HETL Blood Draw Form

Preferred CNS Depressant CNS Stimulants Hallucinogens Dissociate Anesthetics Narcotic Analgesics Inhalants Cannabis Sample: Alprazolam/a- Amphetamine LSD Dextromethorphan 3-methylfentanyl Marijuana Hydroxyalprazolam Cocaine/ MDMA/MDA Ketamine/Norketamine Buprenorphine/ (∆9THC, Hydroxy- Amitriptyline Benzoylecgonine/ PCP Norbuprenorphine THC, Carboxy- Butalbital Cocaethylene Butyrylfentanyl HCL THC) Carbamazepine MDMA/MDA Codeine/6- Carisoprodol Methamphetamine Acetylcodeine/Norcodeine

Chlordiazepoxide Methylphenidate Dihydrocodeine Citalopram Fentanyl/Norfentanyl Clonazepam/7- Heroin/6-acetylmorphine (6- aminoclonazepam MAM) Clonidine Hydrocodone/ Cyclobenzaprine Norhydrocodone Desipramine Hydromorphone Not tested Diazepam/Nordiazepam Meperidine for at HETL Diphenhydramine Methadone/EDDP Doxepin Morphine (Send Etizolam Oxycodone/ Noroxycodone blood Blood Flunitrazepam/7-amino Oxymorphone sample to flunitrazepam Propoxyphene HETL for Fluoxetine Sufentanil decision on Imipramine Tramadol/ out of state Lamotrigine O-Desmethyltramadol testing) Lorazepam Meprobamate Mirtazapine Nortriptyline Olanzapine Oxazepam Phenobarbital Risperidone Secobarbital Sertraline Temazepam Trazadone Triazolam Venlafaxine Zolpidem Zopiclone Urine Drugs/compounds not Drugs/compounds Drugs/compounds Drugs/compounds not Drugs/compounds not listed Drugs/compounds listed above. not listed above. not listed above. listed above. above. not listed above. *Please note the lists above are of drug generic names, a drug may have multiple brand names. * Issued: 01/29/20

Collect blood first if you can get it, urine if you can’t get blood. Do not collect both unless you get them by circumstance, if both blood and urine are collected then both need to be sent in for testing. Don’t get both blood and urine as a matter of course – redundant and Highway Safety will only pay for one sample to be tested.