Interpretation of UDT

Summary of Urine Drug Testing Immunoassay Result Interpretation

Drug PanelDetects WellDetects when in High LevelsClinical PearlsCommon False Positives
Opiates and MorphineMorphine
Codeine
Heroin
Buprenorphine
Hydrocodone (unlikely)
Hydromorphone (unlikely)
Oxycodone (unlikely)
Oxymorphone (unlikely)
Nalorphine (unlikely)
Procaine (unlikely)
Thebaine (unlikely)
Naloxone (been reported)
Both heroin and codeine metabolize into morphine

Will detect semi-synthetic opioids when in high concentration (ie: oxycodone, buprenorphine) but never synthetic opioids (ie: fentanyl, methadone)
Dextromethorphan
Poppy seeds
Levorphanol
Quinine
Fluoroquinolones (have been reported)
Promethazine (highly unlikely)
Trimipramine (unlikely)
Rifampin, rifampicin (have been reported)
OxycodoneOxycodone
Oxymorphone
Hydrocodone
Hydromorphone
Naloxone
Oxymorphone, oxycodone’s primary metabolite, also highly detectedLevorphanol
Naltrexone
BuprenorphineBuprenorphine
Norbuprenorphine
Morphine
Heroin
Methadone
Tramadol
Detects buprenorphine and related metabolites (ie norbuprenorphine) with high sensitivityDextromethorphan
Poppy seeds
Codeine
Amisulpride
Sulpiride
Quinine
Fluoroquinolones (have been reported)
Rifampin, rifampicin (have been reported)
EDDPEDDPMethadone (highly unlikely)
Norfentanyl (highly unlikely)
Methadone is highly metabolized into EDDP once in the bodyDextromethorphan
Diphenhydramine
Doxylamine (NyQuil)
Meperidine (highly unlikely)
Phencyclidine (highly unlikely)
Promazine (unlikely)
Promethazine (unlikely)
Prothipendyl (unlikely)
Prozine
Phenytoin (unlikely)
Tapentadol
Theophylline (unlikely)
Quetiapine
Verapamil and metabolites
FentanylFentanyl
Norfentanyl
Low false negative rate for fentanyl and norfentanylTrazodone
BenzodiazepinesCommon benzodiazepine metaboliteAssay cannot distinguish between different benzodiazepines as assay only detects common metabolite

Lipophilic agents (ie: diazepam, temazepam, oxazepam, alprazolam, bromazepam, clobazam, desalkflurazepam, flurazepam, norchlordiazepoxide) can be detected within 36 hours of administration whereas some agents are not detected reliably at all (ie: clonazepam, lorazepam, chlordiazepoxide, clorazepate, estazolam, flurazepam, lormetazepam, medazepam, midazolam, nitrazepam, prazepam, triazolam
Oxaprozin
Sertraline
CocaineCocaine metabolite benzoylecgonine
Cocaine
Low false negative for benzoylecgonine (Cocaine metabolite), slightly higher for unmetabolized cocaineCocaine (unmetabolized)
Ecogonine
Coca leaf tea (likely)
Topical anaesthetics containing cocaine (likely)
Children receiving excessive passive exposure to cocaine smoke (likely)
AmphetaminesAmphetaminesMethamphetamines
MDMA
High rates of false positives and cross-reactions

If you are interested in detecting MDMA you should use specific panel to reliably detect it
Amantadine
Benzphetamine
Bupropion (likely)
Chlorpromazine (likely)
Clobenzorexl-Deprenyl (likely)
Desipramine (likely)
Dextroamphetamine
Doxepin (likely)
Ephedrine (likely)
Fenproporex
FluoxetineIsometheptene (likely)
Isoxsuprine
Labetalol (likely)
Methylphenidate
Phentermine
Phenylephrine (likely)
Phenylpropanolamine
Promethazine (likely)
Pseudoephedrine (likely)
Ranitidine (likely)
Ritodrine (likely)
Selegiline (likely)
Thioridazine (likely)
Trazodone (likely)
Trimethobenzamide (likely)
Trimipramine
MethamphetaminesMethamphetamine
MDMAMDMA
MDA
MDEA
Amphetamines
Methamphetamines

Urine Drug Testing Liquid/Gas Chromatography - Mass Spectrometry Possible Analytes Produced by Each Drug

DrugDrugs/metabolites that may be found on LC-MS or GC-MS
Opioids
CodeineCodeine, Codeine glucuronide, Norcodeine, Norcodeine glucuronide, Morphine, Morphine 3-glucuronide, Normorphine, Normorphine glucuronide, Hydrocodone, Hydromorphone, Dihydrocodeine
BuprenorphineBuprenorphine, Norbuprenorphine
FentanylNorfentanyl, Fentanyl
Heroin6-Monoacetylmorphine, Morphine, Morphine 3-glucuronide, Normorphine, Normorphine glucuronide, Hydromorphone
HydrocodoneHydrocodone, Hydromorphone, Norhydrocodone
HydromorphoneHydromorphone
MethadoneEDDP, Methadone
MorphineMorphine, Morphine 3-glucuronide, Normorphine, Normorphine glucuronide, Hydromorphone
OxycodoneOxycodone, Oxymorphone, Noroxycodone
Stimulants
AmphetaminesAmphetamine, Methamphetamine
CocaineCocaine (parent drug rarely observed), Benzoylecgonine, m-hydroxy Benzoylecgonine, Cocaethylene (when cocaine is used with alcohol), Levamisole (common cocaine cutting agent)
MethamphetamineMethamphetamine
TobaccoCotinine, Norcotinine, trans-3-Hydroxycotinine, Anabasine (supports active tabacco use vs nicotine replacement)
Hallucinogenics
CannabisTetrahydrocannabinol (THC), carboxy-THC
MDMAMethylenedioxyamphetamine (MDA, a MDMA metabolite), Methylenedioxyethylamphetamine (MDEA), Methylenedioxymethamphetamine (MDMA)
PhencyclidinePhencyclidine
Benzodiazepines
AlprazolamAlpha-hydroxyalprazolam
Clonazepam7-Amino-clonazepam,
DiazepamDiazepam, Temazepam, Oxazepam
FlurazepamDesalkylflurazepam, Alpha-hydroxyethylflurazepam
LorazepamLorazepam
MidazolamMidazolam, Alpha-hydroxymidazolam
OxazepamOxazepam
TemazepamTemazepam, Oxazepam
TriazolamAlpha-hydroxytriazolam
Barbiturates
BarbituratesButalbital, Phenobarbital, Secobarbital
Other
MeperidineNormeperidine, Meperidine
MethylphenidateMethylphenidate, Ritalinic acid
TapentadolTapentadol, N-Desmethyltapentadol
TramadolTramadol, O-Demethyltramadol, N-Desmethyltramadol

Urine Drug Testing Liquid/Gas Chromatography - Mass Spectrometry Possible Parent Drugs of Each Analyte

MetaboliteDrug That Can Produce Metabolite
Alpha-hydroxyalprazolamAlprazolam
Alpha-hydroxyethylflurazepamFlurazepam
Alpha-hydroxymidazolamMidazolam
Alpha-hydroxytriazolamTriazolam
7-Amino-clonazepamClonazepam
AmphetamineAmphetamines
BenzoylecgonineCocaine
BuprenorphineBuprenorphine
ButalbitalBarbituates
Cocaethylene (when cocaine is used with alcohol)Cocaine
Cocaine (parent drug rarely observed)Cocaine
Codeine glucuronideCodeine
CodeineCodeine
CotinineTobacco
DesalkylflurazepamFlurazepam
N-DesmethyltapentadolTapentadol
N-DesmethyltramadolTramadol
O-DesmethyltramadolTramadol
DiazepamDiazepam, Medazepam
DihydrocodeineCodeine
EDDPMethadone
FentanylFentanyl
HydrocodoneCodeine, Hydrocodone
HydromorphoneCodeine, Morphine, Heroin, Hydrocodone, Hydromorphone
m-hydroxy BenzoylecgonineCocaine
Levamisole (common cocaine cutting agent)Cocaine
LorazepamLorazepam
MeperidineMeperidine
MethadoneMethadone
MethamphetamineAmphetamines, Methamphetamines
Methylenedioxyamphetamine (MDA, a MDMA metabolite)MDMA
Methylenedioxyethylamphetamine (MDEA)MDMA
Methylenedioxymethamphetamine (MDMA)MDMA
MethylphenidateMethylphenidate
MidazolamMidazolam
6-MonoacetylmorphineHeroin
Morphine 3-glucuronideCodeine, Morphine, Heroin
MorphineCodeine, Morphine, Heroin
NorbuprenorphineBuprenorphine
Norcodeine glucuronideCodeine
NorcodeineCodeine
NorcotinineTobacco
NordiazepamNordiazepam
NorfentanylFentanyl
NorhydrocodoneHydrocodone
NormeperidineMeperidine
NormorphineCodeine, Morphine, Heroin
Normorphine glucuronideCodeine, Morphine, Heroin
NoroxycodoneOxycodone
OxazepamDiazepam, Medazepam, Oxazepam, Temazepam
OxycodoneOxycodone
OxymorphoneOxycodone
PhencyclidinePhencyclidine
PhenobarbitalBarbituates
Ritalinic acidMethylphenidate
SecobarbitalBarbituates
TapentadolTapentadol
TemazepamDiazepam, Medazepam, Temazepam
Tetrahydrocannabinol (THC)Cannabis
TramadolTramadol