Drug Testing

Question 1

General Detection Windows

Answer 1

serum/oral fluid = min - hrs
urine = hrs - days
sweat = hrs - weeks
scalp hair = up to 3 months
body hair = up to 12 months

Question 2

THC specific detection windows in urine based on frequency of use

Answer 2

urine will detect
1x use = up to 13 days
reg use = up to 45 days
heavy use = up to 90 days

Question 3

1) POC urine tests use what type of testing?
2) What circumstances make these tests negative?
3) What circumstances make these tests positive?

Answer 3

1) immunoassays on urine using EMIT / ELISA / CEDIA
2) negative when NO DRUG or TOO LOW CONCENTRATION OF DRUG or WEAK TEST RESPONSE or ADULTERANT or LAB ERROR
3) positive when RECENT USE ONLY of TARGET DRUG or DRUG THAT CROSS REACTS

Question 4

What are the most sensitive tests for detection of specific drugs in a urine sample?

Answer 4

At 99% sens and spec, GAS Chromatography Mass Spectrometry&raquo_space;
LIQUID Chromatography Mass Spectrometry

Question 5

What indicates that a drug was dipped into a urine sample to turn test positive?

Answer 5

buprenorphine ratio to norbuprenorphine > 2

Question 6

What can cross react to produce positive urine testing for AMPHETAMINE?

Answer 6

pseudoephedrine
bupropion
seleginine
metformin
phentermine
atomoxetine
ranitidine
MOST COMMON X-RXNs in UDS

Question 7

Can poppy seeds produce positive urine testing for OPIOIDS?

Answer 7

poppy seed as cause of positive opiate screen can be considered if
1) < 5000 ng/mL morphine
2) < 1000 ng/mL morphine, with codeine positive
3) < 300 ng/mL total codeine
4) morphine : codeine ratio > 2

Question 8

What can cross react to produce positive urine testing for PHENCYCLIDINE (PCP)?

Answer 8

dextromethorphan
lamotrigine
venlafaxine

Question 9

What are opiates?
What are opioids?

Answer 9

OPIATES = morphine and thebaine

OPIOIDS = everything else

Question 10

Opioids specific detection windows in urine

Answer 10

short (1-3 days) = codeine, heroin, hydrocodone, hydromorphone, morphine, oxycodone, oxymorphone

medium (up to 4 days) = buprenorphine & some ER products

long (3-11 days) = methadone

Question 11

If 6-MAM is present on UDS, what does this indicate?

Answer 11

recent use of heroin

Question 12

What values would indicate that a UDS sample was adulterated by
1) dilution
2) substitution

Answer 12

1) sp gravity <1.003 & ur Cr <20mg/dL
2) sp gravity <1.002 & ur Cr <5mg/dL

Question 13

false positive amphetamine -
which cross reactive drugs?

Answer 13

selegine (MAOI)