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Urine Drug Screen

Urine Drug Screen

The past decade has seen a significant increase in prescribed analgesics and anti-inflammatory drugs for managing chronic pain, but more than 40% of patients report that their condition still hasn’t been adequately treated. This prompts clinicians to face the challenge of providing patients proper pain control while also keeping the risk of substance abuse at bay. How? With urine drug confirmation (UDC).

Unlike regular screening, this is a much more precise method of pain management, assessing compliance and detecting undisclosed substances. Our laboratory at Insight Diagnostics is equipped to offer extensive drug confirmations with accurate results on abused drugs and prescribed medications.

Screenings like immunoassays are qualitative tests but due to problematic sensitivity, they can only detect the presence of a drug class and not the individual drug itself. For a far more precise analysis, all positive specimens should be put to test on a method called liquid chromatography-tandem mass spectrometry (LC-MS/MS) for confirmation.

Requests for drug screen confirmation in pain management and monitoring has increased substantially since 2008, and with our technical staff’s phased approach, you will always receive interpreted test results with pinpoint accuracy and clarity. Our new LC-MS/MS with increased sensitivity can simultaneously detect various drugs, opioids, and metabolites, while also reducing costs and eliminating the need for any additional testing.

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Urine Drug Testing
    • Specimen Validity Testing

    • Although urine testing is the most common drug testing method, it’s not foolproof. That’s why we suggest specimen validity testing. By measuring pH, creatinine and specific gravity and testing for adulterants and may be added to the urine; we can ensure the integrity of the test. Insight Diagnostics is one of the few laboratories to offer oxidant identification for some of the most common oxidizing adulterants.
    • Here are definitions to provide a better understanding of terms related to specimen validity testing:
    • a. Adulterated Specimen: A urine specimen containing a substance that is not a normal constituent or containing an endogenous substance at a concentration that is not a normal physiological concentration.
    • b. Creatinine is endogenously produced and cleared from the body by the kidneys.  It is a normal constituent in urine. Normal human urine creatinine concentrations are at or above 20 mg/dL.
    • c. Dilute Specimen: A urine specimen with creatinine and specific gravity values that are lower than expected for human urine.
    • d. Invalid Result: Refers to the result reported by a laboratory for a urine specimen that contains an unidentified adulterant, contains an unidentified interfering substance, has an abnormal physical characteristic, or has an endogenous substance at an abnormal concentration that prevents the laboratory from completing testing or obtaining a valid drug test result.
    • e. Oxidizing Adulterant:  A substance that acts alone or in combination with other substances to oxidize drugs or drug metabolites to prevent the detection of the drugs or drug metabolites, or affects the reagents in either the initial or confirmatory drug test. Examples of these agents include, but are not limited to, nitrites, pyridinium chlorochromate, chromium (VI), bleach, iodine, halogens, peroxidase and peroxide.
    • f. pH is the measurement of acid-base. Human urine is usually near neutral (pH 7), although some biomedical conditions affect urine pH. HHS set the program cutoffs for pH based on a physiological range of approximately 4.5 to 9.
    • g. Specific gravity is a measure of the density of a substance compared to the density of water.  For urine, the specific gravity is a measure of the concentration of dissolved particles in the urine.  Normal values for the specific gravity of human urine range from approximately 1.0020 to approximately 1.0200.
    • h. Substituted Specimen: A urine specimen with creatinine and specific gravity values that are so diminished or so divergent that they are not consistent with normal human urine.
    • The use of oxidizing adulterants – such as nitrites, chromates and halogens (e.g., bleach and iodine) – is one of the most common ways donors try to “cheat a drug test.” Insight Diagnostics is one of the few laboratories to offer oxidant identification for some of the most common oxidizing adulterants and is available when requested by the customer or Medical Review Officer. We monitor and adjust our testing as necessary when new adulterants become commonplace. All “Invalid” specimens,” based on analytical test results, are automatically tested twice on a different portion of the urine specimen to ensure accuracy.
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