Drug Confirmation Test

drug confirmation test is the definitive lab step used to verify a non-negative drug screen. While screening immunoassays are fast and useful, they can cross-react with certain medicines or supplements. Confirmation uses high-specificity methods—typically LC-MS/MS (liquid chromatography–tandem mass spectrometry) or GC-MS (gas chromatography–mass spectrometry)—to identify the exact drug and metabolite at defined cutoffs.

A proactive approach pairs an initial screen with confirmation when required by workplace, clinical, legal, or treatment-program policy. You can select the matrix (urine, oral fluid, hair, blood) and the drug class panel that best matches your window of detection and policy. Confirmation provides defensible, quantitative results that reduce false positives and clarify complex cases (e.g., prescribed vs. non-prescribed use).

Signs, Situations & Related Needs

  • Workplace / compliance: non-negative rapid or lab screen, return-to-duty, post-accident, or reasonable-suspicion testing

  • Clinical care: pain-management monitoring, medication adherence, unexpected screen results

  • Legal / treatment programs: abstinence verification, court or custody orders

  • Specimen concerns: unusual screen patterns; need to rule out cross-reactivity or adulteration

  • Urgent care: suspected overdose or impairment is a medical emergency—seek immediate clinical help
    All testing should be interpreted by a qualified clinician, MRO, or program administrator.

Why These Tests Matter

What confirmation can do

  • Provide definitive identification of drugs and metabolites with quantitative levels

  • Differentiate look-alike results (e.g., amphetamine vs. methamphetamine; heroin use via 6-MAM)

  • Reduce false positives from screening cross-reactivity and support policy or legal requirements

  • Enable trend comparison across time and matrices

What confirmation cannot do

  • Prove intoxication or exact dose/time since use

  • Replace clinical judgment, chain-of-custody procedures, or program policy requirements

  • Interpret intent or impairment without context

What These Tests Measure (at a glance)

  • Opioids & semisynthetics: morphine, codeine, heroin metabolite 6-MAM, hydrocodone/hydromorphone, oxycodone/oxymorphone, methadone/EDDP, buprenorphine/norbuprenorphinefentanyl/norfentanyl

    • Use: verify class and metabolite patterns; distinguish heroin via 6-MAM

  • Stimulants: amphetamine/methamphetamine (with potential D/L isomer analysis), MDMA/MDA, methylphenidate metabolites (as applicable)

    • Use: rule out cross-reactive meds; confirm specific stimulant

  • Cocaine: benzoylecgonine, ecgonine methyl ester

    • Use: definitive cocaine exposure

  • Cannabinoids: THC-COOH (urine), parent THC (blood/oral fluid)

    • Use: recent vs. residual exposure context by matrix

  • Benzodiazepines: alprazolam/α-hydroxyalprazolam, lorazepam, oxazepam, temazepam, clonazepam/7-aminoclonazepam

    • Use: detect glucuronidated benzos missed by some screens

  • Barbiturates, PCP, others: class-specific analyte lists available

    • Use: targeted confirmation as policy requires

  • Specimen validity/adulteration: urine creatinine, specific gravity, pH, oxidants

    • Use: assess dilution or tampering

Detection windows (typical, vary by use & cutoff)

  • Urine: ~1–3 days for many drugs; THC longer with frequent use

  • Oral fluid: hours to ~1–2 days; reflects recent use

  • Blood: hours to ~1 day; best for current presence

  • Hair: weeks to months; pattern over time (not impairment)

How the Testing Process Works

  1. Define goal & matrix: “verify non-negative” (urine/oral fluid) vs. “pattern over time” (hair) vs. “current presence” (blood)

  2. Collection & chain of custody: follow program instructions; some settings require observed collection and COC documentation

  3. Laboratory confirmation: definitive LC-MS/MS or GC-MS with established cutoffs; quantitative reporting

  4. Result release: secure report with drug, metabolite(s), and levels; specimen validity if applicable

  5. Next steps: MRO/clinician review with prescriptions, timing, and policy to determine final disposition

Interpreting Results (General Guidance)

  • Confirmed positive: target analyte(s) identified at/above cutoff—review metabolite patterns (e.g., oxycodone with oxymorphone) and prescriptions

  • Negative / below cutoff: analyte not detected or under threshold—does not guarantee no prior use outside the window

  • Special markers: 6-MAM indicates heroin; norfentanyl confirms fentanyl exposure; 7-aminoclonazepamsupports clonazepam use

  • Consider matrix & window: oral fluid/blood = recent use; urine = clearance window; hair = longer-term patterns
    Always interpret with collection details, medications, timing, and program policy.

Choosing Panels vs. Individual Tests

  • Screen follow-up (non-negative): choose urine or oral fluid confirmation panels matching the screened classes

  • Pain-management adherence: targeted opioid/benzodiazepine confirmation with metabolite patterns and specimen validity

  • Workplace DOT/non-DOT: follow employer or regulator’s panel and chain-of-custody requirements

  • Pattern/relapse review: consider hair confirmation for longer windows; pair with periodic urine/oral fluid

  • Tampering concerns: add specimen validity/adulteration testing

FAQs

What’s the difference between a screen and a confirmation test?
screen is a quick yes/no immunoassay; a confirmation uses mass spectrometry to precisely identify and quantify specific drugs/metabolites.

Can prescription meds cause a false positive on screens?
Yes. That’s why confirmation is used—to distinguish cross-reactivity from true drug presence.

Does a confirmed positive show impairment?
No. It shows presence above a cutoff, not whether someone was impaired.

Which specimen is best?
Match the detection window to your goal: blood (now), oral fluid (recent), urine (recent/clearance), hair (weeks–months).

Why are metabolites important?
They prove biologic processing of a parent drug (e.g., 6-MAM for heroin, norfentanyl for fentanyl) and help verify source.

What if adulteration is suspected?
Use specimen validity checks (creatinine, specific gravity, pH, oxidants) and follow collection policy.

Internal Links & Cross-References

  • Drug & Alcohol Tests Hub

  • Drug Screening

  • Alcohol

  • Employment & Compliance Testing

  • Pain Management Monitoring

  • Nicotine & Tobacco

  • Key Lab Tests: LC-MS/MS Drug Confirmation (Urine) • Oral Fluid Drug Confirmation • Hair Drug Confirmation • Specimen Validity Panel • Opioid/Benzodiazepine Targeted Confirmation • Fentanyl/Norfentanyl Confirmation • Cocaine (Benzoylecgonine) Confirmation • THC-COOH Confirmation

References

  1. Substance Abuse and Mental Health Services Administration (SAMHSA). Laboratory testing guidelines and cutoffs for drugs of abuse.

  2. U.S. Department of Transportation (DOT). Drug Testing Program requirements and confirmatory testing protocols.

  3. College of American Pathologists (CAP). Toxicology and mass spectrometry best practices.

  4. American Association for Clinical Chemistry (AACC). Guidance on definitive drug testing and interpretation.

  5. World Health Organization (WHO). Drug testing in clinical and workplace settings—principles and limitations.

  6. ARUP Consult/clinical toxicology compendia. Confirmation testing, detection windows, and metabolite interpretation.

Available Tests & Panels

Your drug confirmation menu is pre-populated in the Ulta Lab Tests system. Choose the matrix and drug class panel that fit your goal (screen follow-up, adherence, workplace, legal). Add specimen validity when needed, and review all results with your clinician, MRO, or program administrator.

  • Page
  • 1
  • of
  • 2
  • Total Rows
  • 27
Name Matches

The Panel 1 Urine Drug Screen with Confirmation detects multiple commonly abused drugs in urine and verifies positive findings with advanced confirmatory testing. This two-step process improves accuracy by reducing the chance of false positives, making it valuable for clinical, workplace, or monitoring settings. The combination of broad screening and confirmation ensures reliable assessment of recent substance exposure.

Urine
Urine Collection
Also Known As: Drug Monitoring Panel 1 Screen with Confirmation Urine

The Panel 6 Urine Drug Screen with Confirmation detects multiple commonly abused drugs in urine via immunoassay screening and then validates positive findings with confirmatory testing. This two-step method enhances result reliability by reducing false positives, providing a trustworthy overview of substance exposure suited for clinical, monitoring, or workplace settings.

Urine
Urine Collection
Also Known As: Drug Monitoring Panel 6 Screen with Confirmation Urine

The Alcohol Urine Drug Screen with Confirmation detects and confirms the presence of ethyl glucuronide (EtG), a direct metabolite of alcohol, in urine samples. This test is designed to identify recent alcohol use and verify initial screening results with confirmatory analysis, providing reliable and accurate information for monitoring purposes in clinical, legal, and treatment settings.

Urine
Urine Collection
Also Known As: Drug Monitoring Alcohol Metabolite Screen with Confirmation Urine

The Amphetamines Urine Drug Screen with Confirmation combines initial screening and confirmatory testing to detect and verify the presence of amphetamines in urine. This method delivers both sensitivity and specificity, ensuring positive results are validated. Ideal for clinical, legal, or monitoring settings, it supports reliable reporting of amphetamine use.

Urine
Urine Collection
Also Known As: Drug Monitoring Amphetamines Screen with Confirmation Urine

The Amphetamines Urine Drug Screen with Confirmation and D/L Isomers first screens for amphetamine compounds, then applies confirmatory testing that distinguishes D- and L-methamphetamine isomers. This test combines detection, verification, and isomer differentiation to offer more precise insight in clinical, legal, or monitoring settings.

Urine
Urine Collection
Also Known As: Drug Monitoring Amphetamines Screen with Confirmation and D/L Urine

The Barbiturates Urine Drug Screen with Confirmation performs an initial immunoassay screening for barbiturates and then confirms positives using mass spectrometry. It verifies the presence of barbiturate drugs like phenobarbital, pentobarbital, secobarbital, and more. Designed for clinical, legal, or treatment monitoring, it delivers both detection and validation for greater confidence in results.

Urine
Urine Collection
Also Known As: Drug Monitoring Barbiturates Screen with Confirmation Urine

The Base Panel Urine Drug Screen with Confirmation combines an initial multi-drug immunoassay screen with confirmatory testing to validate positive findings. It detects common substances across multiple drug classes in urine, then uses advanced analysis to confirm the presence of specific analytes. This dual approach boosts accuracy and confidence in results for clinical or monitoring settings.

Urine
Urine Collection
Also Known As: Drug Monitoring Base Panel Screen with Confirmation Urine

The Benzodiazepines Urine Drug Screen with Confirmation performs an initial screening for benzodiazepine compounds in urine, followed by confirmatory testing to validate positive results. This process ensures reliable identification of drugs like diazepam, lorazepam, or alprazolam in clinical or monitoring settings, adding confidence and specificity to benzodiazepine detection.

Urine
Urine Collection
Also Known As: Drug Monitoring Benzodiazepines Screen with Confirmation Urine

The Buprenorphine and Naloxone Urine Drug Screen with Confirmation begins with a screening test for buprenorphine and its metabolites (including naloxone) in urine, then validates positive findings using confirmatory methods. This combined approach balances sensitivity and specificity, helping clinicians, treatment programs, or monitoring services to reliably verify medication-assisted therapy adherence.

Urine
Urine Collection
Also Known As: Drug Monitoring Buprenorphine Screen with Confirmation includes Naloxone Urine

The Cocaine Urine Drug Screen with Confirmation combines an initial immunoassay screen for cocaine metabolites with confirmatory testing to verify positive findings. This two-step approach ensures both detection and validation of cocaine use in urine, improving specificity and confidence of results for clinical, legal, or monitoring applications.

Urine
Urine Collection
Also Known As: Drug Monitoring Cocaine Metabolite Screen with Confirmation Urine

The Fentanyl Urine Drug Screen with Confirmation performs an initial immunoassay screening for fentanyl and then applies confirmatory testing (e.g. mass spectrometry) to verify positive results. This two-step process reduces false positives and ensures specificity in detecting fentanyl use in urine for clinical or monitoring programs.

Urine
Urine Collection
Also Known As: Drug Monitoring Fentanyl Screen with Confirmation Urine

The Heroin Urine Drug Screen with Confirmation begins with an immunoassay screen for heroin metabolites (such as 6-monoacetylmorphine), then reflexes positives to mass spectrometry confirmation. This two-step approach ensures both sensitivity and specificity, validating the presence of heroin use in urine and reducing false positives for clinical or monitoring purposes.

Urine
Urine Collection
Also Known As: Drug Monitoring Heroin Metabolite Screen with Confirmation Urine

The Marijuana Urine Drug Screen with Confirmation performs an initial immunoassay screen for THC metabolites (such as THC-COOH) in urine, followed by confirmatory testing to validate any positive findings. This two-step testing approach ensures both sensitivity and specificity, providing reliable confirmation of cannabis use in clinical, monitoring, or compliance settings.

Urine
Urine Collection
Also Known As: Drug Monitoring Marijuana Metabolite Screen with Confirmation Urine

The MDMA/MDA Urine Drug Screen with Confirmation begins with a broad immunoassay screen for MDMA and its metabolite MDA, then applies confirmatory testing (e.g. mass spectrometry) to validate positives. This two-step approach enhances specificity and ensures that detected substances are correctly identified, providing reliable verification of ecstasy (MDMA/MDA) use in clinical or monitoring settings.

Urine
Urine Collection
Also Known As: Drug Monitoring MDMA/MDA Screen with Confirmation Urine, Ecstasy Urine Drug Screen

The Methadone Urine Drug Screen with Confirmation begins with immunoassay screening for methadone metabolites, then applies confirmatory analysis to verify positive findings. This two-step approach enhances specificity and reduces false positives, providing reliable validation of methadone use in urine for clinical, compliance, or monitoring purposes.

Urine
Urine Collection
Also Known As: Drug Monitoring Methadone Metabolite Screen with Confirmation Urine

The Mitragynine Urine Drug Screen with Confirmation screens for the kratom alkaloid mitragynine in urine, then applies confirmatory testing to validate positive findings. This two-step process enhances accuracy and specificity, helping clinicians and monitoring programs reliably identify kratom use with both detection and verification of mitragynine presence.

Urine
Urine Collection
Also Known As: Drug Monitoring Mitragynine Screen with Confirmation Urine

The Opiates Urine Drug Screen with Confirmation begins with immunoassay screening for opiate compounds (such as morphine, codeine, hydrocodone), then validates positive results using confirmatory methods. This two-step process ensures specificity and reduces false positives, delivering reliable confirmation of opiate detection in urine for clinical, legal, or monitoring settings.

Urine
Urine Collection
Also Known As: Drug Monitoring Opiates Screen with Confirmation Urine

The Oxycodone Urine Drug Screen with Confirmation begins with an immunoassay screen for oxycodone and its metabolites in urine, then uses confirmatory testing (e.g. mass spectrometry) to validate positive results. This two-step process enhances specificity and reduces false positives, offering reliable confirmation of oxycodone exposure in clinical and monitoring settings.

Urine
Urine Collection
Also Known As: Drug Monitoring Oxycodone Screen with Confirmation Urine

Urine
Urine Collection
Also Known As: Drug Monitoring Panel 1 Screen with Confirmation and D/L Isomers Urine

The Panel 3 Urine Drug Screen with Confirmation detects multiple commonly abused drugs in urine through immunoassay screening, with positive results verified by advanced confirmatory methods. This two-step process enhances accuracy by minimizing false positives and provides reliable insight into substance exposure. It is suited for clinical, workplace, and monitoring applications requiring dependable results.

Urine
Urine Collection
Also Known As: Drug Monitoring Panel 3 Screen with Confirmation Urine

The Panel 4 Urine Drug Screen with Confirmation detects multiple commonly abused drugs in urine through immunoassay screening, then verifies positive findings using confirmatory analysis. This two-step process enhances specificity and reduces false positives, providing dependable insight into substance exposure for clinical, monitoring, or workplace applications.

Urine
Urine Collection
Also Known As: Drug Monitoring Panel 4 Screen with Confirmation Urine

The Panel 5 Urine Drug Screen with Confirmation detects multiple commonly abused drugs in urine via immunoassay screening and validates positive findings through confirmatory analysis. This dual-step approach reduces false positives and improves specificity, offering a more trustworthy evaluation of substance exposure in clinical, monitoring, or workplace contexts.

Urine
Urine Collection
Also Known As: Drug Monitoring Panel 5 Screen with Confirmation Urine

The Panel 5 Urine Drug Screen with Confirmation and D/L Isomers detects multiple commonly abused drugs in urine via immunoassay screening and verifies positive findings. It further differentiates D- and L-isomer forms of amphetamines to improve specificity and interpretive clarity. This multi-step analysis supports accurate results in clinical, workplace, and monitoring settings.

Urine
Urine Collection
Also Known As: Drug Monitoring Panel 5 Screen with Confirmation and D/L Isomers Urine

The Panel 7 Urine Drug Screen with Confirmation detects multiple commonly abused drugs in urine via immunoassay screening and then validates positive results through confirmatory testing. This two-step approach increases specificity by reducing false positives, providing dependable insight into exposure to an extended panel of substances in clinical, monitoring, or workplace settings.

Urine
Urine Collection
Also Known As: Drug Monitoring Panel 7 Screen with Confirmation Urine

The Panel 8 Urine Drug Screen with Confirmation detects multiple commonly abused drugs in urine through immunoassay screening and validates positive results using confirmatory analysis. This two-step method enhances specificity and reduces false positives, providing reliable insight into substance exposure across a broader panel of substances in clinical, workplace, and monitoring environments.

Urine
Urine Collection
Also Known As: Drug Monitoring Panel 8 Screen with Confirmation Urine