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Test Code PANOX Pain Clinic Survey 10, Chain of Custody, Random, Urine

Useful For

Detecting drug use involving amphetamines, barbiturates, benzodiazepines, cocaine, methadone, opiates, phencyclidine, and tetrahydrocannabinol

 

This chain-of-custody test is intended to be used in a setting where the test results can be used to make a definitive diagnosis. Chain of custody is required whenever the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that it was always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.

 

This test is not intended for use in employment-related testing.

Profile Information

Test ID Reporting Name Available Separately Always Performed
PN10X Pain Clinic Survey 10, CoC No Yes
OXYSX Oxycodone Screen, CoC, U Yes Yes

Additional Tests

Test ID Reporting Name Available Separately Always Performed
COCH Chain of Custody Processing No Yes
ADLTX Adulterants Survey, CoC, U Yes Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
AMPHX Amphetamines Confirmation, CoC, U Yes No
COKEX Cocaine and metabolite Conf, CoC, U Yes No
BARBX Barbiturates Confirmation, CoC, U Yes No
MTDNX Methadone Confirmation, CoC, U Yes No
PCPX Phencyclidine Confirmation, CoC, U Yes No
THCX Carboxy-THC Confirmation, CoC, U Yes No
OPATX Opiate Confirmation, CoC, U Yes No
OXYCX Oxycodone w/metabolite Conf, CoC, U Yes No
BNZX Benzodiazepines Conf, CoC, U Yes No

Testing Algorithm

Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography mass spectrometry for barbiturates, cocaine and metabolites, methadone, and phencyclidine) at an additional charge. Amphetamines, benzodiazepines, opiates, and tetrahydrocannabinol metabolite that screen positive will be quantified with liquid chromatography tandem mass spectrometry at an additional charge.

 

Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.

Reporting Name

Pain Clinic Survey 10, CoC, U

Specimen Type

Urine


Specimen Required


Supplies: Chain of Custody Kit (T282)

Container/Tube: Chain-of-Custody Kit containing the specimen containers, seals, and documentation is required.

Specimen Volume: 30 mL

Collection Instructions: Collect a random specimen without preservative in the container provided, seal, and submit with the associated documentation to satisfy the legal requirements for chain-of-custody testing.

Additional Information: Submitting less than 30 mL will compromise the ability to perform all necessary testing.


Specimen Minimum Volume

20 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 7 days
  Frozen  14 days

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

This assay was designed to test for and confirm by gas chromatography mass spectrometry (GC-MS) the following:

-Barbiturates

-Cocaine

-Methadone

-Phencyclidine

 

This assay was designed to test for and confirm by liquid chromatography tandem mass spectrometry (LC-MS/MS) the following:

-Opiates

-Benzodiazepines

-Carboxy-tetrahydrocannabinol

-Amphetamines

 

This test uses the simple screening technique which involves immunoassay testing for drugs by class. Oxycodone is not detected well with the opiate screening assay; therefore, confirmation testing is included to detect this drug. All positive screening results are confirmed by either GC-MS or LC-MS/MS and quantitated before a positive result is reported.

 

Chain of custody is a record of the disposition of a specimen to document the individuals who collected, handled, and performed the analysis. When a specimen is submitted in this manner, analysis will be performed in such a way that it will withstand regular court scrutiny.

Reference Values

Negative

Screening cutoff concentrations

Amphetamines: 500 ng/mL

Barbiturates: 200 ng/mL

Benzodiazepines: 100 ng/mL

Cocaine (benzoylecgonine-cocaine metabolite): 150 ng/mL

Methadone metabolite: 300 ng/mL

Opiates: 300 ng/mL

Phencyclidine: 25 ng/mL

Tetrahydrocannabinol carboxylic acid: 50 ng/mL

This report is intended for use in clinical monitoring or management of patients. It is not intended for use in employment-related testing.

Interpretation

A positive result derived by this testing indicates that the patient has used one of the drugs detected by these techniques in the recent past.

 

For information about drug testing, including estimated detection times, see Drug Class Testing on MayoClinicLabs.com.

Cautions

The test does not screen for drug classes other than those listed previously. More comprehensive screening is available using the serum or urine drug screens (DSSX / Drug Screen, Prescription/Over the Counter, Chain of Custody, Serum or PDSUX / Drug Screen, Prescription/Over the Counter, Chain of Custody, Urine).

Method Description

Adulterant:

All results are measured using spectrophotometry at wavelengths specified by the reagent manufacturer. The use of a refractometer may also be used in the specific gravity measurement.(Package inserts: Specimen Validity Test Creatinine. Roche Diagnostics; V3.0, 08/2015; Specimen Validity Test Nitrite. Roche Diagnostics; V3.0, 08/2018, Specimen Validity Test Oxidant. Roche Diagnostics; V 3.0, 08/2018; Specimen Validity Test pH Roche Diagnostics; V3.0, 02/2019, Specimen Validity Test Specific Gravity. Roche Diagnostics; V4.0, 08/2022)

 

The amphetamines, barbiturates, benzodiazepines, cocaine, methadone metabolite, opiates, phencyclidine, and tetrahydrocannabinol metabolite assays are based on the kinetic interaction of microparticles in a solution as measured by changes in light transmission. In the absence of sample drug, soluble drug conjugates bind to antibody-bound microparticles causing the formation of particle aggregates. As the aggregation reaction proceeds in the absence of sample drug, the absorbance increases. When a urine sample contains the drug in question, this drug competes with the drug derivative conjugate for microparticle-bound antibody. Antibody bound to sample drug is no longer available to promote particle aggregation, and subsequent particle lattice formation is inhibited. The presence of sample drug diminishes the increasing absorbance in proportion to the concentration of drug in the sample. Sample drug content is determined relative to the value obtained for a known cutoff concentration of drug.(Package inserts: AMPS2. Roche Diagnostics; V 10.0, 09/2018; BARB. Roche Diagnostics; V 13.0, 09/2021; THC2. Roche Diagnostics; V 13.0, 03/2022; BNZ2. Roche Diagnostics; V 2.0, 04/2024; COC2. Roche Diagnostics; V 9.0, 03/2019; OPI2. Roche Diagnostics; V 16.0, 01/2022; PCP. Roche Diagnostics; V 13.0, 09/2021; EDDP Specific Urine Enzyme Immunoassay, Immunalysis Corp; 09/2018)

Day(s) Performed

Monday through Saturday

Report Available

2 to 3 days

Specimen Retention Time

2 weeks

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

80307

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PANOX Pain Clinic Survey 10, CoC, U 69739-1

 

Result ID Test Result Name Result LOINC Value
36253 Amphetamines 43983-6
61727 Oxycodone 19642-8
36027 Chain of Custody 77202-0
36258 Barbiturates 70155-7
36259 Benzodiazepines 14316-4
36254 Cocaine 43984-4
36260 Methadone metabolite 41858-2
36255 Opiates 70151-6
36256 Phencyclidine 14310-7
36257 Tetrahydrocannabinol 14312-3
36261 Chain of Custody 77202-0

Method Name

Immunoassay followed by Gas Chromatography Mass Spectrometry (GC-MS) or Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) as needed

Forms

1. Chain of Custody Request is included in the Chain-of-Custody Kit (T282).

2. If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.