CUTOFF AND TOXICITY LEVELS FOR DRUGS-OF-ABUSE AND TOXICOLOGY TESTING
Tis table summarizes information for the interpretation of drugs-of-abuse toxicology assays; originally developed by the late Daniel M. Baer, MD, and updated by Richard A. Paulson, MT(ASCP), supervisor of Chemistry and Toxicology, VA Medical Center, Portland, OR. Te table was updated and reviewed this year by Allison B. Chambliss, PhD, DABCC, FAACC, Director of Clinical Chemistry and Point of Care Testing, LAC and USC Medical Center, Assistant Professor of Clinical Pathology, Keck School of Medicine of USC (University of Southern California).
Drug (and example trade names)
Heroin (Diacetylmorphine)
Morphine (Duramorph)
Methadone (Dolophine)
Meperidine (Demerol, Pethidine)
Codeine (Analgesics with codeine)
Tramadol1 (Ultram, Tramal Ultracet)
Oxycodone (Oxycontin, OxyIR, Percocet, Percodan)
Hydrocodone (Lorcet, Vicodin, Lortab, Hycodan)
Hydromorphone (Dilaudid)
Fentanyl2 (Sublimaze,
Duragesic, Actiq, Fentora)
Lysergic acid diethylamide (LSD)
Marijuana and cannabinoids
Common street names
Horse, Smack, Junk, Brown Sugar, China White, H, Skag, White Horse, Skunk
M, White stuff, Miss Emma, Monkey
Fizzies with MDMA Chocolate Chip Cookies, Amidone
Demmies, Pain Killer
School boy, Captain Cody, Cody, Lean, Sizzurp,
Ultra T
Oxy, Oxycotton, O.C., Oxycet, Hillbilly Heroin, Percs
Vikes, Watson-387
Juice, Smack, D, Footballs, Dillies
Apache, China girl, China white, Dance fever, Friend, Goodfella, Jackpot,Murder 8, TNT, Tango and Cash
Acid, Blotter, Boomers, Cid, Golden Dragon, Looney Tunes, Lucy Mae, Microdots, Tabs, Yellow Sunshine
Weed, Mary Jane, Ganja, Sensemilla, Blunt, Bud, Doobie, Dope, Grass, Pot, Green, Herb, Joint, Smoke, Stinkweed, Trees
Phencyclidine Cocaine
PCP, Angel dust, Hog, Embalming Fluid, Rocket Fuel, Sherms
Coke, Crack, Flake, Snow
Amphetamine (Benzedrine, Dexedrine)
Methylene-3,4 dioxy- Methamphetamine (MDMA)
Methamphetamine (Desoxyn, Methedrine)
Speed, Bennies, Uppers, Dexies
Ecstasy, Adam, XTC, Love drug, Hug drug
Speed, Meth, Crystal ice, Crank
Typical duration in urine aſter last dose
1-2 days
Common positive cutoff concentrations for urine screening assay*
2000 ng/mL (as morphine) 150 ng/mL (for 6-monoacetylmorphine)
2 days 3 days 2-3 days 2 days 6 hours to 2 days 1-3 days 1-2 days 1-2 days 1-2 days
2000 ng/mL 300 ng/mL
300 ng/mL 200 ng/mL 150 ng/mL
200 ng/mL
2000 ng/mL 300 ng/mL
200 ng/mL
100 ng/mL 300 ng/mL
300 ng/mL 100 ng/mL 50 ng/mL
2000 ng/mL 300 ng/mL
1 ng/mL 2 ng/mL
Toxic blood level Blood reference/ therapeutic range
>200 ng/mL None detected
>200 ng/mL >2000 ng/mL >1000 ng/mL >1000 ng/mL >1000 ng/mL >200 ng/mL >100 ng/mL >100 ng/mL
>3 ng/mL (naïve patients)
10-80 ng/mL
For narcotic stabilization: 300-1000 ng/mL For pain: 100-400 ng mL
70-500 ng/mL 10-100 ng/mL
100-800 ng/mL, variable by patient and dosing regimen
10-100 ng/mL 10-40 ng/mL 10-30 ng/mL
0.6-3.0 ng/mL (highly variable; depends on dose and route of administration)
1-5 days
0.5 ng/mL 100 pg/mL
>2 ng/mL None detected
Single use: 2-7 days (as ∆9-THC-COOH) Prolonged use: 1-2 months (as ∆9-THC-COOH)
15-100 ng/mL
50-200 ng/mL
None detected
Single use: 1 week Prolonged use: 2-4 weeks
Single use: 1-3 days Prolonged use: 4 days
Single use: 48 hours Prolonged use: 7-10 days
Single use: 24 hours
Single use: 48 hours Prolonged use: 7-10 days
25 ng/mL
300 ng/mL 150 ng/mL (as metabolite benzoylecgonine)
500 ng/mL 1000 ng/mL
300 ng/mL 500 ng/mL 1000 ng/mL
500 ng/mL 1000 ng/mL
>100 ng/mL >1000 ng/mL
None detected None detected
>200 ng/mL 100-1000 ng/mL >500 ng/mL
20-30 ng/mL 20-30 ng/mL 10-50 ng/mL
*Based on common screening assays currently in use and CAP Proficiency Testing reporting (2020) unless otherwise indicated. Confirmation results by Gas Chromatography-Mass Spectrometry (GC-MS) or Liquid Chromatography-Mass Spectrometry/Mass Spectrometry (LC-MS/MS) vary by laboratory.
10 CLR 2021-2022 • MLO •
www.clr-online.com
Stimulants
Hallucinogens
OPIATES
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