CLIENT NOTICE: CHANGES TO URINE DRUGS OF ABUSE (DOA) IMMUNOASSAY SCREENING March 2015 Danijela Konforte, PhD FCACB Clinical Biochemist, ON LifeLabs Effective March 23rd 2015, LifeLabs (formerly CML) will implement new technology for urine drugs of abuse (DOA) immunoassay screens and plasma ethanol testing. As a reminder, specimen collection at LifeLabs is not done using chain of custody processes and results must be used for medical purposes only. In parallel, LifeLabs will implement reporting changes to improve layout and include interpretive messages related to potential causes of false positive and false negative results. Example reports are provided for your perusal (please see Appendix). What do changes to urine DOA screening technology mean to LifeLabs’ clients? 1. No change to the DOA screen menu whether it is ordered on its own (OHIP- L078), or in context of Broad Spectrum Toxicology Screen (OHIP-L079): Urine DOA screen will continue to include Amphetamines, Benzodiazepines, THC, Cocaine Metabolite (BEG), Opiates, Oxycodone, Methadone metabolite (EDDP), and ethanol Urine Barbiturate screen will be tested only when specifically requested on the OHIP requisition 2. No change in analytical specificity for any DOA screens. 3. No change to drug detection limits (cut-offs) except for Benzodiazepines, Cocaine metabolite, and Barbiturates which are lowered to 200 ug/L, 150 ug/L and 200 ug/L, respectively, for improved sensitivity (See Table 1). 4. Urine DOA screen result reporting is now qualitative: Results at or above the method’s detection limit will be reported as ‘Detected’ Results below the method’s detection limit will be reported as ‘Not Detected’ Note: Qualitative reporting for medical urine DOA screens is the standard of practice in Canada. Quantitative reporting is required only for legal and forensic urine testing. LifeLabs is excited to implement these changes to urine DOA testing and reporting. If you have any questions, please consult with a member of the LifeLabs Medical/Scientific Biochemistry team at 1-877-404-0637. We welcome your feedback! 1/2 Table 1. Drugs included in urine DOA screen on the Siemens ADVIA 2400 Testing Platform Urine Drug/Drug Class Immunoassay method Detection Limit Amphetamine/Ecstasy CEDIA (Thermo Scientific) 1000 ug/L Benzodiazepines EMIT (Siemens) 200 ug/L Cannabinoids (THC) EMIT (Siemens) 50 ug/L Cocaine Metabolite (Benzoylecgonine-BEG) EMIT (Siemens) 150 ug/L Opiates EMIT (Siemens) 300 ug/L EDDP (Methadone metabolite) CEDIA (Thermo Scientific) 100 ug/L Oxycodone EMIT (DRI-Thermo Scientific) 100 ug/L Barbiturates EMIT (Siemens) 200 ug/L Ethanol Enzymatic 2 mmol/L CEDIA – Cloned Enzyme Donor Immunoassay Technology – Homogenous Competitive Immunoassay; EMIT – Enzyme Multiplied Immunoassay Technology – Homogenous Competitive Immunoassay 2/2
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