Pain Management by Time-of-Flight Mass Spec, Urine

The test is useful in context of compliance and/or abuse drug monitoring in pain management population, particularly in patients co-prescribed benzodiazepines and opiates. Testing is performed by qualitative liquid-chromatography time-of-flight high resolution mass spectrometry that has an increased sensitivity for the detection of benzodiazepines (e.g., lorazepam and clonazepam) and opioids (e.g., hydrocodone, hydromorphone, fentanyl and buprenorphine) and their metabolites.
A targeted panel of forty-one drugs and metabolites are monitored, including:
Amphetamines and amphetamine-like: amphetamine (e.g., Vyvanse), methamphetamine (e.g, Desoxyn, Selegiline), MDMA (e.g., Ecstacy), MDA, methylphenidate (e.g., Ritalin, Focalin, Concerta) and phentermine
Benzodiazepines: alprazolam (e.g., Xanax), alpha-hydroxyalprezolam, clonazepam (e.g., Klonopin), 7-aminoclonazepam, diazepam (e.g., Valium), nordiazepam, oxazepam (e.g., Serax), temazepam (e.g., Restoril), lorazepam (e.g., Ativan) and zolpidem (e.g., Ambien)
Opiates: codeine, morphine, heroin and 6-monoacetylmorphine
Opiods: Oxycodone, noroxycodone, oxymorphone (e.g., Opana), hydrocodone, dihydrocodeine, hydromorphone (e.g., Dilaudid), tramadol, fentanyl, norfentanyl, methadone, EDDP, buprenorphine (Subutex, Suboxone), norbuprenorphine and naloxone
Tricyclic antidepressants: amitriptyline, nortriptyline and doxepin (e.g., Silenor)
Other drugs: pregabalin (e.g., Lyrica), gabapentin (e.g., Gralise, Neurontin), Eszopiclone (e.g., Lunesta), cyclobenzaprine (e.g., Amrix).
This test is not recommended as a general drug screen in other clinical contexts than pain management. Of the forty-one drugs and metabolites monitored for each urine specimen, only the drugs and/or metabolites that are qualitatively identified will be reported as positive.
For questions regarding the test and help with interpretation of the results, please contact The Toxicology and Drug Analysis Laboratory at 734-936-6758 between 7am - 11pm.