Drugs Of Abuse: 5 Drugs

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Rapid urine/blood screening panels.

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Drugs Of Abuse: 5 Drugs Test Information Guide

Why is it done?
- Test Purpose: Screens for the presence of five commonly abused drugs in urine, blood, or saliva samples to detect substance use
- Primary Indications: Workplace drug screening, pre-employment testing, legal/court-ordered testing, substance abuse treatment programs, pain management monitoring, criminal investigations, and clinical suspicion of drug use
- Typical Drugs Screened: Commonly includes marijuana (THC), cocaine, amphetamines, opioids, and phencyclidine (PCP)
- Timing of Testing: Performed at initial screening, periodic monitoring during employment or treatment, immediately after accidents or incidents, and when clinical evidence of substance use is present
Normal Range
- Normal Result: Negative (reported as "Not Detected" or "Negative for all drugs screened")
- Cutoff Thresholds (typical values): Marijuana: 50 ng/mL (immunoassay) or 15 ng/mL (confirmatory), Cocaine: 300 ng/mL, Amphetamines: 500 ng/mL, Opioids: 300 ng/mL, PCP: 25 ng/mL
- Positive Result: Reported as "Positive" or "Detected" when levels exceed established cutoff values, typically indicating recent drug use
- Units of Measurement: Nanograms per milliliter (ng/mL) for immunoassay screening; confirmatory testing by mass spectrometry also uses ng/mL
- Interpretation Guidelines: Negative = No drugs detected above threshold; Positive = Drug present above cutoff level, usually requires confirmatory testing; results indicate drug presence regardless of impairment or timing of use
Interpretation
- Negative Result Interpretation: No detectable levels of the five drugs screened; indicates likely absence of recent drug use or levels below detection threshold
- Positive Result Interpretation: Indicates presence of detected drug(s) above cutoff threshold; suggests recent use; does not indicate degree of impairment or exact time of ingestion; requires confirmatory testing to verify and rule out false positives
- Marijuana (THC): Can be detected for days to weeks depending on frequency of use; does not indicate impairment at time of test; passive smoke exposure rarely causes positive results with modern thresholds
- Cocaine: Typically detectable for 2-4 days after use; benzoylecgonine (metabolite) is what is actually measured; indicates cocaine or crack use
- Amphetamines: Detectable for 1-3 days after use; includes methamphetamine and amphetamine; legitimate prescription medications (Adderall, Ritalin) can produce positive results
- Opioids: Detectable for 1-3 days; includes heroin, morphine, and codeine; prescription pain medications (hydrocodone, oxycodone) cause positive results; can result from eating poppy seeds
- PCP (Phencyclidine): Detectable for 7-14 days after use; indicates dissociative drug use; associated with significant behavioral and health risks
- Factors Affecting Results: Frequency and amount of use, individual metabolism, body composition, hydration status, specimen integrity, time since ingestion, certain foods and supplements, cross-reactivity with structurally similar compounds, specimen tampering or adulteration
- False Positives: Initial screening (immunoassay) has higher false positive rate; confirmatory testing by GC-MS eliminates most false positives; certain medications and substances can cause cross-reactivity
Associated Organs
- Primary Organ Systems Affected by Drug Abuse: Central nervous system (CNS), cardiovascular system, respiratory system, hepatic system (liver), renal system (kidneys), and metabolic pathways
- Marijuana (THC) Effects: CNS depression, impaired cognition, respiratory irritation, cardiovascular stress (increased heart rate), mental health effects (anxiety, psychosis in vulnerable individuals), potential cannabinoid hyperemesis syndrome
- Cocaine Effects: Acute cardiovascular stress (hypertension, tachycardia, arrhythmias, myocardial infarction), CNS stimulation, nasal septum perforation (if snorted), respiratory damage, kidney damage from rhabdomyolysis, seizures, stroke
- Amphetamines Effects: CNS overstimulation, severe hypertension, tachycardia, cardiac arrhythmias, hyperthermia, neurotoxicity, psychosis, dental deterioration ("meth mouth"), liver damage, kidney failure
- Opioid Effects: CNS depression, respiratory depression (potentially fatal), liver toxicity, renal impairment, immunosuppression, gastrointestinal dysfunction, overdose risk, addiction potential
- PCP Effects: Severe CNS disruption, dissociation, psychosis, violent behavior, hypertension, hyperthermia, rhabdomyolysis with acute kidney injury, seizures, coma, neurotoxicity
- Conditions Associated with Abnormal Results: Substance use disorder, intoxication, withdrawal syndromes, overdose, drug-induced psychiatric conditions, cardiovascular complications, hepatic disease, renal dysfunction, respiratory failure, neurotoxicity
Follow-up Tests
- Confirmatory Testing: Gas Chromatography-Mass Spectrometry (GC-MS) or Liquid Chromatography-Mass Spectrometry (LC-MS) to confirm positive screening results; gold standard for accuracy and specificity
- Extended Drug Panel Testing: Testing for synthetic drugs, designer drugs, benzodiazepines, barbiturates, or other substances if clinically indicated
- Liver Function Tests: AST, ALT, bilirubin, albumin to assess hepatic damage from chronic drug use
- Renal Function Tests: BUN, creatinine to evaluate kidney function impaired by drug use or rhabdomyolysis
- Cardiac Evaluation: Electrocardiogram (ECG), troponin levels, echocardiography if cocaine or stimulant use suspected
- Infectious Disease Screening: HIV, hepatitis B and C testing (especially for intravenous drug users); baseline screening recommended
- Psychiatric Evaluation: Assessment for substance use disorder, mental health comorbidities, suicide risk, and need for treatment referral
- Toxicology Screening in Emergency Settings: Blood and urine comprehensive toxicology panel, metabolic panel, CBC for acute intoxication or overdose situations
- Periodic Retesting: Random drug testing at work, monthly testing in substance abuse treatment programs, or per employer/legal requirements
- Hair Drug Testing: Long-term detection window (up to 90 days); used for extended drug history assessment or when urine testing not feasible
Fasting Required?
- Fasting Requirement: No, fasting is not required for urine or saliva drug screening
- Specimen Collection Preparation: For urine: collect first morning void if possible (more concentrated); for blood: can be drawn anytime; for saliva: no special preparation needed
- Medications to Disclose: Inform testing personnel of ALL medications and supplements: prescription stimulants (Adderall, Ritalin), pain medications (hydrocodone, oxycodone), cough medicines (dextromethorphan), decongestants (pseudoephedrine, phenylephrine), antihistamines, and herbal supplements
- Foods to Avoid: Large quantities of poppy seeds within 24-48 hours of test (can cause false positive for opioids); inform laboratory if consumed
- Other Patient Instructions: Wear comfortable clothing allowing easy access to veins for blood draw if applicable; bring valid photo identification; be prepared to provide detailed medication and supplement list; inform of any recent medical procedures or conditions
- Chain of Custody Procedures: Specimen must be handled according to established chain of custody protocols; patient may be observed during collection for workplace or legal testing; specimen is labeled with unique identifier and date/time
- Sample Stability: Urine samples stable for 24-48 hours at room temperature or longer if refrigerated; blood samples stable for several days at 4°C; saliva samples should be processed promptly
- When to Schedule: Can be scheduled any time; no specific time of day preference unless employer/legal requirements specify; may be conducted without advance notice for workplace or court-ordered testing

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