Ulta Lab Tests

Pain Management

Pain management drug testing helps clinicians and patients use controlled medicines safely and as prescribed. A proactive plan verifies adherence, checks for undisclosed substances, and flags dangerous combinations (for example, opioids with benzodiazepines). It starts with the right specimen (urine is most common; oral fluid, blood, or hair when indicated), a rapid screen for broad classes, and definitive confirmation by mass spectrometry (LC-MS/MS or GC-MS) whenever results are non-negative or policy requires it.

Testing supports clinic agreements, risk-mitigation visits, and documentation for quality care. Results do not prove impairment, dose, or timing. Always interpret with your medication list, exam findings, and program policy.

Signs, Situations & Related Needs

  • Adherence checks: verify that prescribed opioids/adjuncts are present with expected metabolites

  • Unexpected negatives/positives: possible non-adherence, diversion, or undisclosed substances

  • Risk mitigation: high MED (morphine-equivalent) dosing, concurrent benzodiazepines, history of substance use disorder

  • Care transitions: new patient intake, peri-operative planning, return-to-work/safety-sensitive roles

  • Urgent care: suspected overdose, severe sedation, chest pain, suicidal thoughts—seek immediate medical help
    All testing should be reviewed by your clinician or Medical Review Officer (MRO).

Why These Tests Matter

What testing can do

  • Confirm presence/absence of prescribed drugs and identify specific metabolites

  • Detect non-prescribed or illicit substances that increase risk

  • Provide objective trends over time to guide visit frequency, counseling, or taper plans

What testing cannot do

  • Prove impairment, exact dose, or time since use

  • Replace clinical judgment, PDMP checks, chain-of-custody, or program policies

  • Explain intent without context

What These Tests Measure (at a glance)

  • Opioids & semisynthetics

    • Morphine, codeine; 6-MAM (heroin metabolite) — confirms heroin exposure

    • Hydrocodone → hydromorphone; Oxycodone → oxymorphone — expected metabolite patterns

    • Fentanyl → norfentanyl — definitive fentanyl exposure

    • Methadone → EDDP; Buprenorphine → norbuprenorphine — adherence in MAT/pain

    • Tramadol → O-desmethyltramadol; Tapentadol → N-desmethyl/O-sulfate — synthetic analgesics
      Caveat: patterns matter; use confirmation for specificity.

  • Benzodiazepines

    • Alprazolam → α-hydroxyalprazolam; Clonazepam → 7-aminoclonazepam; Diazepam → nordiazepam/oxazepam/temazepam; Lorazepam/oxazepam/temazepam (often glucuronidated; best detected by LC-MS/MS).
      Caveat: some screens miss glucuronidated benzos; confirm by LC-MS/MS.

  • Adjuncts / co-prescribed (as ordered)

    • Gabapentin, Pregabalin, Carisoprodol → meprobamate, TCAs — adherence and interaction context

  • Illicit/other classes (when indicated)

    • Cocaine (benzoylecgonine), Amphetamines (± D/L isomer), THC-COOH, PCP, barbiturates, synthetic opioids/novel psychoactives

  • Specimen validity (urine): creatinine, specific gravity, pH, oxidants — detects dilution/adulteration

  • Alcohol context (when relevant): EtG/EtS for recent exposure; PEth for sustained use (not impairment tests)

Detection windows (typical; vary by dose/frequency/cutoff)

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

  • Oral fluid: hours to ~1–2 days (very recent)

  • Blood: hours to ~1 day (current presence)

  • Hair: weeks–months (patterns, not impairment)

How the Testing Process Works

  1. Define the goal & matrix: adherence vs. abstinence vs. recent or long-term pattern; choose urine, oral fluid, blood, or hair.

  2. Screen first: rapid immunoassay for target classes per clinic policy.

  3. Confirm definitively: any non-negative (or policy-directed classes) by LC-MS/MS or GC-MS with metabolites and cutoffs.

  4. Add validity (urine): creatinine, specific gravity, pH, oxidants to assess dilution/adulteration.

  5. Review & trend: compare with prescriptions, timing, PDMP, and clinical findings; schedule repeat testing as needed.

Interpreting Results (General Guidance)

  • Confirmed positive with expected metabolites: supports adherence (e.g., oxycodone with oxymorphone).

  • Confirmed positive for non-prescribed/illicit drugs: safety risk; clinician review required.

  • Negative or below cutoff for a prescribed drug: consider timing, metabolism, formulation, or possible non-adherence/diversion.

  • Special markers: 6-MAM (heroin), norfentanyl (fentanyl), EDDP (methadone), norbuprenorphine(buprenorphine) strengthen interpretation.

  • Matrix matters: oral fluid/blood reflect recent use; urine reflects clearance; hair shows long-term use.
    Always interpret within clinical and policy context.

Choosing Panels vs. Individual Tests

  • Routine pain-clinic monitoring: targeted opioid ± benzodiazepine panel with metabolite confirmation and urine validity

  • MAT (buprenorphine/methadone): include parent metabolite (norbuprenorphine or EDDP) to verify metabolism

  • Unexpected screen results: broaden to definitive LC-MS/MS; consider amphetamines D/L isomer testing

  • Long-term pattern review: hair panels; pair with periodic urine or oral fluid for near-term checks

  • Tampering concerns: add specimen validity to urine tests

FAQs

Why confirm after a non-negative screen?
Screens can cross-react. Mass spectrometry confirms the specific drug and metabolite and reduces false positives.

Does a positive mean the patient was impaired?
No. It shows presence above a cutoff—not impairment or exact timing.

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

How do metabolite patterns help?
They verify biologic processing (e.g., norfentanyl with fentanyl) and help distinguish adherence from non-prescribed use.

What if a prescribed drug is negative?
Check dosing interval, formulation, metabolism, and timing; consider definitive confirmation and clinical discussion.

Can urine be diluted or adulterated?
Yes—use specimen validity (creatinine, specific gravity, pH, oxidants) and follow collection policy.

Internal Links & Cross-References

  • Drug & Alcohol Tests Hub

  • Employment & Compliance Testing

  • Drug & Alcohol Tests Hub

  • Drug Screening

  • Drug Confirmation Test

  • Drug Monitoring

  • Drug Toxicology Monitoring

  • Alcohol

  • Key Lab Tests: Opioid/Benzodiazepine Targeted Panel • LC-MS/MS Drug Confirmation • Fentanyl/Norfentanyl Confirmation • Buprenorphine/Norbuprenorphine • Methadone/EDDP • Specimen Validity • Hair Drug Panel

References

  1. Centers for Disease Control and Prevention. Opioid prescribing and risk-mitigation: urine drug testing considerations.

  2. American Society of Interventional Pain Physicians. Guidelines for responsible opioid prescribing and monitoring.

  3. American Society of Addiction Medicine (ASAM). Appropriate use of drug testing in clinical addiction medicine.

  4. Substance Abuse and Mental Health Services Administration (SAMHSA). Drug testing cutoffs and laboratory guidance.

  5. American Association for Clinical Chemistry (AACC). Definitive drug testing best practices (LC/GC-MS).

  6. College of American Pathologists (CAP). Toxicology standards and chain-of-custody considerations.

  7. ARUP Consult/clinical toxicology compendia. Detection windows, metabolite interpretation, and specimen validity.

Available Tests & Panels

Your pain management testing menu is pre-populated in the Ulta Lab Tests system. Choose a targeted opioid ± benzodiazepine panel, add LC/GC-MS confirmation for any non-negative results, and include specimen validity for urine. Use filters to select the specimen matrix and drug classes that fit your program, and review all results with your clinician or MRO.

  • Page
  • 2
  • of
  • 3
  • Total Rows
  • 75
Name Matches

The Carisoprodol Urine Drug Test quantitatively measures levels of carisoprodol metabolite(s) in urine using highly sensitive analytical methods. This test provides precise concentration values instead of mere detection, supporting clinical monitoring, compliance evaluation, and case review. Results help distinguish trace exposure from significant use in medical or treatment settings.

Urine
Urine Collection
Also Known As: Drug Monitoring Carisoprodol Metabolite Quantitative Urine Test
Add to  

The Cocaine Urine Drug Test quantitatively measures the concentration of benzoylecgonine (the primary cocaine metabolite) in urine using high-precision analytical methods. This quantitative analysis provides more than detection—it reveals the level of cocaine exposure to support clinical monitoring, compliance evaluation, or detailed case review over time.

Urine
Urine Collection
Also Known As: Drug Monitoring Cocaine Metabolite Quantitative Urine Test
Add to  

The Cocaine Urine Drug Screen detects the presence of benzoylecgonine (a primary cocaine metabolite) in urine above threshold levels using immunoassay screening. This test serves as an initial assessment of recent cocaine use in clinical, treatment, or monitoring settings. Detection indicates use beyond cutoff but does not include confirmatory testing in this version.

Urine
Urine Collection
Also Known As: Drug Monitoring Cocaine Metabolite Screen Urine
Add to  

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
Add to  

The Eszopiclone Urine Drug Test quantitatively measures the concentration of eszopiclone (Lunesta®) and related metabolites in urine using sensitive analytical methods. This precise test supports clinical monitoring, adherence tracking, or medication evaluation by providing actual levels rather than simply detecting presence, offering more insight into drug exposure over time.

Urine
Urine Collection
Also Known As: Drug Monitoring Eszopiclone Quantitative Urine Test
Add to  

The Fentanyl Urine Drug Test quantitatively measures the concentration of fentanyl and its metabolites in urine using advanced analytical techniques. This precise testing approach gives detailed insight into levels of fentanyl exposure, supporting clinical evaluation, treatment monitoring, and substance use analysis beyond simple detection.

Urine
Urine Collection
Also Known As: Drug Monitoring Fentanyl Quantitative Urine Test
Add to  

The Fentanyl Urine Drug Screen detects the presence of fentanyl and its metabolites in urine above established cutoff levels using immunoassay screening methods. This test provides an initial assessment of opioid exposure, useful in clinical, monitoring, or treatment settings. A positive result indicates detection but does not include confirmatory testing.

Urine
Urine Collection
Also Known As: Drug Monitoring Fentanyl Screen Urine
Add to  

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
Add to  

The Gabapentin Urine Drug Test quantitatively measures gabapentin levels in urine using advanced laboratory analysis. This precise assay provides actual concentration values (not just presence/absence), enabling clinicians to assess medication use, adherence, and exposure over time. It offers more detailed insight than a standard screen, helping differentiate between low-level exposure and therapeutic dosing.

Urine
Urine Collection
Also Known As: Drug Monitoring Gabapentin Quantitative Urine Test
Add to  

The Heroin Urine Drug Test quantitatively measures levels of 6-monoacetylmorphine (6-MAM), the primary heroin metabolite, in urine using LC/MS/MS methodology. This precise analysis provides exact concentration values, offering deeper insight than a simple screen and supporting clinical monitoring, compliance review, or drug exposure evaluation over time.

Urine
Urine Collection
Also Known As: Drug Monitoring Heroin Metabolite Quantitative Urine Test
Add to  

The Heroin Urine Drug Screen detects the presence of heroin metabolites (such as 6-monoacetylmorphine) in urine above established cutoff levels, using immunoassay screening. This test provides a first-line assessment of recent heroin use in clinical, monitoring, or treatment settings. A positive result indicates detection but does not include confirmatory testing.

Urine
Urine Collection
Also Known As: Drug Monitoring Heroin Metabolite Screen Urine
Add to  

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
Add to  

The Marijuana Urine Drug Test quantitatively measures levels of THC metabolites (such as THC-COOH) in urine using precise analytical methods. This test provides more insight than a simple screen by reporting exact concentrations, helping clinicians monitor patterns of use, track compliance, and distinguish low-level exposure from substantial ingestion in clinical or monitoring settings.

Urine
Urine Collection
Also Known As: Drug Monitoring Marijuana Metabolite Quantitative Urine Test
Add to  

The Marijuana Urine Drug Screen detects THC metabolites (such as THC-COOH) in urine above established cutoff levels using immunoassay screening methods. This test provides an initial indication of recent cannabis use in clinical, monitoring, or workplace settings. A positive result signals detection above threshold, but confirmatory testing is not part of this version.

Urine
Urine Collection
Also Known As: Drug Monitoring Marijuana Metabolite Screen Urine
Add to  

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
Add to  

The MDMA Urine Drug Screen detects the presence of MDMA (ecstasy) and related metabolites in urine above defined cutoff levels using immunoassay screening. This test offers an initial evaluation of recent MDMA use in clinical, treatment, or monitoring settings. A positive result indicates detection beyond threshold levels, but does not include confirmatory testing in this version.

Urine
Urine Collection
Also Known As: Drug Monitoring MDMA Screen Urine, Ecstacy Urine Drug Screen
Add to  

The MDMA/MDA Urine Drug Test quantitatively measures concentrations of MDMA (ecstasy) and its metabolite MDA in urine using precise analytical instrumentation. This test goes beyond mere detection to report actual levels, offering clinicians and monitoring programs deeper insight into dosage, exposure trends, and compliance in drug use assessment.

Urine
Urine Collection
Also Known As: Drug Monitoring MDMA/MDA Quantitative Urine Test, Ecstasy Urine Drug Test
Add to  

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
Add to  

The Meperidine Urine Drug Test quantitatively measures the concentration of meperidine and its metabolite(s) in urine using sensitive analytical methods. This precise test delivers numeric levels, enabling clinicians and monitoring programs to assess exposure, differentiate low versus significant use, and observe trends over time. It offers more insight than a simple detection screen.

Urine
Urine Collection
Also Known As: Drug Monitoring Meperidine Quantitative Urine Test
Add to  

The Methadone Urine Drug Test quantitatively measures the concentration of methadone and its metabolites in urine using precise analytical techniques. This detailed assay provides numeric values, offering deeper insight into methadone exposure, compliance, or therapeutic monitoring. It gives clinicians more context than a basic screen by showing how much methadone is present.

Urine
Urine Collection
Also Known As: Drug Monitoring Methadone Metabolite Quantitative Urine Test
Add to  

The Methadone Urine Drug Screen detects the presence of methadone metabolites in urine above defined cutoff levels using immunoassay screening methods. This test provides a first-pass assessment of methadone use in clinical, monitoring, or treatment settings. Positive results indicate detection beyond threshold limits, but no confirmatory steps are included in this test version.

Urine
Urine Collection
Also Known As: Drug Monitoring Methadone Metabolite Screen Urine
Add to  

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
Add to  

The Methamphetamine D/L Isomers Urine Drug Test differentiates and quantifies both D- (dextro) and L- (levo) isomers of methamphetamine in urine using precise analytical methods. This test provides insight not just into methamphetamine presence, but into stereoisomer composition—helpful in clinical, forensic, or monitoring contexts to distinguish illicit use from prescription forms.

Random
Phlebotomist
Also Known As: Drug Monitoring Methamphetamine D/L Isomers Urine Test
Add to  

The Methylphenidate Urine Drug Test quantitatively measures levels of methylphenidate (Ritalin) and its metabolites in urine using advanced analytical methods to report precise concentrations. This quantitative assay helps clinicians, monitoring programs, or treatment providers track medication adherence, distinguish therapeutic use from excess, and understand dosage exposure over time.

Urine
Urine Collection
Also Known As: Drug Monitoring Methylphenidate Metabolite Quantitative Urine Test
Add to  

The Mitragynine Urine Drug Test quantitatively measures mitragynine levels in urine, the principal alkaloid found in kratom, using sensitive analytical methods. This precise assay reports exact concentrations rather than just detection, giving clinicians and monitoring programs more insight into exposure, dosage trends, and user behavior over time in kratom use assessment.

Urine
Urine Collection
Also Known As: Drug Monitoring Mitragynine Quantitative Urine Test
Add to