A: The lab results support that the patient has not recently taken their oxycodone. The reason could be prescription diversion, medication hoarding, finishing prescription ahead of time, etc. Regardless of the reason, the negative lab result the action to interview and discover why the medication has not recently been taken.
A: Our urine drug testing will detect most benzodiazepines. Their metabolism is complex and many benzodiazepines have poor detection by immunoassay techniques including the Rapid Test Cup. Our laboratory confirms samples by mass spectrometry, which has excellent detection limits for benzodiazepines. We strongly recommend that all Rapid Test Cup results be confirmed by mass spectrometry.
A: The Rapid Test Cups use immunoassay test strips which are prone to false positive results. This is the reason why samples are sent to the laboratory to confirm all drug test results by mass spectrometry. The mass spectrometry result from the laboratory is the correct result because it is a very sensitive and accurate test. In this specific case, pseudoephedrine, found in cold medicines, can cause a false positive for methamphetamine.
A: No, this is lab result is consistent with the medication prescribed because hydromorphone is a metabolite of hydrocodone.
A: The approximate urine retention time for Morphine is 48-72 hours. Over the course of 4 days (96 hours), the body likely removed all of the morphine explaining the reason for the negative result. It is important to note the urine retention times with relation to specimen collection when interpreting the results.
A: Vicodin is Hydrocodone and is not metabolized into morphine. The test subject is adulterating that prescription with morphine.
A: Norfentanyl is the primary metabolite of Fentanyl and Norfentanyl is generally present at approximately 5-10x higher concentrations in urine than the parent Fentanyl. It is possible that the concentration of Fentanyl was too low for the mass spectrometry equipment to detect. However the presence of Norfentanyl indicates that the patient is taking their Fentanyl prescription.
A: A false positive is a positive test result for a drug, but the drug is not actually present. A false negative is a negative test result indicating the absence of a drug, but the drug is actually present. Rapid Test Cups are prone to both false positives and false negatives which is why the results are confirmed in the laboratory. False positives are commonly caused by other substances cross-reacting with the immunoassay strips used in the Rapid Test Cups. False negatives are commonly to the Rapid Test Cup because their limit of detection is high. Mass spectrometry, which is used in the laboratory, has a much lower limit of detection and will be able to find much lower concentrations of drugs.
A: Not necessarily. Aside from the propensity of the Rapid Test Cup for false negatives, point of care tests only examine the urine for a limited number of drugs and drug classes. There are many others drugs a patient may be taking that will not be discovered with a Rapid Test Cup, such as buprenophrine, fentanyl, and carisoprodol. When sent to the laboratory these and many other drugs can be detected at much lower concentrations by using mass spectrometry. Therefore, the Rapid Test Cup is a great quick screening device, but further laboratory testing is recommended.
A: Understandable logic, but the reality is that the Rapid Test Cup is still a great tool to provide instantaneous results at the time of the office visit. Take a scenario in which the patient tests positive for an illicit drug like cocaine. Although the result should be sent in for confirmation at the laboratory, that quick result does give the clinician additional information to make better decisions at the time of treatment.
A: The lab results support that the patient has not recently taken their oxycodone. The reason could be prescription diversion, medication hoarding, finishing prescription ahead of time, etc. Regardless of the reason, the negative lab result warrants an interview to discover why the medication has not recently been taken.