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Drugs Of Abuse: 6 Drugs

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Rapid urine/blood screening panels.

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Drugs Of Abuse: 6 Drugs Test Information Guide

  • Why is it done?
    • Screens for presence of six common drugs of abuse in urine, blood, or saliva samples
    • Typically detects: Marijuana (THC), Cocaine, Amphetamines, Opioids, Phencyclidine (PCP), and Benzodiazepines or Methamphetamine
    • Ordered for pre-employment screening to establish baseline drug-free status before hiring
    • Performed as part of workplace safety programs and random employee testing
    • Used in clinical settings to monitor compliance in substance abuse treatment programs
    • Ordered by healthcare providers to evaluate patients for unexplained altered mental status or behavioral changes
    • May be required for law enforcement purposes, legal proceedings, or DUI investigations
    • Performed prior to certain medical procedures or when prescribing controlled substances
  • Normal Range
    • Normal Result: NEGATIVE - No drugs detected or levels below established cutoff thresholds
    • Standard Cutoff Concentrations (most common):
      • Marijuana (THC): 50 ng/mL (screen), 15 ng/mL (confirmatory)
      • Cocaine Metabolite: 150 ng/mL (screen), 100 ng/mL (confirmatory)
      • Amphetamines: 500 ng/mL (screen), 250 ng/mL (confirmatory)
      • Opioids: 300 ng/mL (screen), 300 ng/mL (confirmatory)
      • Phencyclidine (PCP): 25 ng/mL (screen), 25 ng/mL (confirmatory)
      • Benzodiazepines: 200 ng/mL (screen), 200 ng/mL (confirmatory)
    • Abnormal Result: POSITIVE - One or more drugs detected at or above cutoff levels
    • Units of Measurement: ng/mL (nanograms per milliliter) for screening and confirmatory tests
    • Result Interpretation Categories:
      • Negative: No drugs detected or all results below cutoff thresholds
      • Positive: One or more substances detected above established cutoff levels (preliminary positive)
      • Invalid: Test cannot be interpreted due to technical issues; recollection required
  • Interpretation
    • Negative Results (Normal):
      • Indicates no detectable drugs of abuse in the system at or above testing thresholds
      • Clinically favorable for employment, legal, or monitoring purposes
    • Positive Results (Abnormal):
      • Preliminary positive results typically trigger confirmatory testing using Gas Chromatography/Mass Spectrometry (GC/MS) to eliminate false positives
      • Confirmed positive results indicate recent use of the detected substance(s)
      • May have employment, legal, medical, or clinical consequences depending on context
    • Factors Affecting Results:
      • Legitimate prescribed medications (benzodiazepines, opioids, amphetamine-based ADHD medications) may produce positive results
      • Cross-reactivity with certain medications or substances can cause false positives (e.g., antihistamines, cold medications)
      • Timing of collection affects results; detection windows vary by substance (THC: days to weeks; cocaine/amphetamines: 2-3 days; opioids: 2-4 days)
      • Passive smoke exposure (minimal but possible for cannabis)
      • Collection errors, specimen contamination, or improper handling can affect accuracy
      • Individual metabolism varies; some individuals metabolize drugs faster than others
    • Clinical Significance:
      • Positive results for cocaine or PCP require immediate further evaluation in medical settings due to cardiovascular and neurological risks
      • Opioid positivity in patients not prescribed opioids suggests illicit use and warrants substance abuse intervention
      • Multiple drug positivity suggests complex substance abuse requiring specialized treatment
  • Associated Organs
    • Primary Organ Systems Affected:
      • Central Nervous System (CNS) - All substances directly affect brain function and neurotransmitter activity
      • Cardiovascular System - Stimulants (cocaine, amphetamines) increase heart rate and blood pressure; can cause arrhythmias and myocardial infarction
      • Respiratory System - Particularly affected by smoked drugs (marijuana, cocaine); opioids depress respiration
      • Hepatic System - Liver metabolizes most drugs; chronic use can lead to hepatotoxicity
      • Renal System - Kidneys filter and excrete drugs and metabolites; chronic use can cause kidney dysfunction
    • Associated Medical Conditions:
      • Cocaine/Amphetamines - Acute coronary syndrome, myocardial infarction, cardiac arrhythmias, stroke, hypertensive crisis, seizures, intracranial hemorrhage
      • Opioids - Respiratory depression, overdose, hypoxemia, aspiration pneumonia, hepatitis (IV use), HIV infection (IV use), endocarditis
      • PCP - Violent behavior, agitation, psychosis, seizures, coma, acute kidney injury, rhabdomyolysis
      • Benzodiazepines - Respiratory depression (especially combined with opioids), sedation, dependence, overdose, impaired cognition
      • THC/Marijuana - Impaired cognition, short-term memory deficits, psychosis (in susceptible individuals), respiratory issues, tachycardia, cannabis hyperemesis syndrome
    • Potential Complications of Positive Results:
      • Acute medical emergencies and hospitalizations
      • Long-term organ damage (heart disease, chronic lung disease, liver cirrhosis, kidney disease)
      • Infectious diseases (hepatitis, HIV, sexually transmitted infections from high-risk behavior)
      • Neuropsychiatric complications (psychosis, depression, anxiety, cognitive impairment)
  • Follow-up Tests
    • Confirmatory Testing (after positive screening):
      • GC-MS (Gas Chromatography-Mass Spectrometry) - Gold standard confirmatory test for positive screening results
      • LC-MS/MS (Liquid Chromatography-Tandem Mass Spectrometry) - Alternative high-sensitivity confirmatory method
    • Additional Clinical Evaluation Tests:
      • 12-Lead Electrocardiogram (ECG) - For stimulant use (cocaine, amphetamines) to assess cardiac effects
      • Troponin (cardiac biomarker) - To evaluate for myocardial injury in acute presentations
      • Comprehensive Metabolic Panel (CMP) - Assess liver and kidney function in chronic users
      • Complete Blood Count (CBC) - Screen for anemia or infection related to drug use
      • Liver Function Tests (LFTs) - Evaluate hepatic damage from chronic substance use
    • Infectious Disease Screening (for IV drug users):
      • HIV Antibody Test
      • Hepatitis B Surface Antigen (HBsAg) and Antibody
      • Hepatitis C Antibody
    • Mental Health and Substance Abuse Assessments:
      • Psychiatric evaluation for co-occurring mental health disorders
      • Substance abuse counseling and referral to treatment programs
      • AUDIT (Alcohol Use Disorders Identification Test) if alcohol use also suspected
    • Monitoring and Repeat Testing:
      • Repeat drug screening at prescribed intervals for patients in treatment/recovery programs
      • Frequency typically every 3-6 months or as clinically indicated
      • Random testing may be implemented for workplace or legal compliance
    • Extended Panel Testing (if indicated):
      • 9-panel or 12-panel drug screening for more comprehensive substance detection
      • Hair drug testing for extended detection window (past 90 days)
      • Synthetic cannabinoid testing if K2/Spice use suspected
  • Fasting Required?
    • Fasting Required: NO
    • Fasting is not required for drug screening tests. The patient may eat and drink normally before collection.
    • General Patient Preparation Instructions:
      • Bring valid photo identification to the testing facility
      • Inform the healthcare provider or technician of all current medications, supplements, and over-the-counter products being taken
      • Disclose any prescriptions for benzodiazepines, opioids, or amphetamine-containing medications
      • Wear comfortable, easily removable clothing (may be required to change into testing garments)
    • Sample Collection Specifics:
      • Urine Sample (most common): Typically midstream clean-catch collection; first morning urine preferred for higher concentration
      • Blood Sample: Venipuncture (needle stick) into appropriate collection tubes; minimal discomfort expected
      • Saliva Sample: Non-invasive collection using absorbent collection device placed between cheek and gums
    • Medications to Avoid or Disclose:
      • Do NOT avoid prescribed medications; disclose all to healthcare provider
      • Stimulant ADHD medications (Adderall, Ritalin, Concerta) - may test positive for amphetamines
      • Prescription opioids (morphine, codeine, hydrocodone) - may test positive for opioids
      • Benzodiazepines (Valium, Xanax, Ativan) - may test positive for benzodiazepines
      • Over-the-counter antihistamines and decongestants - may cause false positive for amphetamines
    • Special Instructions:
      • Arrive on time; some facilities may have limited collection windows
      • Be aware that specimen collection is often observed for workplace and legal testing to prevent adulteration
      • For urine collection, avoid touching the inside of the collection cup
      • Do not eat poppy seed foods for 24 hours before testing (can produce false positive for opioids)
      • Chain of custody procedures strictly followed; maintain documentation for legal proceedings if applicable

How our test process works!

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