drug of abuse test
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Indications
- altered state of consciousness
- evaulation of drug abuse
Laboratory
Clinical significance
- drugs commonly included in qualititative drug abuse screen:
- amphetamine+methamphetamine*
- barbiturates
- benzodiazepines
- cannabinoids (THC metabolites)*
- cocaine metabolite (benzoylecgonine*
- methadone
- methaqualone
- opiates (morphine, codeine)*
- phencyclidine (PCP)*
- propoxyphene
* testing mandated by SAMHSA for federal employees
False-positives on screening[2]
- dependent on manufacturer's assay
- need to be ruled-out with qunatitative confirmation test
- amphetamine: pseudoephedrine, ephedrine, phenylzine, cough & cold medications
- opioid: rifampin,levofloxacin
- poppy seeds contain codeine & morphine
- typical muffin with poppy seeds will NOT yield a positive test
- concentrated poppy seeds in 2 pastries can be detected
- cannabinoids, cocaine, benzodiazepines, barbiturates: none
Persistence of drugs & drug metabolites[2]
- a single dose of amphetamine or heroin can generally be detected for 1-3 days after use
- marijuana & phencyclidine (PCP) are generally detectable for about a week (longer with chronic use)
- exposure to SECOND-HAND marijuana smoke is NOT likely yield a positive test
Notes
- no foolproof way to beat drug screen
- home urine drug tests are available[2][3]
- also see blood alcohol
- California' proposition 46 (Nov 2014) would mandate hospitals to test physicians for drugs & alcohol[6]
- positive results would lead to immediate suspension of a physician's license, with no timetable specified for an investigation & hearing
- punitive approach -
- test results may be available for civil or criminal litigation
- no provisions for rehabilitation of impaired physicians
More general terms
More specific terms
- 2-Ethylidene-1,5-Dimethyl-3,3-Diphenylpyrrolidine (EDDP) in urine
- 6-monoacetylmorphine (6-MAM) in specimen
- amphetamine in specimen
- amphetamines in specimen
- barbiturate in urine
- benzodiazepine in urine
- buprenorphine in specimen
- cannabinoid in specimen
- cocaine in specimen
- cocaine or metabolite in body fluid
- codeine in urine
- dihydrocodeine in urine
- ethanol in specimen
- fenetylline in urine
- lysergate diethylamide (LSD) measurement
- methamphetamine in specimen
- methaqualone in specimen
- methylenedioxyamphetamine in specimen
- methylenedioxyethylamphetamine in specimen
- methylenedioxymethamphetamine in specimen
- opiates measurement; opiates in specimen
- phencyclidine in specimen
- trans-3-hydroxycotinine in specimen
Additional terms
References
- ↑ Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
- ↑ 2.0 2.1 2.2 2.3 Prescriber's Letter 12(3): 2005 Drug Abuse Urine Tests: False-positive Results Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210310&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 3.0 3.1 QuickScreen At Home Drug Test http://www.phamatech.com
Peace of Mind 5 Panel Home Drug Test http://www.adldrugtest.com
Accu-Stat Drugs of Abuse Home Test Cup http://www.accu-stat.com
ADC Advantage Marijuana and Cocaine Home Test www.advantagediagnostics.com - ↑ 4.0 4.1 ARUP Consult: Drug Testing The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/pain-and-addiction-management
- ↑ ARUP Consult: Newborn Drug Testing - Meconium and Umbilical Cord Tissue The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/newborn-drug-testing
Newborn Drug Testing Algorithm https://arupconsult.com/algorithm/newborn-drug-testing-algorithm - ↑ 6.0 6.1 Young K, Fairchild DG California's Prop. 46 Could Lead to Mandatory Drug Testing of Physicians. Physician's First Watch, Sept 30, 2014 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Pham JG, Pronovost PJ California's Proposition 46: A Wolf in Sheep's Wool. Ann Intern Med. Published online 30 September 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25265344 <Internet> http://annals.org/article.aspx?articleid=1910340
Ejnes YD California's Proposition 46 and Mandatory Physician Drug Testing: A Cause for Concern. Ann Intern Med. Published online 30 September 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25265244 <Internet> http://annals.org/article.aspx?articleid=1910339