact quantitative value. Burlington Labs provides
normalization results on all reports for THC values.
Normalization values are calculated using the client’s
creatinine value, providing insight into the donor’s
level of hydration at the time of collection. Hydration
greatly affects results, so when assessing an individual’s THC values over time, it is important to compare
the normalized THC value.
Amphetamines:
• Amphetamine detection time varies greatly. Urine
pH greatly influences the excretion of amphetamines.
If urine is acidic, 80% of a dose will be excreted
unchanged in urine while only 1-2% will be excreted
if the urine is alkaline. The time period of detection
in urine is typically 1-2 days, but chronic users of
amphetamines can take up to 4 days to completely
eliminate.
• Common cross reactants are buproprion (Wellbutrin), over the counter cold/flu medications containing pseudoephedrine, diet agents, and
decongestants.
For more information:
contact our scientists at
1-888-378-4645, ext 120
Barbiturates:
• Short Acting barbiturates like pentobarbital and
secobarbital can be detected 4-6 days after last use.
Intermediate acting drugs like amobarbital, butabarbital and butalbital can be detected up to 8 days after
last use. The long acting barbiturate, phenobarbital,
can be detected up to 30 days after last use.
• The screen used here at Burlington Labs is not
quite as specific to phenobarbital as other barbiturates. This means that more drug is needed to elicit
a positive screen, so it is unlikely that a specimen
would screen positive for the full 30 days after last
use.
Benzodiazepines:
• Our benzodiazepine screen here at Burlington Labs
is sensitive to many types of benzodiazepines. Because of this, it may prove difficult to determine the
duration where a client may screen positive. Certain
benzodiazepines, like diazepam, break down into
active metabolites which our screen is also sensitive
to. Diazepam, for example, can be detected for up to
8 days. Diazepam’s metabolite, nordiazepam, can be
detected up to 24 days.
• Short Acting benzodiazepines like triazolam can be
detected up to 24 hours, while intermediate acting
drugs like alprazolam and temazepam can be detected for up to 12.5 days.
• Our screen is not as sensitive to low dose drugs,
like clonazepam (Klonopin) or lorazepam (Ativan).
We recommend confirmation testing if the goal of
drug testing is to monitor low dose benzodiazepines.
Ecstasy:
• Most commonly known as Molly or Ecstasy, MDMA
(3,4-methylenedioxymethamphetamine) can typically be detected in urine using the Burlington Labs
ecstasy test 2 days after the last dose.
• An analog of MDMA, MDEA (3,4-methylenedioxyN-ethylamphetamine) is also sensitive to the Burlington Labs screen. This drug is also abused on its own
and produces similar effects to MDMA. An ecstasy
pill may contain a combination of MDMA and MDEA.
• The screen is also sensitive to MDA, the primary
metabolite of both MDMA and MDEA.
• An ecstasy confirmation panel will include MDMA,
MDEA, MDA, Amphetamine and Methamphetamine.
• According to the manufacturer of Burlington Labs
assays, amphetamine and methamphetamine will not
cross react with the ecstasy screen.
Cocaine:
• Cocaine is metabolized very quickly. Cocaine’s major metabolite, benzoylecgonine, is used as a marker
of cocaine use.
• Benzoylecgonine is detected one to three days
after last use.
• Our cocaine screen is very specific to benzoylecgonine with no known cross-reactants.
6-MAM (Heroin Metabolite):
• Heroin is rapidly metabolized into 6-Monoacetylmorphine minutes after administration. 6-MAM
itself is a short-lived metabolite, which is further
metabolized to morphine.
• The presence of 6-MAM and morphine in urine is
unique to heroin use.
• 6-MAM is detected in urine up to 24 hours after
heroin administration.
Learn more at www.burlingtonlabs.com