Detection of oxycodone and oxymorphone in urine following chain-of-custody procedures
This chain-of-custody test is intended to be used in a setting where the test results can be used definitively to make a diagnosis.
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
OXYCX | Oxycodone w/metabolite Conf, CoC, U | Yes | No |
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
COCH | Chain of Custody Processing | No | Yes |
ADLTX | Adulterants Survey, CoC, U | Yes | Yes |
Testing begins with screening assay. If oxycodone screen is positive, then the liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmation with quantification will be performed at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Immunoassay
Oxycodone (Oxycontin, Percodan)
Oxycontin (Oxycodone)
Oxymorphone
Percodan (Oxycodone)
Testing begins with screening assay. If oxycodone screen is positive, then the liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmation with quantification will be performed at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Urine
Container/Tube: Chain-of-Custody Kit (T282) containing the specimen containers, seals, and documentation required.
Specimen Volume: 20 mL
Collection Instructions: Collect specimen in the container provided, seal, and submit with the associated documentation to satisfy the legal requirements for chain-of-custody testing.
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.
2.5 mL
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 14 days | |
Frozen | 14 days | ||
Ambient | 72 hours |
Detection of oxycodone and oxymorphone in urine following chain-of-custody procedures
This chain-of-custody test is intended to be used in a setting where the test results can be used definitively to make a diagnosis.
Testing begins with screening assay. If oxycodone screen is positive, then the liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmation with quantification will be performed at an additional charge.
Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.
Opiates are the natural or synthetic drugs that have a morphine-like pharmacological action. Medically, opiates are used primarily for relief of pain. Opiates include morphine and drugs structurally similar to morphine (eg, codeine, hydrocodone, hydromorphone, oxycodone, oxymorphone).
Oxycodone is metabolized to noroxycodone, oxymorphone, and their glucuronides and is excreted primarily via the kidney. The presence of oxycodone greater than 100 ng/mL indicates exposure to oxycodone within 2 to 3 days prior to specimen collection.
Oxymorphone is metabolized in the liver and excreted via the kidney primarily as the glucuronide conjugates. Oxymorphone is also a metabolite of oxycodone and therefore the presence of oxymorphone could also indicate exposure to oxycodone.
Chain of custody is a record of the disposition of a specimen to document who collected it, who handled it, and who 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. 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 under the control of personnel involved with testing the specimen at all times; this control implies that the opportunity for specimen tampering would be limited.
Negative
Screening cutoff concentration:
A positive result indicates that the patient has used the drugs detected in the recent past. See individual tests (eg, OXYCU / Oxycodone with Metabolite Confirmation, Urine) for more information.
Other drugs in the opioid class, such as fentanyl, meperidine, methadone, and opiate antagonists such as naloxone, are not detected.
1. Anderson DT, Fritz KL, Muto JJ: Oxycontin: the concept of a "ghost pill" and the postmortem tissue distribution of oxycodone in 36 cases. J Anal Toxicol 2002;26:448-459
2. Jannetto PJ, Gock SG: Oxycodone: Recognition and Pharmacogenomics. Clinical and Forensic Toxicology News 2003 March
3. Cone EJ: Oxycodone Involvement in Drug Abuse Deaths: A DAWN-Based Classification Scheme applied to an Oxycodone Postmortem Database Containing over 1000 Cases. J Anal Toxicol 2003;27:57-67
4. Baselt RC, Cravey RH: Oxycodone. In Disposition of Toxic Drugs and Chemicals in Man. Fourth edition. Chemical Toxicology Institute, Foster City, CA. 1995;572-574
Oxycodone and its metabolite, oxymorphone, are analyzed via immunoassay. The assay uses specific antibodies that can detect oxycodone and oxymorphone without any significant cross-reactivity to other opiate compounds. The assay is based on the competition between a drug labeled with glucose-6-phosphate dehydrogenase (G6PDH), and free drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of free drug from the sample, the specific antibody binds the drug labeled with G6PDH and causes a decrease in enzyme activity. This phenomenon creates a direct relationship between the drug concentration in urine and enzyme activity. The enzyme activity is determined spectrophotometrically at 340 nm by measuring the conversion of nicotinamide adenine dinucleotide (NAD) to NADH.(Package insert: Roche Oxycodone, Roche Diagnostic Corp, Indianapolis, IN)
Monday through Saturday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
80307
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
OXYSX | Oxycodone Screen, CoC, U | 19642-8 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
61727 | Oxycodone | 19642-8 |
36027 | Chain of Custody | 77202-0 |