TEST CATALOG ORDERING & RESULTS SPECIMEN HANDLING CUSTOMER SERVICE EDUCATION & INSIGHTS
Test Catalog

Test ID: PDSOX    
Pain Clinic Drug Screen, Chain of Custody, Urine

Useful For Suggests clinical disorders or settings where the test may be helpful

Detecting drug abuse involving amphetamines, barbiturates, benzodiazepines, cocaine, ethanol, methadone, opiates, phencyclidine, 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.

 

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.

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

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 barbiturates, benzodiazepines, cocaine and metabolites, methadone, phencyclidine, and tetrahydrocannabinol metabolite; liquid chromatography-tandem mass spectrometry for amphetamines and opiates) at an additional charge. If only oxycodone screens positive, only confirmation of oxycodone with metabolite will be performed. Any other opiate positive screen will result in the full opiate confirmation being performed.

 

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

 

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

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:

-Barbiturates

-Benzodiazepines

-Cocaine

-Ethanol

-Methadone

-Phencyclidine

-Tetrahydrocannabinol

 

Confirmation by liquid chromatograph-tandem mass spectrometry (LC-MS/MS) is completed for all opiates and amphetamines.

 

This panel uses the screening technique that involves immunoassay testing for drugs by class. All positive screening results are confirmed by GC-MS, GC-FID, or LC-MS/MS, and quantitated, before a positive result is reported.

 

The panel includes PDSUX / Drug Screen, Prescription/OTC, Chain of Custody, 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.

 

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.

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

 

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.

Interpretation Provides information to assist in interpretation of the test results

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, Urine) for more information.

 

For information about drug testing, including estimated detection times, see Drugs of Abuse Testing at https://www.mayocliniclabs.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

Not intended for use in employment-related testing.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Physician's Desk Reference. 61st edition. Montvale, NJ. Thomson PDR, 2007

2. Goodman and Gilman's The Pharmacological Basis of Therapeutics. Tenth edition. New York, NY. McGraw-Hill Professional, 2001

3. Langman LJ, Bechtel L, Holstege CP: Chapter 35. In 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