PHYSICIANS REFERENCE LABORATORY
ANATOMIC PATHOLOGY | MOLECULAR PATHOLOGY | CYTOLOGY | TOXICOLOGY
PAIN MED |
CLINICAL LABORATORY TESTING | TEST RESULTS
SPECIMEN REQUIREMENTS | PATIENT CARE SERVICES | SERVICE CENTERS
PATIENT INFORMATION
TOXICOLOGY INFORMATION
Toxicology provides medical and legal toxicology services for the Kansas City region and looks forward to meeting your special needs.
COMMON DRUG PANELS
| The Five Panel | The Eight Panel | The Ten Panel |
| Marijuana | Marijuana | Marijuana |
| Cocaine | Cocaine | Cocaine |
| Amphetamines | Amphetamines | Amphetamines |
| Opiates | Opiates | Opiates |
| PCP | PCP | PCP |
| Barbiturates | Barbiturates | |
| Benzodiazepines | Benzodiazepines | |
| Propoxyphene | Propoxyphene | |
| Methadone | ||
| Alcohol |
STREET NAMES
| Amphetamines | Stimulants | Dexedrine Methamphetamine Speed |
| Barbiturates | "Downer" | Amytal Black Beauties Blue Angels Butisol Florinal Nembutal Phenobarbital Reds Seconal Tuinal |
| Benzodiazepines | "Downer" | Ativan Dalmane Diazepam Librium Serax Valium Xanax |
| Cocaine | "Abused Drug" | Coke Crack Flake Snow |
| Marijuana | Hallucinogens | Dope Grass Mary Jane Pot |
| Methadone | Synthetic Narcotic | Dolly |
| Opiates, Expanded | Opiate Narcotic | Codeine Heroin Horse Morphine Smack Vicodin |
| Phencyclidine | Hallucinogen | Angel Dust Hog PCP |
| Propoxyphene | Synthetic Narcotic | Darvon |
DRUG TESTING CUTOFFS
| Amphetamines | 1000 | amphetamine methamphetamine |
500 500 |
| Barbiturates | 200 | amobarbital butabarbital butalbital phenobarbital secobarbital |
200 200 200 200 200 |
| Benzodiazepines | 200 | diazepam fluorazepam lorazepam nordiazepam oxazepam |
200 200 200 200 200 |
| Cocaine | 300 | benzoylecgonine (cocaine metabolite) |
150 |
| Marijuana | 20 | thca (thc metabolite) | 7 |
| Opiates | 300 | codeine dihydrocodeine hydrocodone hydromorphone morphine oxycodone |
300/2000 300/2000 300/2000 300/2000 300/2000 300/2000 |
| Phencyclidine (PCP) | 25 | phencyclidine | 25 |
| Propoxyphene | 300 | norpropoxyphene (propoxyphene metabolite) |
300 |
| Amphetamines | 1 - 2 days |
| Barbiturates | up to 2 - 6 weeks |
| Benzodiazepines | 3 - 5 days (3 - 6 weeks following heavy abuse) |
| Cocaine | 2 - 4 days |
| Codeine | 1 - 2 days |
| Heroin | 1 - 2 days as morphine 6 - 24 hours as 6-acetylmorphine |
| LSD | 12 - 24 hours |
| Marijuana | 2 days (one joint) 2 weeks (3 joints a week) 3 - 6 weeks (daily use) |
| Methadone | 2 - 3 days |
| Morphine | 1 - 2 days |
| PCP | 2 - 8 days |
| Propoxyphene | 1 - 2 days as norpropoxyphene |
URINE TESTING RESULT INTERPRETATION GUIDELINES
Positive Urine Drug Testing Results
- Indicates that the Donor was exposed to the identified drug at some point prior to specimen collection.
- Does NOT indicate that the Donor was under the influence of the drug at the time of specimen collection.
Negative Urine Drug Testing Results
- Indicates that there were no drugs present at or above the cutoff levels used.
- Only indicates that no drugs were detected in that particular testing panel.
Drug Testing Recommendations
- Follow an established specimen collection procedure for all collections.
- Collect specimens at random.
- Give Donor as little notice as possible regarding specimen collection time.
- Collect specimens in the morning if possible.
- Inform Donor ahead of time that excessively dilute urine specimens will not be accepted.
- Work with the toxicology department to select a drug panel that reflects the most common abused drugs in your area.
- Consider using a Medical Review Officer (MRO) to interpret results and to keep Donor’s legitimate medications confidential.
ADULTERANTS
Adulterants are chemical materials that are added to urine specimens in an attempt to foil drug tests. Originally adulterants were the chemical products found under the bathroom sink, i.e. cleansers, soaps, and disinfectants. Today adulterants are a major industry and many of the products are quite sophisticated. While the older products sought to interfere with the screening test, the new products, called oxidants, actually change the drug’s molecular structure. While the change in the drug’s molecular structure changes does not impact the screening, it does interfere with the GC/MS confirmation. When a sample does not confirm as expected, PRL's laboratory checks for oxidants before issuing a report.
PRL also recognizes that adulterants will constantly change, and so we are dedicated to staying on the cutting edge for their detection.
OPIATE CUTOFF INFORMATION
DOT specimens utilize a 2,000 ng/mL screening and confirmation cutoff for morphine and codeine and a 10 ng/mL for heroin metabolite when morphine confirms at 2,000 ng/mL or greater. Toxicology offers a 2,000 ng/mL NIDA look alike opiate cutoffs. However, most of our clients prefer our expanded opiate panel which utilizes a screening cutoff of 300 ng/mL. The confirmation cutoffs for this service are 2,000 ng/mL for morphine and codeine (just like DOT samples) and 300 ng/mL for hydrocodone and dihydrocodeine. The 300 ng/mL screening and confirmation cutoff is used in order to ensure the reliable detection of the commonly abused opiates, hydrocodone and dihydrocodeine.