Test Spotlight, Toxicology

New Tests: Urine Drug Screen with Confirmation 23 Targets & 32 Targets

Effective January 19, 2019, Spectrum Health Regional Laboratory – Toxicology is proud to announce the availability of two new drug screen panels:

The development of these two new panels arose in response to the growing opioid crisis, as well as concerns from patients, providers, and our community.  The benefits of the new panels are centered around four areas: Specificity and sensitivity of drug screening results; results reporting for providers that is both qualitative and quantitative; lower financial impact to our patients; and support of public health initiatives to combat fatal drug overdoses.

The current urine drug screens that Spectrum Health offers (LAB677, LAB3227, LAB3382, LAB2111041 & LAB2111694) are performed using a combination of immunoassay (IA) and/or liquid chromatography/mass spectrometry (LC/MS), and have a number of known concerns in regards to screening, including false positives on amphetamines and methadone, false negatives on benzodiazepines, and the inability to screen for heroin metabolite, opiates, oxycodone, fentanyl and tramadol.  This inability to screen has led to the subsequent ordering of additional standalone confirmation by LC/MS, which results in longer turnaround times for providers, as well as more cost to the patient.  The new tests will go straight to LC/MS methodology with a single specimen, detecting targets with a greater degree of sensitivity and specificity, and will reduce turnaround time to a final report for providers.

Both panels will include adulteration testing, and will consist of the result targets listed below, which include all but one of the drug classes covered by the current screens, as well as multiple other classes not previously built into panels.

Compared to existing offerings, this will have a significant positive financial impact on patients who have to have routine testing, such as in pain management, but will also end up being less expensive than current offerings when positives lead to subsequent confirmation testing.

When asked how this test might be used to take steps towards preventing the opioid crisis, Dr. Stephen Cohle, Kent County Medical Examiner, commented, “Well, identifying what drugs the person might have been using would give us an idea of what drugs are out there on the street that are causing deaths and nonfatal overdoses – the human cost of the opioid crisis.”  From a public health standpoint, he noted “…if we get people that have overdosed, fatally, and we’re doing the autopsy this enables us to access information on what drugs they might have used when living, and that might guide us and inform us as to what testing we can do postmortem, particularly what drugs we might look for.”

Additional test information can be found in the lab catalog.

23 Targets: Amphetamines (2) – (Amphetamine, Methamphetamine); Benzodiazepines (6) – (Oxazepam, Alprazolam Metabolite, Clonazepam Metabolite, Lorazepam, Nordiazepam, Temazepam); Cannabinoids (1) – (THC Metabolite); Cocaine (1) – (Cocaine Metabolite); Methadone (2) – (Methadone, Methadone Metabolite); Opiates (7) – (Codeine, Morphine, 6MAM Heroin Metabolite, Hydrocodone, Hydromorphone, Oxycodone, Oxymorphone); Tramadol (2) – (Tramadol, Tramadol Metabolite); Fentanyl (2) – (Fentanyl, Fentanyl Metabolite)

32 Targets: All of the above, plus Methylphenidate (2) – (Methylphenidate, Methylphenidate Metabolite); Methylenedioxyamphetamines (2) – (MDMA, MDA); Buprenorphine (2) – (Buprenorphine, Buprenorphine Metabolite); Gabapentin (1) – (Gabapentin); Pregabalin (1) – (Pregabalin); Ethanol (1) – (Ethanol)

For questions or more information about our testing, please use the “Contact Us” link above.

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