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Test Code MTDNX Methadone Confirmation, Chain of Custody, Random, Urine

Reporting Name

Methadone Confirmation, CoC, U

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Monitoring for compliance of methadone treatment for analgesia or drug rehabilitation

 

Assessing compliance with rehabilitation programs

 

Chain of custody is required whenever the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that it was always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.

Method Name

Immunoassay/Gas Chromatography Mass Spectrometry (GC-MS)


Specimen Required


Supplies: Chain of Custody Kit (T282)

Container/Tube: Chain-of-custody kit containing the specimen containers, seals, and documentation required.

Specimen Volume: 10 mL

Collection Instructions: Collect urine specimen in the container provided, seal, and submit with the associated documentation to satisfy the legal requirements for chain-of-custody testing.

Additional Information: Submitting less than 10 mL will compromise our ability to perform all necessary testing.


Specimen Type

Urine

Specimen Minimum Volume

2.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  14 days

Reject Due To

Gross hemolysis OK
Gross icterus OK

Reference Values

Negative

Positives are reported with a quantitative gas chromatography mass spectrometry result.

 

IMMUNOASSAY SCREEN

<300 ng/mL

 

Cutoff concentrations:

METHADONE BY GC-MS

<100 ng/mL

2-ETHYLIDENE-1,5-DIMETHYL-3,3-DIPHENYLPYRROLIDINE GC-MS

<100 ng/mL

Interpretation

The absolute concentration of methadone and its metabolites found in patient urine specimens can be highly variable and does not correlate with dose. However, the medical literature and our experience show that patients who are known to be compliant with their methadone therapy have ratios of 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP):methadone of greater than 0.60.(7)

 

An EDDP:methadone ratio less than

Day(s) Performed

Tuesday, Thursday

Report Available

3 to 7 days

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80358

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MTDNX Methadone Confirmation, CoC, U 104626-7

 

Result ID Test Result Name Result LOINC Value
21105 Methadone Immunoassay Screen 70149-0
36208 EDDP-by GC-MS 58429-2
36209 Methadone-by GC-MS 16246-1
36210 Methadone Interpretation 69050-3
36211 Chain of Custody 77202-0

Forms

1. Chain of Custody Request is included in the Chain-of-Custody Kit (T282).

2. If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Additional Tests

Test ID Reporting Name Available Separately Always Performed
COCH Chain of Custody Processing No Yes
ADLTX Adulterants Survey, CoC, U Yes Yes

Testing Algorithm

Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.