About Medication Monitoring Programs

An estimated one in four Americans suffers from chronic pain and it is a primary reason that people seek medical care. Opioid medications are often prescribed for the therapeutic benefit but it is also recognized they are powerful drugs. As a healthcare provider you care about the safety of your patients and the use of some drugs in combination can be harmful. Medication monitoring can help you better understand what medications your patient is currently taking, which could interfere with newly prescribed medications. The results aid you to safely prescribe medication as part of your overall treatment plan.
Rather than having to decide who might best benefit from testing, Clinicians may pick patients for testing at random intervals. Random testing ensures no patient is ever singled out and no patient is accidentally skipped over.
When patients understand how medication monitoring will help their chronic pain, they are less likely to resist.
Instruct patients to tell you about any other prescription or non-prescription drugs, vitamins, or supplements they are taking, or make them bring in everything for review. Some medications or health problems can cause inconsistent results. It is always better to understand possible interactions upfront than after delivering inconsistent results.
If you have questions on what are the appropriate tests to order for your patient, DRUGSCAN has a team of qualified people ready to help you including our extremely knowledgeable Customer Service team and expert toxicologists. DRUGSCAN prides itself as being a company committed to delivering a personal touch and a live voice on the phone to answer questions and provide support.
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Shipping & Supplies

DRUGSCAN supplies everything that you need to collect specimens that you intend to send to our laboratory for testing. Customers should contact their Account Executive or Customer Service for more information or to order supplies.
DRUGSCAN uses UPS and FedEx, so no matter where you are in the country we can receive samples the next day. To expedite and help make shipping easy we provide specimen-collection kits that come pre-addressed and ready to ship. You have the option of scheduling pick up as needed or we can arrange a regularly scheduled pickup.
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Specimen Collection

Results are generally available within 2-3 business days from specimen receipt at our lab. The DRUGSCAN team makes every effort to expedite results. We do everything we can to get customers accurate and reliable results as quickly as possible.
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Test Results/Interpretation

If you have questions about your patient’s test results, DRUGSCAN’s expert toxicologists can assist you. DRUGSCAN prides itself as being a company committed to delivering a personal touch and a live voice on the phone to answer questions and provide support.
There are two common ways that users attempt to "cheat" a urine drug test:
  • modify their urine sample with chemicals
  • drink large amounts of water prior to testing to dilute their sample
Many products are available on the Internet that claim to enable a person to produce a negative test result after drug use if that product is added to a urine sample. Most of these products contain strong chemicals known as oxidants, which can modify the chemical structure of a drug.
DRUGSCAN performs thorough validity testing on every urine sample for the presence of oxidants to identify potential adulteration. DRUGSCAN can also detect diluted samples by measuring the concentration of creatinine in each sample. Individuals who consume large quantities of water prior to a test to dilute their sample will often have abnormally low levels of creatinine. Validation tests such as those described above are performed to identify individuals who are adulterating their urine specimen in this manner.

Historically, “instant” urine drug testing has been used for pre-employment, workplace monitoring, and law enforcement applications. In these instances, results were used to verify that individuals are not under the influence or abusing drugs. Standard cut-off levels (normally as high as 300 or 2,000ng/mL for opiates) are adequate for detecting drug concentrations in their most basic form. However, standard cut-off levels are not effective in providing accurate assessments of patient compliance, or to monitor detox. Medication monitoring and the most accurate drug testing requires much lower cut-off levels that can only be achieved at a lab. DRUGSCAN cut-off levels are designed to achieve 100% accuracy.

POCT devices and analyzers are based on immunoassay technologies, which not only have elevated cut-offs but also are unable to identify specific drugs within a class. DRUGSCAN uses the most advanced technology that provides a unique “chemical fingerprint” for the drug in question, enabling positive identification and quantitation at very low levels.

Manufacturers’ instructions regarding POCT devices suggest subsequent quantification by a more specific method, such as LC/MS/MS. LC-MS/MS should be used when deemed medically necessary for the following reasons:

  • A more sensitive method is required allowing for better detection of individual drugs and metabolites
  • A more specific result is required that identifies both drug classes and specific drugs and metabolites within that class
The concept of false positive is limited to immunoassay screening tests. DRUGSCAN reports results based on confirmation testing by GC/MS or LC/MS/MS. This type of testing provides what is effectively a “chemical fingerprint” pattern for each drug. DRUGSCAN advanced confirmation technology eliminates the possibility of false positives.
Patients may be taking a prescription medication, such as Protonix, that is known to cross react with the cup and result in a THC positive. Also, THC metabolizes into several metabolites between which the cup cannot differentiate, meaning that the cup response is a cumulative result. Laboratory analysis detects only one of the many cross-reacting compounds, carboxy-THC, which may be at a concentration below the reporting limit.

This can happen when you rely solely on a POCT device or in office analyzer to determine results. Such devices recognize drug classes based on their “chemical shape” and most commonly change color when that shape is recognized. If other drugs with similar chemical shapes are present in the sample, this can result in a "false positive."

Sustiva, Protonix, and other proton pump inhibitors can cause individuals to test positive for THC, while common antibiotics such as amoxicillin can cause a person to test positive for cocaine on certain POCT devices. DRUGSCAN uses advanced technology to confirm specific drugs and metabolites with 100% accuracy.

Morphine is not known to metabolize to codeine. Trace urinary codeine concentrations may be present in individuals on high doses of morphine due to codeine impurities in the morphine tablet. The presence of this codeine impurity is well documented and can account for low concentrations of codeine detected in the urine from patients who have been prescribed relatively high doses of morphine for extended periods of time.

When the morphine concentration is low, this trace codeine impurity is undetectable; however, at high morphine concentrations, codeine may increase slightly above the minimum detection limit. That is why detection levels must not be too high or too low and set at just the right level to make a good decision.

There are many variables associated with urine drug levels. Caution should be used when interpreting quantitative levels. A few common reasons for the differences in urine levels for two patients on the same dose of drug include urine pH, co-administration of other drugs, hydration level, cardiac output, timing between dose and specimen collection, and possibly patient non-compliance.

While DRUGSCAN confirmation testing can accurately detect specific medications, drugs, and metabolites and demonstrate recent use; it is very difficult to correlate urine drug concentration with a patient’s dose because of the criteria listed above.

That depends on a combination of factors including: dose, frequency of dose, and metabolism/excretion capabilities. If the patient is prescribed oxycodone TID or QID then the urine should still test positive for the drug. If the patient is only prescribed single daily doses and they are capable of rapid metabolism/excretion, then the result may be negative due to screening cut-offs. The patient may also test positive for oxymorphone only as the detection window in the urine for this metabolite is longer than the parent drug.
Not necessarily. Clinical trials indicate that the ratio of oxymorphone to oxycodone can vary from 0-184 percent and that there is no direct correlation between the dose and the resulting ratio. The detection window for oxymorphone is slightly longer than oxycodone. This means oxymorphone may still be detectable even though oxycodone has been completely eliminated from the body.
Adderall does not contain methamphetamine. The use of Adderall can cause a patient to test positive for amphetamine but not methamphetamine. Amphetamine does not metabolize to methamphetamine.
Concentrations of methadone and its metabolite, EDDP, vary widely and depend on many factors such as metabolism/excretion rates, dose and dose frequency, and urine pH. Compliance cannot be determined solely from urinary methadone/metabolite concentrations.
It is possible. Low doses of benzodiazepines (especially alprazolam and lorazepam) can be reported negative during a screen. For this reason, DRUGSCAN uses direct assay for all opiates and benzodiazepines and drugs in this class skip screens with higher cut-offs to avoid false negative results.
At DRUGSCAN, our toxicologists have the experience to determine if results detect morphine or codeine resulting from poppy seed ingestion, which applies only when the patient is not prescribed morphine or codeine.
No. Phentermine (Adipex) is distinguished from amphetamine and methamphetamine during DRUGSCAN confirmation testing. Mass spectrometry provides a chemical fingerprint for phentermine, which is independent of those obtained for amphetamine and methamphetamine.
Ethanol (drinking alcohol) may be detected in blood and urine after consumption of alcoholic beverages. Blood and urine ethanol concentrations may be very different, depending on the time between ethanol consumption and specimen collection and frequency of urination. The ethanol concentration will often be higher in urine than in blood. In some cases, urine ethanol may be highly positive and the blood completely negative.
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Upon request, we can provide a complete list of providers that consider DRUGSCAN in network. Contact Customer Service for additional assistance.
DRUGSCAN will only bill the patient for the amount allowed by the insurance carrier as the patient’s responsibility for in network benefits. Additionally, DRUGSCAN will work with patients on an individual basis to establish payment options on any outstanding balances. Customers may contact Customer Service for additional assistance.
DRUGSCAN will work with your patients on an individual basis to establish payment options on any outstanding balances. Our Customer Service team will help you to make payment arrangements if necessary.
Contact DRUGSCAN’s Customer Service team for assistance
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DRUGSCAN can interface with certain EMR software. Please contact DRUGSCAN Customer Service for more information.