Updates to Urine Toxicology Confirmatory Testing

On December 17, 2019, Providence Regional Laboratory will begin in-house testing of urine barbiturates, urine carisoprodol, urine zolpidem, urine flunitrazepam, and urine mitragynine by quantitative liquid chromatography tandem mass spectrometry (LC-MS/MS). These orders have historically been referred to ARUP and NMS Laboratories.

Please note new ordering information and result cutoff information below:

Epic Orderable Component Analyzed Cutoff Concentration Drugs of Abuse, Barbiturate, Confirm, Urine Phenobarbital 250 ng/mL LAB365 Butalbital 250 ng/mL Drug of Abuse, Carisoprodol/Meprobamate, Urine Carisoprodol 150 ng/mL LAB24205 Meprobamate 150 ng/mL Zolpidem, Urine, Quantitative Zolpidem (AMBIEN) 25 ng/mL LAB25177 Zolpidem phenyl-4-carboxylic acid 25 ng/mL Drugs of Abuse, Flunitrazepam, Confirm, LC-MS Flunitrazepam (ROHYPNOL) 2 ng/mL LAB23463 7-aminoflunitrazepam 2 ng/mL Mitragynine, Urine, Quantitative Mitragynine (KRATOM) 10 ng/mL* LAB25176

*Mitragynine concentration reported qualitatively. Mitragynine level is reported POSITIVE when urine concentration is greater than or equal to 10 ng/mL.

These changes are designed to improve consistency, efficiency and reduce overall result turnaround time.

For all orders, please refer to the following guidelines for specimen collection and submission:

Collect: Random Urine (minimum 0.2 mL). Transport: Transport to the laboratory at 2-8oC within 4 days of collection. Stability: Refrigerated (2-8oC) 7 days (4 days for 7-aminoflunitrazepam). Frozen specimens are acceptable and stable up to 3 years. Unacceptable: Specimens exposed to additives, preservatives, or repeated freeze/thaw cycles. Performed: Batched daily. Reported: 1-3 days.

December, 2019

These assays are for medical purposes only. These assays are not valid for forensic use.

The concentration value must be greater than or equal to the cutoff to be reported as positive. Interpretive questions should be directed to Dr. Alec Saitman, Associate Director of Toxicology at Providence Regional Laboratory-Oregon.

The absence of expected drug(s) and/or drug metabolite(s) may indicate non-compliance, inappropriate timing of specimen collection relative to drug administration, poor drug absorption, diluted/adulterated urine, or limitations of testing.

These tests were developed and characteristics determined by Providence Regional Laboratory - Oregon. The US Food and Drug Administration has not approved or cleared these tests; however FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Please contact Providence Regional Laboratory Client Services at (503) 215-6660 with questions regarding these changes.

December, 2019