Urine drugs of abuse
Laboratory Testing Cut-offs & Methods
DRUGS OF ABUSE - SALIVA SCREENING & CONFIRMATION METHODS
- Screening Cut-off Levels and Methods
- Confirmation Cut-off Levels and Methods
- Oral Fluid Detection Times
OVERVIEW
Oral fluid testing is gaining popularity with many programs that require convenient, gender-neutral specimen collection combined with the accuracy of lab testing. RTL provides an easy and affordable lab-based testing solution for the detection of drugs of abuse in oral fluid: RTL-Oral. RTL-Oral utilizes the only collection device that has a volume adequacy indicator. This indicator ensures that sufficient saliva (1 mL) is collected to prevent possible false negative results due to insufficient sample size, and to provide a meaningful quantitative result.
The RTL-Oral collection device also allows drug concentrations to be reported per mL of oral fluid (GC/MS confirmations only). One (1) mL of oral fluid combined with three (3) mL of buffering agent provides four (4) mL of specimen, allowing a sufficient amount of sample for screening and confirmation procedures.
The following is an explanation of RTL's saliva screening and confirmation procedures/cut-off levels. The routine cut-off levels listed below may periodically change. Note: some cut-off levels may differ for your agency.
SALIVA SCREENING METHODOLOGY
Specimens collected with the RTL-Oral collection device are sent to Redwood Toxicology Laboratory for screening by Enzyme-Linked Immunosorbent Assay (ELISA). (See "saliva confirmation methodology" below).
| SCREENING CUT-OFF LEVELS BY ELISA Cut-off levels updated periodically. | |||||||||
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| Drug | ELISA | ||||||||
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| Amphetamine | 50 ng/mL | ||||||||
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| Barbiturates | 50 ng/mL | ||||||||
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| Benzodiazepine | 20 ng/mL | ||||||||
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| Benzoylecgonine (cocaine metabolite) & Cocaine |
20 ng/mL | ||||||||
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| Methamphetamine | 50 ng/mL | ||||||||
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| Opiates (codeine, hydrocodone, hydromorphone, morphine, oxycodone, 6-monoacetylmorphine) | 40 ng/mL | ||||||||
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| Phencyclidine | 10 ng/mL | ||||||||
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| THC (∆ - 9 THC) | 4 ng/mL | ||||||||
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| Methadone | 50 ng/mL | ||||||||
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These oral fluid cut-offs are based upon preliminary guidelines established by the Substance Abuse Mental Health Services Administration (SAMHSA) Drug Advisory Board for drug testing of alternative matrices.
SALIVA DRUG TEST CONFIRMATION METHODOLOGY
Positive screens are confirmed by gas chromatography/mass spectrometry (GC/MS).
| CONFIRMATION CUT-OFF LEVELS BY GC/MS Cut-off levels updated periodically. | |||||||||
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| Drug | GC/MS | ||||||||
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| Amphetamine | 15 ng/mL | ||||||||
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| Barbiturates | 20 ng/mL | ||||||||
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| Benzodiazepine | 15 ng/mL | ||||||||
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| Benzoylecgonine (cocaine metabolite) & Cocaine |
8 ng/mL | ||||||||
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| Methamphetamine | 15 ng/mL | ||||||||
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| Opiates - Codeine - Hydrocodone - Hydromorphone - Morphine - Oxycodone - 6-monoacetylmorphine |
20 ng/mL 20 ng/mL 20 ng/mL 20 ng/mL 20 ng/mL 4 ng/mL |
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| Phencyclidine | 5 ng/mL | ||||||||
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| THC (∆ - 9 THC) | 1 ng/mL | ||||||||
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| Methadone | 10 ng/mL | ||||||||
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| ORAL FLUID DETECTION TIMES | |||||
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| Drugs of Abuse | Detection Time | ||||
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| Amphetamine |
From minutes up to 48 hours | ||||
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| Barbiturates | From minutes up to 48 hours | ||||
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| Benzodiazepines | From minutes up to 48 hours | ||||
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| Methamphetamine | From minutes up to 48 hours | ||||
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| Cocaine | From minutes up to 48 hours | ||||
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| Opiates | From minutes up to 48 hours | ||||
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| Phencyclidine | From minutes up to 48 hours | ||||
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| THC (∆ - 9 THC) | From minutes up to 24 hours | ||||
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| Methadone | From minutes up to 48 hours | ||||
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The Resource Library includes information available in our printed Reference Guide, delivered to all new clients. To download a PFD of our Reference Guide, click here.