Laboratory Testing Cut-offs & Methods

COMPREHENSIVE DRUG TEST - URINE SCREENING & CONFIRMATION METHODS

Overview

The following is an explanation of RTL's urine screening and confirmation procedures/cut-off levels. The routine cut-off levels listed below may periodically change. The analytical methods used by RTL are scientifically accepted and approved by the U.S. Department of Health and Human Services.

• Screening Cut-off Levels and Methods
• Confirmation Cut-off Levels and Methods

COMPREHENSIVE PANEL SCREEN

The following list provides screening detail for the Comprehensive Drug Test panel. RTL screens urine specimens by enzyme assay (EA), enzyme immunoassay (EIA) and gas chromatography/ mass spectrometry (GC/MS). Presumptive positive specimens will be confirmed by a second method (GC/MS) prior to reporting positive results.

	SCREENING CUT-OFF LEVELS BY PROCEDURE
	Drug		METHOD		Cut-off
	Alcohol (Ethanol)		EA		0.04 g/dL
	Amphetamines     - Amphetamines     - Methylenedioxyamphetamine (MDA)     - Methylenedioxymethamphetamine (MDMA)     - Methylenedioxyethylamphetamine (MDEA)		GC/MS GC/MS GC/MS GC/MS		1000 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL
	Anticonvulsants     - Carbamazepine Metabolite     - Oxcarbazepine Metabolite		GC/MS GC/MS		100 ng/mL 100 ng/mL
	Antidepressants     - Amitriptyline/Nortriptyline     - Bupropion Metabolite     - Citalopram/Escitalopram     - Desipramine/Imipramine     - Doxepin     - Fluoxetine Metabolite     - Maprotiline     - Paroxetine     - Sertraline Metabolite     - Trazodone/Nefazodone Metabolite     - Venlafaxine Metabolite		GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS		100 ng/mL 250 ng/mL 150 ng/mL 100 ng/mL 100 ng/mL 150 ng/mL 100 ng/mL 150 ng/mL 150 ng/mL Qualitative 200 ng/mL
	Barbiturates		EIA		200 ng/mL
	Benzodiazepines     - Alprazolam Metabolite     - Clonazepam Metabolite     - Flunitrazepam Metabolite     - Flurazepam Metabolite     - Lorazepam     - Midazolam Metabolite     - Nordiazepam     - Oxazepam     - Temazepam     - Triazolam Metabolite		GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS		50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL
	Cocaine		EIA		300 ng/mL
	Methylphenidate		GC/MS		50 ng/mL
	Narcotics/Opiates     - Buprenorphine     - Butorphanol Metabolite     - Codeine     - Fentanyl     - Hydrocodone     - Hydromorphone     - Ketamine Metabolite     - Meperidine Metabolite     - Methadone     - Morphine     - Nalbuphine     - Oxycodone     - Pentazocine     - Propoxyphene     - Tramadol Metabolite		GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS EIA GC/MS GC/MS GC/MS GC/MS EIA GC/MS		1 ng/mL Qualitative 100 ng/mL 10 ng/mL 100 ng/mL 100 ng/mL 300 ng/mL 100 ng/mL 150 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 300 ng/mL 200 ng/mL
	Phencyclidine (PCP)		EIA		25 ng/mL
	Sedative/Hypnotic Agents     - Carisoprodol/Meprobamate     - Zolpidem Metabolite		GC/MS GC/MS		200 ng/mL Qualitative
	THC (Marijuana)		EIA		50 ng/mL

COMPREHENSIVE PANEL CONFIRMATION

The following list provides confirmation detail for the Comprehensive Drug Test panel. RTL confirms urine specimens by gas chromatography/mass spectrometry (GC/MS) and gas chromatography-flame ionization detector (GC-FID). The analytical methods used by RTL are scientifically accepted.

	CONFIRMATION CUT-OFF LEVELS BY PROCEDURE
	DRUG		METHOD		CUT-OFF LEVEL
	Alcohol (Ethanol)		GC-FID		0.02 g/dL
	Amphetamines     - Amphetamine     - Methamphetamine     - Methylenedioxyamphetamine (MDA)     - Methylenedioxymethamphetamine (MDMA)     - Methylenedioxyethylamphetamine (MDEA)		GC/MS GC/MS GC/MS GC/MS GC/MS		100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL
	Anticonvulsants     - Carbamazepine     - 10,11-Dihydroxycarbazepine     - Oxcarbazepine     - 10-Hydroxycarbazepine     - 10,11-Dihydroxycarbazepine		GC/MS GC/MS GC/MS GC/MS GC/MS		100 ng/mL Qualitative 100 ng/mL 100 ng/mL Qualitative
	Antidepressants     - Amitriptyline     - Nortriptyline     - Hydroxynortriptyline     - Hydroxybupropion     - Citalopram/Escitalopram     - Desipramine     - Imipramine     - Hydroxydesipramine     - Hydroxy-desmethyldesipramine     - Doxepin     - Desmethyldoxepin     - Fluoxetine     - Norfluoxetine     - Maprotiline     - Paroxetine     - Sertraline     - Norsertraline     - mCPP     - Hydroxy-mCPP     - Trazodone     - Hydroxytrazodone     - Venlafaxine     - O-Desmethylvenlafaxine		GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS		100 ng/mL 100 ng/mL Qualitative 250 ng/mL 150 ng/mL 100 ng/mL 100 ng/mL Qualitative Qualitative 100 ng/mL 100 ng/mL 150 ng/mL 150 ng/mL 100 ng/mL 150 ng/mL 150 ng/mL 150 ng/mL 100 ng/mL Qualitative Qualitative Qualitative 100 ng/mL Qualitative
	Barbiturates     - Amobarbital     - Butabarbital     - Butalbital     - Pentobarbital     - Phenobarbital     - Secobarbital		GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS		200 ng/mL 200 ng/mL 200 ng/mL 200 ng/mL 200 ng/mL 200 ng/mL
	Benzodiazepines     - alpha-Hydroxyalprazolam (Alprazolam)     - 7-Aminoclonazepam (Clonazepam)     - 7-Aminoflunitrazepam (Flunitrazepam)     - 2-Hydroxyethyl flurazepam (Flurazepam)     - Lorazepam     - alpha-Hydroxymidazolam (Midazolam)     - Nordiazepam     - Oxazepam     - Temazepam     - alpha-Hydroxytriazolam (Triazolam)		GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS		50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL 50 ng/mL
	Cocaine		GC/MS		50 ng/mL
	Methylphenidate		GC/MS		50 ng/mL
	Narcotics/Opiates     - Buprenorphine     - Norbuprenorphine     - Butorphanol     - Hydroxybutorphanol     - Codeine     - Fentanyl     - Hydrocodone     - Hydromorphone     - Ketamine     - Norketamine     - Dehydronorketamine     - Normeperidine     - Methadone     - Methadone Metabolite (EDDP)     - Morphine     - Nalbuphine     - Oxycodone     - Pentazocine     - Propoxyphene     - Norpropoxyphene     - Tramadol     - O-Desmethyl-cis-Tramadol		GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS GC/MS		0.5 ng/mL 2 ng/mL 5 ng/mL Qualitative 100 ng/mL 5 ng/mL 100 ng/mL 100 ng/mL 5 ng/mL 5 ng/mL 25 ng/mL 25 ng/mL 25 ng/ml 50 ng/mL 100 ng/mL 250 ng/mL 100 ng/mL 250 ng/mL 300 ng/mL 300 ng/mL 100 ng/mL 100 ng/mL
	Phencyclidine (PCP)		GC/MS		5 ng/mL
	Sedative/Hypnotic Agents     - Carisoprodol     - Meprobamate     - Hydroxyzolpidem		GC/MS GC/MS GC/MS		100 ng/mL 200 ng/mL Qualitative
	THC (Marijuana)     - THC-COOH (Marijuana)     - THC-COOH/Creatinine Ratio		GC/MS Calculation		5 ng/mL

URINALYSIS ADULTERATION EXAMINATION

RTL's Standard Operating Procedures (SOP's) require that each urine specimen be examined for signs of adulteration. This examination includes the following:

Physical Examination: Color, excessive foaming, excess sediments, or unusual odor are noted. If adulteration is suspected, this is noted on the final report.

Analytical Examination: Upon request, pH, creatinine (tested by default) and specific gravity are run to aid in determining possible adulteration.

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