DOA Tests - Drugs of Abuse Testing

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• Drug Detection - How long do drugs stay in the human body?

• DOA Info - Important information on other Drugs of Abuse.

• Drug Test FAQ - Frequently asked questions about drug testing.

• Glossary Of Drug Terms - A Glossary of terms (definitions) applicable to the subjects of drug testing and pharmacology.

• How To Use Drug Tests - Complete instructions on how to use various drug testing kits.

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Transmetron offers only the highest quality, instant drug test kits and supplies. Our tests are the same tests used by hospitals and clinics. Each test is FDA approved, easy to use and easy to read. We offer instant drug test dips, cassettes ( devices ), saliva drug tests, integrated drug test cups, breath alcohol and saliva alcohol tests. Our urine drug screen test kits can test for the following drugs: amphetamine ( AMP ), barbiturates, benzodiazepines ( BZO ), cocaine ( COC ), marijuana ( THC ), methadone ( MTD ), methamphetamine ( mAMP ) - meth, methylenedioxymethamphetamine ( MDMA ), morphine, opiate, opiates, phencyclidine ( PCP ), and tricyclic antidepressants ( TCA ). When you need to know, TRANSMETRON is the way to go!

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		One Step Single/Multi-Drug Screen Test Panel Package Insert for 1 to 10 Drug Screen Panel “Dip” Instruction Sheet for testing of any combination of the following drugs: AMP, BAR, BZO, COC,THC, MTD , mAMP, OPI, PCP AND TCA Amphetamine (AMP) Barbiturates (BAR) Benzodiazepines (BZO) Cocaine (COC) Marijuana (THC) Methadone (MTD) Methamphetamine (mAMP) Opiate (300 ng/ml) (OPI 300 or MOP 300) Opiate (OPI) (2000 ng/ml) Phencyclidine Tricyclic Antidepressant (TCA) Non Cross-Reacting Compounds A rapid, one step screening test for the simultaneous, qualitative detection of multiple drugs and drug metabolites in human urine. For healthcare professionals and professionals at point of care sites. For professional in vitro diagnostic use. INTENDED USE Back To Top The One Step Multi-Drug Screen Test Panel is a lateral flow chromatographic immunoassay for the qualitative detection of multiple drugs and drug metabolites in urine at the following cut-off concentrations: 300 ng/mL Benzoylecgonine (Cocaine metabolite), 1,000 ng/mL Amphetamine, 1,000 ng/mL Methamphetamine, 50 ng/mL 11-nor-.9 -THC-9- COOH (THC), 2,000 ng/mL Opiate, 25 ng/mL Phencyclidine, in urine. This assay provides only a preliminary analytical test result. A more specific alternate chemical method must be used in order to obtain a confirmed analytical result. Gas chromatography/mass spectrometry (GC/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are used. SUMMARY Back To Top AMPHETAMINE (AMP) Amphetamine is a Schedule II controlled substance available by prescription (Dexedrine®) and is also available on the illicit market. Amphetamines are a class of potent sympathomimetic agents with therapeutic applications. They are chemically related to the human body’s natural catecholamines: epinephrine and norepinephrine. Acute higher does lead to enhanced stimulation of the central nervous system and induce euphoria, alertness, reduced appetite, and a sense of increased energy and power. Cardiovascular responses to Amphetamines include increased blood pressure and cardiac arrhythmias. More acute responses produce anxiety, paranoia, hallucinations, and psychotic behavior. The effects of Amphetamines generally last 2-4 hours following use, and the drug has a halflife of 4-24 hours in the body. About 30% of Amphetamines are excreted in the urine in unchanged form, with the remainder as hydroxylated and deaminated derivatives. The AMP One Step Amphetamine Test Strip is a rapid urine screening test that can be performed without the use of an instrument. The test utilizes a monoclonal antibody to selectively detect elevated levels of Amphetamine in urine. The AMP One Step Amphetamine Test Strip yields a positive result when Amphetamines in urine exceed 1,000 ng/mL. BARBITURATES (BAR) Barbiturates are central nervous system depressants. They are used therapeutically as sedatives, hypnotics, and anticonvulsants. Barbiturates are almost always taken orally as capsules or tablets. The effects resemble those of intoxication with alcohol. Chronic use of barbiturates leads to tolerance and physical dependence. Short acting Barbiturates taken at 400mg/day for 2-3 months produces a clinically significant degree of physical dependence. Withdrawal symptoms experienced during periods of drug abstinence can be severe enough to cause death. Only a small amount (less than 5%) of most Barbiturates are excreted unaltered in urine. The approximate detection time limits for Barbiturates are: Short Acting (e.g. Secobarbital) 100 mg PO (oral) 4 – 5 days Long Acting (e.g. Phenobarbital 400 mg PO (oral) 7 days1 The One Step Drug Screen Test yields a positive result when the Barbiturates in urine exceeds 300ng/ml. BENZODIAZEPINES (BZO) Benzodiazepines are medications that are frequently prescribed for symptomatic treatment of anxiety and sleep disorders. They produce their effects via specific receptors involving a neurochemical called gamma aminobutyric acid (GABA). Because they are safer and more effective, Benzodiazepines have replaced barbiturates in the treatment of both anxiety and insomnia. Benzodiazepines are also used as sedatives before some surgical and medical procedures, and for the treatment of seizure disorders and alcohol withdrawal. Risk of physical dependence increases if Benzodiazepines are taken regularly (e.g., daily) for more than a few months, especially at higher than normal doses. Stopping abruptly can bring on such symptoms trouble sleeping, gastrointestinal upset, feeling unwell, loss of appetite, sweating and trembling, weakness, anxiety and changes in perception. Only trace amounts (less than 1%) of most Benzodiazepines are excreted unaltered in urine; most of the concentration in urine is conjugated drug. The detection period for the Benzodiazepines in urine is 3 – 7 days. The One Step Drug screen Test Card yields a positive result when the Benzodiazepines in urine exceeds 300 ng/ml. COCAINE (COC) Cocaine is a potent central nervous system (CNS) stimulant and a local anesthetic. Initially, it brings about extreme energy and restlessness while gradually resulting in tremors, over-sensitivity and spasms. In large amounts, cocaine causes fever, unresponsiveness, and difficulty in breathing and unconsciousness. Cocaine is often self-administered by nasal inhalation, intravenous injection and free-base smoking. It is excreted in the urine in a short time primarily as Benzoylecgonine1,2. Benzoylecgonine, a major metabolite of cocaine, has a longer biological half-life (5-8 hours) than cocaine (0.5-1.5 hours), and can generally be detected for 24-48 hours after cocaine exposure2. The COC One Step Cocaine Test Strip is a rapid urine screening test that can be performed without the use of an instrument. The test utilizes a monoclonal antibody to selectively detect elevated levels of cocaine metabolite in urine. The COC One Step Cocaine Test Strip yields a positive result when the cocaine metabolite in urine exceeds 300 ng/mL. This is the suggested screening cut-off for positive specimens set by the Substance Abuse and Mental Health Services Administration (SAMHSA, USA). MARIJUANA (THC) THC (.9--tetrahydrocannabinol) is the primary active ingredient in cannabinoids (marijuana). When smoked or orally administered, it produces euphoric effects. Users have impaired short term memory and slowed learning. They may also experience transient episodes of confusion and anxiety. Long term relatively heavy use may be associated with behavioral disorders. The peak effect of smoking marijuana occurs in 20-30 minutes and the duration is 90-120 minutes after one cigarette. Elevated levels of urinary metabolites are found within hours of exposure and remain detectable for 3-10 days after smoking. The main metabolite excreted in the urine is 11-nor-.9-tetrahydrocannabinol-9-carboxylic acid (.9-THC-COOH). The THC One Step Marijuana Test Strip is a rapid urine screening test that can be performed without the use of an instrument. The test utilizes a monoclonal antibody to selectively detect elevated levels of marijuana in urine. The THC One Step Marijuana Test Strip yields a positive result when the concentration of marijuana in urine exceeds 50 ng/mL. This is the suggested screening cut-off for positive specimens set by the Substance Abuse and Mental Health Services Administration (SAMHSA, USA). 3 METHADONE (MTD) Methadone is a narcotic pain reliever for medium to severe pain. It is also used in the treatment of heroin (opiate dependence: Vicodin, Percocet, Morphine, etc.) addiction. Oral Methadone is very different than IV Methadone. Oral Methadone is partially stored in the liver for late use. IV Methadone acts more like heroin. In most states you must go to a pain clinic or a Methadone maintenance clinic to be prescribed Methadone. Methadone is a long acting pain reliever producing effects that last from twelve to forth-eight hours. Ideally, Methadone frees the client from the pressures of obtaining illegal heroin, from the dangers of injection and from the emotional roller coaster that most opiates produce. Methadone, if taken for long periods and at large doses, can lead to a very long withdrawal period. The withdrawals from Methadone are more prolonged and troublesome than those provoked by heroin cessation, yet the substitution and phased removal of methadone is an acceptable method of detoxification for patients and therapists.1 The MTD One step Methadone test yields a positive result when Methadone in urine exceeds 300 ng/ml. METHAMPHETAMINE (mAMP) Methamphetamine is an addictive stimulant drug that strongly activates certain systems in the brain. Methamphetamine is closely related chemically to amphetamine, but the central nervous system effects of Methamphetamine are greater. Methamphetamine is made in illegal laboratories and has a high potential for abuse and dependence. The drug can be taken orally, injected, or inhaled. Acute higher does lead to enhanced stimulation of the central nervous system and induce euphoria, alertness, reduced appetite, and a sense of increased energy and power. Cardiovascular responses to Methamphetamine include increased blood pressure and cardiac arrhythmias. More acute responses produce anxiety, paranoia, hallucinations, psychotic behavior, and eventually, depression and exhaustion. The effects of Methamphetamine generally last 2-4 hours and the drug has a half-life of 9-24 hours in the body. Methamphetamine is excreted in the urine primarily as amphetamine and oxidized and deaminated derivatives. However, 10-20% of Methamphetamine is excreted unchanged. Thus, the presence of the parent compound in the urine indicates Methamphetamine use. Methamphetamine is generally detectable in the urine for 3-5 days, depending on urine pH level. The mAMP One Step Methamphetamine Test Strip is a rapid urine screening test that can be performed without the use of an instrument. The test utilizes a monoclonal antibody to selectively detect elevated levels of Methamphetamine in urine. The mAMP One Step Methamphetamine Test Strip yields a positive result when the Methamphetamine in urine exceeds 1,000 ng/mL. OPIATE (300 ng/ml) (OPI 300 or MOP 300) Opiate refers to any drug that is derived from the opium poppy, including the natural products, morphine and codeine, and the semi-synthetic drugs such as heroin. Opioid is more general, referring to any drug that acts on the opioid receptor. Opioid analgesics comprise a large group of substances which control pain by depressing the central nervous system. Large dose of morphine can produce higher tolerance levels, physiological dependency in users, and may lead to substance abuse. Morphine is excreted unmetabolized, and is also the major metabolic product of codeine and heroin. Morphine is detectable in the urine for several days after an opiate dose.4 The OPI One Step Opiate Test Strip is a rapid urine screening test that can be performed without the use of an instrument. The test utilizes a monoclonal antibody to selectively detect elevated levels of morphine in urine. The OPI One Step Opiate Test Strip yields a positive result when the morphine in urine exceeds 300 ng/mL. OPIATE (OPI) (2000 ng/ml) Opiate refers to any drug that is derived from the opium poppy, including the natural products, morphine and codeine, and the semi-synthetic drugs such as heroin. Opioid is more general, referring to any drug that acts on the opioid receptor. Opioid analgesics comprise a large group of substances which control pain by depressing the central nervous system. Large dose of morphine can produce higher tolerance levels, physiological dependency in users, and may lead to substance abuse. Morphine is excreted unmetabolized, and is also the major metabolic product of codeine and heroin. Morphine is detectable in the urine for several days after an opiate dose.4 The OPI One Step Opiate Test Strip is a rapid urine screening test that can be performed without the use of an instrument. The test utilizes a monoclonal antibody to selectively detect elevated levels of morphine in urine. The OPI One Step Opiate Test Strip yields a positive result when the morphine in urine exceeds 2,000 ng/mL. This is the suggested screening cut-off for positive specimens set by the Substance Abuse and Mental Health Services Administration (SAMHSA, USA). PHENCYCLIDINE Phencyclidine, also known as PCP or Angel Dust, is a hallucinogen that was first marketed as a surgical anesthetic in the 1950’s. It was removed from the market because patients receiving it became delirious and experienced hallucinations. Phencyclidine is used in powder, capsule, and tablet form. The powder is either snorted or smoked after mixing it with marijuana or vegetable matter. Phencyclidine is most commonly administered by inhalation but can be used intravenously, intra-nasally, and orally. After low doses, the user thinks and acts swiftly and experiences mood swings from euphoria to depression. Self-injurious behavior is one of the devastating effects of Phencyclidine. PCP can be found in urine within 4 to 6 hours after use and will remain in urine for 7 to 14 days, depending on factors such as metabolic rate, user’s age, weight, activity, and diet.5 Phencyclidine is excreted in the urine as an unchanged drug (4% to 19%) and conjugated metabolites (25% to 30%).6 The PCP One Step Phencyclidine Test Strip is a rapid urine screening test that can be performed without the use of an instrument. The test utilizes a monoclonal antibody to selectively detect elevated levels of phencyclidine metabolite in urine. The PCP One Step Phencyclidine Test Strip yields a positive result when the phencyclidine metabolite in urine exceeds 25 ng/mL. This is the suggested screening cut-off for positive specimens set by the Substance Abuse and Mental Health Services Administration (SAMHSA, USA). TRICYCLIC ANTIDEPRESSANT (TCA) TCA (Tricyclic Antidepressants) are commonly used for the treatment of depressive disorders. TCA overdoses can result in profound central nervous system depression, cardiotoxicity and anticholinergic effects. TCA overdose is the most common cause of death from prescription drugs. TCAs are taken orally or sometimes by injection. TCAs are metabolized in the liver. Both TCAs and their metabolites are excreted in urine mostly in the form of metabolites for up to ten days. The One Step Drug Screen Tests yields a positive result when the Tricyclic Antidepressant in urine exceeds 1,000 ng/ml. PRINCIPLE Back To Top The One Step Multi-Drug Screen Test Panel is an immunoassay based on the principle of competitive binding. Drugs which may be present in the urine specimen compete against their respective drug conjugate for binding sites on their specific antibody. During testing, a urine specimen migrates upward by capillary action. A drug, if present in the urine specimen below its cut-off concentration, will not saturate the binding sites of its specific antibody. The antibody will then react with the drug-protein conjugate and a visible colored line will show up in the test line region of the specific drug strip. The presence of drug above the cut-off concentration will saturate all the binding sites of the antibody. Therefore, the colored line will not form in the test line region. A drug-positive urine specimen will not generate a colored line in the specific test line region of the strip because of drug competition, while a drug-negative urine specimen will generate a line in the test line region because of the absence of drug competition. To serve as a procedural control, a colored line will always appear at the control line region, indicating that proper volume of specimen has been added and membrane wicking has occurred. REAGENTS Back To Top The test panel contains specific mouse monoclonal antibody, goat polyclonal antibody and drug protein conjugates. PRECAUTIONS Back To Top • For healthcare professionals and professionals at point of care sites. • For in vitro diagnostic use only. Do not use after the expiration date. • The test panel should remain in the sealed pouch until use. • All specimens should be considered potentially hazardous and handled in the same manner as an infectious agent. • The used test panel should be discarded according to federal, state and local regulations STORAGE AND STABILITY Kit can be stored at room temperature or refrigerated at 2-30°C. The test panel is stable through the expiration date printed on the sealed pouch. The test panel must remain in the sealed pouch until use. DO NOT FREEZE. Do not use beyond the expiration date. MATERIALS PROVIDED • Test panels • Package insert MATERIALS REQUIRED BUT NOT PROVIDED • Specimen collection container • External controls • Timer PREPARATION URINE ASSAY The urine specimen must be collected in a clean and dry container. Urine collected at any time of the day may be used. Urine specimens exhibiting visible precipitates should be centrifuged, filtered, or allowed to settle to obtain a clear supernatant for testing. SPECIMEN STORAGE Urine specimens may be stored at 2-8°C for up to 48 hours prior to testing. For prolonged storage, specimens may be frozen and stored below -20°C. Frozen specimens should be thawed and mixed well before testing. QUALITY CONTROL Back To Top A procedural control is included in the test. A colored line appearing in the control region (C) is considered an internal procedural control. It confirms sufficient specimen volume, adequate membrane wicking and correct procedural technique. Control standards are not supplied with this kit. However, it is recommended that positive and negative controls be tested as good laboratory practice to confirm the test procedure and to verify proper test performance. LIMITATIONS Back To Top 1. The One Step Multi-Drug Screen Test Panel provides only a qualitative, preliminary analytical result. A secondary analytical method must be used to obtain a confirmed result. Gas chromatography and mass spectrometry (GC/MS) is the preferred confirmatory method. 3,4,7 2. There is a possibility that technical or procedural errors, as well as other interfering substances in the urine specimen may cause erroneous results. 3. Adulterants, such as bleach and/or alum, in urine specimens may produce erroneous results regardless of the analytical method used. If adulteration is suspected, the test should be repeated with another urine specimen. 4. A Positive result does not indicate level or intoxication, administration route or concentration in urine. 5. A Negative result may not necessarily indicate drug-free urine. Negative results can be obtained when drug is present but below the cut-off level of the test. 6. Test does not distinguish between drugs of abuse and certain medications. PERFORMANCE CHARACTERISTICS - ACCURACY Back To Top A side-by-side comparison was conducted using The One Step Single Drug Test and commercially available drug rapid tests. Testing was performed on approximately 300 specimens previously collected from subjects presenting for Drug Screen Testing. Presumptive positive results were confirmed by GC/MS. The following compounds were quantified by GC/MS and contributed to the total amount of drugs found in presumptive positive urine samples tested. TEST Compounds Contributed to the Totals of GC/MS AMP Amphetamine BAR Secobarbital, Butalbital, Phenobarbital, Pentobarbital BZO Oxazepam, Nordiazepam, a-OH-Alprazolam, Desalklflurazepam COC Benzoylecgonine THC 11-nor-.9-tetrahydrocannabinol-carboxylic acid TEST Compounds Contributed to the Totals of GC/MS MTD Methadone mAMP Methamphetamine OPI Morphine, Codeine PCP Phencyclidine TCA Nortriptyline The following results are tabulated from these clinical studies: Forty (40) clinical samples for each drug were run using each of the One Step Single Drug tests by an untrained operator at a Professional Point of Care site. Based on GC/MS data, the operator obtained statistically similar Positive Agreement, Negative Agreement and Overall Agreement rates as trained Laboratory personnel. *Note: TCA was based on HPLC data. Precision Back To Top A study was conducted at three physician offices by untrained operators using three different lots of product to demonstrate the within run, between run and between operator precision. An identical panel of coded specimens, containing drugs at the concentration of ± 50% and ± 25% cut-off level, was labeled as a blind and tested at each site. The results are given below: Analytical Sensitivity Back To Top A drug-free urine pool was spiked with drugs to the concentrations at ± 50% cut-off and ± 25% cut-off. The results are summarized below. Drug conc. (Cut-off range) n AMP BAR BZO COC THC MTD mAMP OPI PCP TCA - + - + - + - + - + - + - + - + - + - + 0% Cut-off 30 30 0 30 0 30 0 30 0 30 0 30 1 30 0 30 0 30 0 30 0 -50% Cut-off 30 30 0 30 0 30 0 30 0 30 0 29 1 30 0 30 0 30 0 30 0 -25% Cut-off 30 30 0 27 3 26 4 30 0 12 1 24 6 30 0 30 0 19 11 22 8 Cut-off 30 18 12 22 8 12 18 4 26 1 29 21 9 18 12 30 17 16 14 12 18 +25% Cut-off 30 1 29 7 23 3 27 0 30 1 29 2 28 1 29 30 26 6 24 7 23 +50% Cut-off 30 0 30 2 28 0 30 0 30 0 30 0 30 0 30 0 30 0 30 0 30 Analytical Specificity Back To Top The following table lists the concentration of compounds (ng/mL) that are detected positive in urine by The One Step Multi-Drug Screen Test Panel at 5 minutes. AMPHETAMINE D-Amphetamine 1,000 D,L-Amphetamine sulfate 3,000 L-Amphetamine 50,000 (±)3,4-Methylenedioxyamphetamine 2,000 Phentermine 3,000 Secobarbital 300 Amobarbital 300 Alphenol 150 Aprobarbital 200 Butalbital 75 Butethal 2500 Cyclopentobarbital 100 Pentobarbital 600 Phenobarbital 300 Benzodiazepines Oxazepam 300 Alprazolam 196 a-Hydroxyalprazolam 1262 Bromazepam 1562 Chlordiazepoxide 1562 Chlordiazepoxide HCI 781 Clobazam 98 Clonazepam 781 Clorazepate dipotassium 195 Delorazepam 1562 Desalkyflurazepam 390 Diazepam 195 Estazolam 2500 Flunitrazepam 390 ( + ) Lorazepam 1562 RS-Lorazepam glucuronide 156 Midazolam 12500 Nitrazepam 98 Norchlordiazepoxide 195 Nordiazepam 390 Temazepam 98 Triazolam 2500 COCAINE ng/ml Benzoylecgonine 300 Cocaine HCl 780 Cocaethylene 12,500 Ecgonine HCl 32,000 MARIJUANA (THC) 11-nor-.9 -THC-9 COOH 50 Cannabinol 20,000 11-nor-.8-THC-9 COOH 30 .8 -THC 15,000 .9 -THC 15,000 Methadone Methadone 300 Doxylamine 50000 METHAMPHETAMINE D-Methamphetamine 1,000 ñ-Hydroxymethamphetamine 30,000 L-Methamphetamine 8,000 (±)-3,4-Methylenedioxymethamphetamine 2,000 Mephentermine 50,000 OPIATES ng/ml Morphine 2,000 Codeine 2,000 Ethylmorphine 5,000 Hydrocodone 12,500 Hydromorphone 5,000 Levophanol 75,000 6-Monoacetylmorphine 5,000 Morphine 3-â-D-glucuronide 2,000 Norcodeine 12,500 Normorphone 50,000 Oxycodone 25,000 Oxymorphone 25,000 Procaine 150,000 Thebaine 100,000 PCP Phencyclidine 25 4-Hydroxyphencyclidine 12,500 TCA Nortriptyline 1,000 Nordoxepine 1,000 Trimipramine 3,000 Amitriptyline 1,500 Promazine 1,500 Desipramine 200 Imipramine 400 Clomipramine 12,500 Doxepin 2,000 Maprotiline 2,000 Promethazine 25,000

Effect of Urinary Specific Gravity

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Fifteen (15) urine samples of normal, high, and low specific gravity ranges (1.000-1.037) were spiked with drugs at 50% below and 50% above cut-off levels respectively. The Multi-Drug Screen Test was tested in duplicate using fifteen drug-free urine and spiked urine samples. The results demonstrate that varying ranges of urinary specific gravity does not affect the test results.

Effect of the Urinary pH

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The pH of an aliquoted negative urine pool was adjusted to a pH range of 5 to 9 in 1 pH unit increments and spiked with drugs at 50% below and 50% above cut-off levels. The spiked, pH-adjusted urine was tested with The One Step Multi-Drug Screen Test Panel. The results demonstrate that varying ranges of pH does not interfere with the performance of the test.

Cross-Reactivity

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A study was conducted to determine the cross-reactivity of the test with compounds in either drug-free urine or Cocaine, Amphetamine, Methamphetamine, Marijuana, Opiate or Phencyclidine positive urine. The following compounds show no cross-reactivity when tested with the One Step Multi-Drug Screen Test Panel at a concentration of 100 µg/mL.

Non Cross-Reacting Compounds

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