PRL: Physicians Reference Laboratory

PHYSICIANS REFERENCE LABORATORY

URINE CANNABINOID LEVELS

What is marijuana?

Marijuana is a plant (Cannabis sativa) that is widely distributed throughout the world. It is grown in two varieties: one called hemp, which is used for fiber and has very little to no psychoactive ingredients. The other variety is grown for its psychoactive properties. Marijuana contains a unique variety of chemicals called cannabinoids. One of these cannabinoids, tetrahydrocannabinol (abbreviated as THC) has been identified to be the main active ingredient in marijuana. Unlike in times past, the THC concentrations in most of today’s illegal marijuana are quite high and therefore today’s marijuana is for the most part very potent. Marijuana can also be processed into several products that have even higher THC concentrations, hashish and hashish oil. While marijuana is usually smoked, it or its products can also be taken orally. The effects of marijuana last from 1 to several hours. Individuals “high” on marijuana have a distorted sense of time, feel euphoric, and quite often get the “munchies”. After marijuana effects wear off, the users are usually lethargic.

Marijuana Use- Is it harmful?

According to recent government studies, marijuana is the most commonly used illegal drug of abuse among all age groups. While marijuana does not cause a “hang over”, there is scientific evidence that it is detrimental to health. It is particularly problematic for adolescents and it causes what is known as the “amotivational syndrome”. As the name suggests, individuals with this affliction are found to be lacking in motivation in school, at home, in church, and in their personal lives- with the exception of drug use and its associated activities. Another hallmark of adolescents and young adults with this syndrome is that in almost all cases, they think “everything is OK” and that they do not have a problem. This can be particularly challenging and often calls for professional help. The impact of the amotivational syndrome can be quite significant during the critical adolescent development period, especially in regards to individuals developing to their potential. Marijuana use can also be problematic in that many experts view it as a “gateway” to the use of harder drugs such as methamphetamine (speed), cocaine (coke), and heroin (smack). In some reports, chronic marijuana use has been associated with chromosomal damage.

What can be done?

If you think your loved one has a drug problem, PRL can provide a urine drug test for common illegal drugs. This test definitively identifies whether or not an individual has been exposed to the drugs in question. The detection time for illegal drugs is as follows:

DRUG	DETECTION WINDOW
Marijuana	from the same day to as long as several weeks if the individual is a chronic user
Cocaine	up to 4 days prior to specimen collection
Amphetamines	up to 2 days prior to specimen collection
Opiates	up to 2 days prior to specimen collection
PCP	up to 8 days prior to specimen collection

Urine Cannabinoid Levels

If the initial drug test identifies marijuana, PRL will automatically perform a special test called a “Urine Cannabinoid Level”. This test is actually an index and it provides important information (a baseline) for further testing (monitoring) on individuals identified as Positive for Marijuana on their initial drug test. Urine cannabinoid level results are expressed in nanograms (ng) of cannabinoids per milligram (mg) of creatinine and the units will be listed on the report as “ng/mg”. While these units may seem imposing, they are designed to measure total cannabinoids and then to correct for whether the individual produced a dilute urine specimen or a concentrated urine specimen. Since our test corrects for this important variable, the final result can be used to more accurately assess whether or not your loved one has used marijuana or continued its use, in comparison to a recent baseline test. In order to implement a monitoring program you will need to take the following steps.

Request a urine drug test. If it is positive for marijuana, PRL will automatically include a urine cannabinoid level for no additional charge. If the initial test is positive, a confirmation test will be performed by gas chromatography/mass spectrometry, the definitive “gold standard” for making sure that the drug is actually present.
Monitor your loved one at least once a week by collecting a urine specimen at random either in the privacy of your home or at one of PRL’s collection site. If you bring the specimen from home, we recommend you observe the actual collection of the specimen. This is because, commonly, individuals try to "beat the drug test” and are surprisingly knowledgeable about chemicals that can be added to their urine or other techniques to obscure the presence of drugs.
Evaluate your weekly results. If an individual’s exposure to marijuana stops, their urine marijuana levels will drop every week. If an individual abstains from marijuana use, their urine cannabinoid level will become undetectable within a week if the individual was a light user or as long as 4 to 6 weeks if the individual was a heavy user. If the weekly urine marijuana level does not go down, your loved one has most likely had an exposure to marijuana since the last specimen was tested.
Urine Cannabinoid level examples (units = ng/mg)

Heavy user who totally abstains

Week 0	Week 1	Week 2	Week 3	Week 4	Week 5
1,250	850	425	125	50	not detected

Moderate user who totally abstains

Week 0	Week 1	Week 2	Week 3	Week 4	Week 5
450	285	125	25	Not detected	not detected

Moderate user who uses again

Week 0	Week 1	Week 2	Week 3	Week 4	Week 5
450	285	125	350	195	65

Comment: Individual used sometime between week 2 and week 3

Light user who totally abstains

Week 0	Week 1	Week 2	Week 3	Week 4
200	85	Not detected	Not detected	Not detected

Light user who uses again

Week 0	Week 1	Week 2	Week 3	Week 4
200	85	Not detected	325	185

Comment: Individual used sometime between week 2 and 3

Regular monitoring of your loved one will allow you to accurately assess progress toward your loved one living a drug free life style. If needed, a number of good community programs are available to assist you. Don’t give up! Your loved one is worth it. This is a problem that can be, and often is, overcome.

PHONE 800-821-3627 OR 913-338-4070