1. Drugs of Abuse Detection
By Jovana Zuccala Trident Laboratories, Inc.

2. DRUG TESTING PROCESS NEGATIVES J. Zuccala Sample collection
Sample accession
Drug screening
Drug confirmation
Sample reporting
NEGATIVES
J. Zuccala

3. AMPHETAMINES Adderall, Benzedrine, Dexedrine, Vyvanase
Potent stimulant of central nervous system (CNS)
Induces euphoria, alertness, reduced appetite and the sense of increased power and energy
Reported positive on the urine screen panel if concentration exceeds 1000 ng/mL
Confirmation metabolites: amphetamines and metamphetamines
Window of detection 3-5 days
J. Zuccala

4. BARBITURATES Fioricet, Luminal, Nembutal, Seconal CNS depressants
Induces effects similar to those of alcohol intoxication
Reported positive on the urine screen panel if concentration exceeds 200 ng/mL
Confirmation metabolites: phenobarbital and butalbital
Window of detection 4-6 days to 1-3 weeks
J. Zuccala

5. BENZODIAZEPINES Xanax, Klonopin, Valium, Ativan, Rohypnol, Tamazepam
Less potent CNS depressants than barbiturates
Reported positive on the urine screen panel if concentration exceeds 200 ng/mL
Confirmation metabolites: nordiazepam, oxazepam, alpha-hydroxy-alprazolam
Window of detection up to 7 days (chronic users even longer)
J. Zuccala

6. BUPRENORPHINE Buprenex, Suboxone, Subutex
is a semi-synthetic opioid that is used to treat opioid addiction and moderate acute and chronic pain
Reported positive on the urine screen panel if concentration exceeds 5 ng/mL
Confirmation metabolites: buprenorphine and norbuprenorphine
Window of detection 2-3 days
J. Zuccala

7. COCAINE Potent CNS stimulant and local anesthetic
Brings about extreme energy and restlessness, continuous use causes tremors, spasms, fever unresponsiveness and difficulties in breathing
Reported positive on the urine screen panel if concentration exceeds 300 ng/mL
Confirmation metabolites: benzoylecgonine (BE)
Window of detection 1-5 days
J. Zuccala

8. CANABINOIDS (THC)
Typically detected in urine in after 1-6 days after single use, 3-10 days after chronic weekly use and up to 45 days after daily use
CNS depressant causing euphoria and anxiety, followed by crashing depression feeling
Reported positive on the urine screen panel if concentration exceeds 50 ng/mL
Confirmation metabolites: THC-COOH
J. Zuccala

9. METHADONE
Synthetic opioid used to treat opioid dependence (Dolophine, Methadose)
Easy to overdose on: low levels can cause difficulties in breathing and swallowing, low pressure, coma even death
Reported positive on the urine screen panel if concentration exceeds 300 ng/mL
Confirmation metabolites: methadone and EEDP
Detection window 1-4 days
J. Zuccala

10. OPIATES/OPIOIDS
Avinza, Kadian, MS Contin, MSIR, Norco, Dilaudid, Vicodin
CNS depressants prescribed for chronic pain, sports injuries, and cancer pain
Number one abused prescription medication and number one cause of death from overdose
Reported positive on the urine screen panel if concentration exceeds 300 ng/mL
Confirmation metabolites: morphine, codeine, dihydrocodeine, hydrocodone, hydromorphone
Window of detection 2-3 days
J. Zuccala

11. 6-AM Heroin-specific metabolite Extremely addictive
Can cause respiratory and cardiac arrest, coma and death
Reported positive on the urine screen panel if concentration exceeds 10 ng/mL
Semi-qualitative assay
Window of detection 10 hours to 10 days
J. Zuccala

12. ALCOHOL CNS depressant Ethanol and EtG tests
EtG has longer window of detection
After a single drink, ethanol can be detected for 4-6 hours; EtG in 24 hrs
After binge drinking ethanol usually shows positive for a day or two, while EtG for up to 80 hrs
Reported positive on the urine screen panel if concentration exceeds 500 ng/mL for EtG and 100 ng/mL for ethanol
J. Zuccala

13. OXYCODONE/OXYMORPHONE
Opioid class, but there is a separate assay to screen
Opana, Endocet, Oxycontin, Percocet, Roxicodone, Roxicet
Secondary metabolites of morphine and hydromorphone
Reported positive on the urine screen panel if concentration exceeds 300 ng/mL
Window of detection 1-4 days
J. Zuccala

14. PCP Phencyclidine Potent hallucinogen (similar to LSD)
Reported positive on the urine screen panel if concentration exceeds 25 ng/mL
Window of detection 1-7 days in occasional users, while in chronic users up to 4 weeks
J. Zuccala

15. PPX Propoxyphene (Darvocet, Darvon)
Opioid class (pain management, cancer pain)
Reported positive on the urine screen panel if concentration exceeds 300 ng/mL
Confirmation metabolites: Propoxyphene and Norpoxyphene
Window of detection 6 hours-2days
J. Zuccala

16. ECSTASY
Ecstasy can induce euphoria, a sense of intimacy with others, and diminished anxiety
CNS stimulant illegal in United States
Reported positive on the urine screen panel if concentration exceeds 500 ng/mL
Confirmation metabolites: MDA and MDMA
Window of detection 1-3 days
J. Zuccala

17. CARISOPRODOL (SOMA) Muscle relaxant
Used to treat injuries and painful muscle conditions
Habit-forming and often abused drug
Reported positive on the urine screen panel if concentration exceeds 100 ng/mL
Window of detection 1-2 days
J. Zuccala

18. Ketamine Ketanest, Ketaset, Ketalar (street name “Special K”)
Use in veterinary and human medicine for anesthesia, analgesia and sedation
Similar to PCP, it induces “dissociative anesthesia” and therefore used as recreational drug
Window of detection 1-2 days
J. Zuccala

19. TRAMADOL Ultram, Tramal, Ryzolt
Used as centrally acting synthetic analgesic and in opioid dependency treatments
Reported positive on the urine screen panel if concentration exceeds 200 ng/mL
Window of detection 2-4 days
J. Zuccala

20. FENTANYL Actiq, Duragesic, Fentora, Sublimaze
Extremely strong synthetic opioid, often prescribed in pain management clinics
Reported positive on the urine screen panel if concentration exceeds 2 ng/mL
Exist as a transdermal patch and lozenges (lollipop)
Window of detection 1-3 days
J. Zuccala

21. MEPERIDINE Meperitab, Demerol, Mepergen
Meperidine is an opioid and a controlled substance with an abuse liability similar to morphine.
Reported positive on the urine screen panel if concentration exceeds 200 ng/mL
Window of detection 1-2 days
J. Zuccala

22. Methylphenidate Ritalin, Concerta, Daytrana
Psychostimulant drug approved for treatment of ADHD, lethargy, narcolepsy, depression and obesity
Methylphenidate is sometimes used by students to enhance their mental abilities, improving their concentration and helping them to study
Confirmation of methylphenidate in urine serves to monitor compliance in those receiving the drug therapeutically
Window of detection 1-2 days
J. Zuccala

23. TRICYCLIC ANTIDEPRESSANTS (TCA)
Pamelor, Elavil, Sinequan, Trofanil
Generally low abuse potential
Used as antidepressants, in ADHD therapy and for chronic pain
Reported positive on the urine screen panel if concentration exceeds 300 ng/mL
Window of detection 2-19 days
J. Zuccala

24. Synthetic Cannabinoids
K2, Spice, Black Mamba, Fake Weed, Genie, Bombai Blue…
Psychoactive designer drug derived of natural herbs sprayed with synthetic chemicals
Illegal to posses or use in the U.S.
Synthetic cannabinoid intoxication is associated with acute psychosis, worsening of previously stable psychotic disorders, and also may have the ability to trigger a chronic (long-term) psychotic disorder among vulnerable individuals such as those with a family history of mental illness.
Window of detection up to 72 hours
J. Zuccala

25. Bath Salts
Ivory Dove, Vanilla Sky, Blue Silk, Cloud Nine, Hurricane Charlie, Drones…
“Street name” for the family of designer drugs containing substituted cathinones
Produce effects similar to amphetamines and cocaine
Banned in at least 41 states
Window of detection 2-3 days
J. Zuccala

26. Trident Laboratories, Inc.
Cotinine
Metabolite of nicotine, also found in tobacco
Cotinine is used as a biomarker for exposure to tobacco smoke and has also been sold as an antidepressant under the brand name Scotine.
Cotinine levels <10 ng/mL are considered to be consistent with no active smoking. Values of 10 ng/mL to 100 ng/mL are associated with light smoking or moderate passive exposure, and levels above 300 ng/mL are seen in heavy smokers - more than 20 cigarettes a day. In urine, values between 11 ng/mL and 30 ng/mL may be associated with light smoking or passive exposure, and levels in active smokers typically reach 500 ng/mL or more.
Window of detection in urine is up to 7 days
J. Zuccala
J. Zuccala

27. VALIDITY TESTING-pH
pH test measuring acidity of urine (normal values between 4.5 and 8.9). If pH found to be lower than 4.5 or higher than 8.9, the specimen is considered adulterated
Adulterants that change pH of urine- any acid or base (lemon juice, soap, house cleaning products, etc)
J. Zuccala

28. VALIDITY TESTING-OXIDANTS
Oxidants test for the presence of oxidizing agents such as bleach and hydrogen peroxide. Normal human urine should not contain oxidants or PCC
Cutoff of the assay on instrument is 50 µg/mL
Adulterants that change oxidant levels of urine are Pyridinium chlorochromate (sold under the brand name UrineLuck), bleach, etc.
J. Zuccala

29. VALIDITY TESTING-NITRITES
Nitrites test is testing for the presence of nitrite salts in urine sample (certain foods and meats contain nitrites)
Normal humane urine doesn’t contain any nitrites
Instrument cutoff is 500 µg/mL
Adulterants containing nitrites are Klear, Whizzies, etc.
J. Zuccala

30. VALIDITY TESTING-SPECIFIC GRAVITY
Specific gravity tests for sample dilution. The normal range is from to Values outside this range may be the result of specimen dilution or adulteration.
Factors affecting specific gravity are dehydration, excessive sweating, increased water intake, etc.
Trident lab is currently phasing specific gravity out, due to the fact that this test can be easily manipulated with.
J. Zuccala

31. VALIDITY TESTING-CREATININE
Creatinine is a waste product of creatine; an amino-acid contained in muscle tissue and found in urine. A person may attempt to foil a test by drinking excessive amounts of water or diuretics such as herbal teas to “flush” the system. Creatinine and specific gravity are two ways to check for dilution and flushing, which are the most common mechanisms used in an attempt to circumvent drug testing. Low creatinine and specific gravity levels may indicate dilute urine.
The absence of creatinine (<2mg/dl) is indicative of a specimen not consistent with human urine and is considered substituted (apple juice, etc.)
J. Zuccala