PtProtect® – Testing
Do you know all of the medications your patients take?
Some patients have more than one clinician and may not remember all the medications they take. Patients taking legally prescribed controlled medications may be combining prescriptions from multiple prescribers, putting themselves at risk for adverse drug reactions. Those patients who abuse drugs are more likely to combine them with legal drugs you prescribe, putting them at risk for overdoses and adverse reactions.
The panels in the PtProtect pain medication management program can help protect your patient’s safety by minimizing the risks of unintended drug interactions. Our interpretive report clearly notes any discrepancies between the medications reported taken and the medications detected.
Identify possible diversion
Patients who use drugs of abuse are more likely to abuse pain medications and more likely to divert medication either for financial gain or to fund an addiction to legal or illegal drugs. Family members may pilfer prescription drugs to self-treat or sell on the street.
The detailed PtProtect report, including interpretive comments, will provide you with the documentation needed to address this issue with your patient in a follow-up conversation.
Ensure compliance
Responsibly monitoring patient medication compliance is a challenge. PeaceHealth Laboratories’ pain management panels are designed to monitor patient compliance with commonly used opiates and opioids, as well as to detect common drugs of abuse.
PtProtect’s interpretative report gives a holistic view of the medications and substances the patient has taken and provides documentation needed in managing controlled medication prescribed to chronic pain patients.
Our testing regimen uses cut-off thresholds that reduce false negative results and confirms screened positives of commonly abused drugs.
Cut-off thresholds
| Drug |
Generic Name |
Retention Time |
Threshold |
|
Opiates/Opioids by LC/MS/MS
|
| 6-monoacetylmorphine |
Heroin metabolite |
1–3 days |
5 ng/mL |
| Codeine |
Tylenol-3 |
1–3 days |
5 ng/mL |
| Fentanyl |
Duragesic, Actiq |
1–2 days |
2 ng/mL |
| Hydrocodone |
Vicodin and others |
1–3 days |
5 ng/mL |
| Hydromorphone |
Dilaudid |
2–4 days |
5 ng/mL |
| Meperidine |
Demerol |
1–2 days |
5 ng/mL |
| Morphine |
MS Contin, Roxanol |
1–3 days |
5 ng/mL |
| Norfentanyl |
Fentanyl metabolite |
1–4 days |
2 ng/mL |
| Oxycodone |
Oxycontin, Tylox, Percocet |
1–3 days (SR 2–4 days) |
5 ng/mL |
| Oxymorphone |
Numorphan, Opana |
1–3 days (SR 1–4 days) |
5 ng/mL |
|
Drug Screen by EIA and GC/MS
|
| Alcohol |
Ethanol |
2–14 hours |
0.02/0.02 g/dL |
| Amphetamines |
Amphetamine |
1–2 days |
300/150 ng/mL |
| |
MDMA, MDA |
|
|
| |
Methamphetamine |
|
|
| Barbiturates |
Amobarbital |
1–7 days |
200/200 ng/mL |
| |
Aprobarbital |
1–7 days |
|
| |
Butabarbital |
1–7 days |
|
| |
Butalbital |
1–48 hours |
|
| |
Pentobarbital |
1–24 hours |
|
| |
Phenobarbital |
1–3 weeks |
|
| |
Secobarbital |
1–24 hours |
|
| Benzodiazepines |
Alprazolam metabolite |
Therapeutic Dose: |
200/100 ng/mL |
| |
Chlordiazepoxide metabolite |
3 days |
|
| |
Clonazepam metabolite |
|
|
| |
Clorazepate metabolite |
|
|
| |
Diazepam metabolite |
Extended Dosage: |
|
| |
Flunitrazepam metabolite |
4–6 weeks |
|
| |
Flurazepam metabolite |
|
|
| |
Flurazepam metabolite |
|
|
| |
Lorazepam |
|
|
| |
Nordiazepam |
|
|
| |
Oxazepam |
|
|
| |
Temazepam |
|
|
| Cocaine |
Cocaine metabolite |
1–2 days |
150/100 ng/mL |
| Marijuana |
THC metabolite |
Heavy User: 4–6 weeks |
20/15 ng/mL |
| |
|
Moderate User: 2 weeks |
|
| |
|
Light User: 0–4 days |
|
| Methadone |
Methadone metabolite |
3–11 days |
150/100 ng/mL |
| Phencyclidine |
Phencyclidine |
8 days |
25/25 ng/mL |
| |
|
Chronic Use: up to 30 days |
|
| Propoxyphene |
Propoxyphene metabolite |
1–2 days |
300/300 ng/mL |
|
Misc by LC/MS/MS
|
| Carisoprodol & metabolite |
Soma |
4 days |
0.2 µg/mL |
| (meprobamate) |
| Tramadol & metabolite |
Ultram, Ultracet, Ryzolt |
3 days |
50 ng/mL |
| Buprenorphine |
Buprenex, Subutex, Suboxone |
4 days |
2 ng/mL |