CUT-OFF AND TOXICITY LEVELS FOR DRUGS-OF-ABUSE TESTING
CUT-OFF AND TOXICITY LEVELS FOR DRUGS-OF-ABUSE TESTING
This table summarizes information useful in the interpretation of drugs-of-abuse assays. It was originally developed by the late Daniel M. Baer, MD, and updated by Richard A. Paulson, MT(ASCP), supervisor of Chemistry and Toxicology, VA Medical Center, Portland, OR. The table has been updated annually for CLR since 2001-2002 by Robert H. Williams, PhD, D(ABCC), F(ACB), MT(ASCP), CQA(ASQ), clinical associate professor of Pathology, University of South Florida, in Tampa, FL.
Drug (and
Some common
trade name)
street names
Detectable duration Urine cut?off points
in urine after
for reporting positive
last dose
or limit of quantitation*
Toxic blood level
Blood reference (therapeutic) range
OPIATES
Heroin
Horse,
(Diacetylmorphine)
Stuff,
Smack,
Junk
1-2 days
2000 ng/mL
(total opiate) (S)(1)
(as morphine)
150 ng/mL (S)(2)
(as 6-monacetyl morphine)
18 ng/mL (C)(3)
(as 6-monacetyl morphine)
>200 ng/mL
Morphine (Duramorph)
M,
2 days
Junk,
Morpho,
White stuff
2000 ng/mL (S)(1) 300 ng/mL (C)(3)
>200 ng/mL
Methadone
Methadose
3 days
300 ng/mL
1-2 ?g/mL
(Dolophine,
200 ng/mL (C)(3)
Amidone)
Meperidine (Demerol, Pethidine)
Fortis,
2-3 days
Demies
200 ng/mL (S)(2) 200 ng/mL (C)(3)
>1000 ng/mL
Codeine (Analgesics with codeine)
Rabo,
2 days
2000 ng/mL (S)(1)
School boy 300 ng/mL (C)(3) lethal)
>1.1 ?g/mL
Propoxyphene (Darvon, Darvocet-N)
Yellow,
6 hours to 2 days
Footballs
300 ng/mL (S)(1) 200 ng/mL (C)(3)
>500 ng/mL
Oxycodone (Oxycontin, OxyIR, Percocet, Percodan)
Oxy,
1-3 days
OC,
Oxycotton,
Killer
100-500 ng/mL (S)(1) (highly variable) 100-300 ng/mL (C)(3) (highly variable)
>200 ng/mL
Hydrocodone (Lorcet, Vicodin, Lortab, Hycodan)
Vikes,
1-2 days
Hydro,
Norco
300 ng/mL (S)(1) 100 ng/mL (C)(3) 50 ng/mL (C)(4)
>100 ng/mL
Hydromorphone
Dust, Juice, Smack, 1-2 days
(Dilaudid)
D, Footballs
300 ng/mL (S)(1) 100 ng/mL (C)(3) 50 ng/mL (C)(4)
>100 ng/mL
Fentanyl (Sublimaze, Duragesic, Actiq, Fentora,)
percopop, apache, 1-2 days
1-5 ng/mL (S)(4), (S)(5)
>34 ng/mL
china girl, china white,
0.2-1 ng/mL (C)(4)
dance fever, friend,
(na?ve patients)
goodfella, jackpot,
murder 8, TNT,
Tango and Cash.
Lysergic acid, diethylamide (LSD)
Acid,
1-5 days
0.5 ng/mL (S)(1)
>2 ng/mL
Microdot,
100 pg/mL (C)(4)
White lightning
Marijuana and
Marijuana,
Single use:
cannabinoids
Hashish,
2-7 days
Bhang,
(as 9-THC-COOH)
Ganja,
Sensemilla
Prolonged use:
1-2 months
(as 9-THC-COOH)
100, 50, 25, or 20 ng/mL (S)(1) 15 ng/mL (C)(3)
50-200 ng/mL
Phencyclidine
PCP,
Angel dust,
Killer weed,
Hog
Single use: 1 week
Prolonged use: 2-4 weeks
25 ng/mL (S)(1) 25 ng/mL (C)(3)
1 mg/mL
None detected
65-80 ng/mL
For narcotic stabilization: 300-1000 ng/mL For pain: 50-100 ng/mL 70-500 ng/mL
13-33 ng/mL
100-400 ng/mL
10-100 ng/mL
10-40 ng/mL
10-30 ng/mL
1-3 ng/mL
>3 ng/mL
hgihvylaaribel
depends on dose
and route of
administration
None detected 5-20 ng/mL (clinical studies)
None detected
None detected
HALLUCINOGENS
STIMULANTS
Cocaine
Coke,
Crack,
Flake,
Snow
Amphetamine
Speed,
(Benzedrine,
Bennies,
Dexedrine)
Uppers,
Dexies
Methylene-3,4 dioxyMethamphetamine (MDMA)
Ecstasy, Adam, XTC, Love drug, Hug drug
Methamphetamine
Speed,
(Desoxyn,
Meth,
Methedrine)
Crystal ice,
Crank
Single use: 3 days
300 ng/mL (S)(1) 150 ng/mL (C)(3)
Prolonged use: 4 days
Single use: 48 hours
100 ng/mL (S)(1) 500 ng/mL (C)(3)
Prolonged use: 7-10 days
Single use:
3000-5000 ng/mL (S)(1)
Urine: 24 hours5 ng/mL (C)(3)
Plasma: 5-6 hours
Single use: 48 hours
Prolonged use: 7-10 days
100 ng/mL (S)(1) 500 ng/mL (C)(3)
>1 ?g/mL 0.5-1.0 ?g/mL 0.1-1.0 ?g/mL 0.1-1.0 ?g/mL
100-500 ng/mL 30-50 ng/mL 20-30 ng/mL 20-30 ng/mL
NOTE: Refer to manufacturer's insert for information on other benzodiazepines and metabolites.
*Commonly accepted cut-off values; may be different for specific jurisdictions and methods. Sensitivities to various drugs are method-specific. Sensitivity/cut-off data are from method literature and package inserts.
(S) =
Screeningcut-off (C)=Confirmationcut-offorLimitofQuantitation(LOQ)
(1) Screening single-use immunoassay device (consult package insert for specific method)
(2) High-performance liquid chromatography (HPLC)
(3) Gas Chromatography-Mass Spectrometry (GC-MS)
(4) Liquid Chromatography - Mass Spectrometry/Mass Spectrometry (LC-MS/MS)
(5) Screening single-use ELISA device - Forensic toxicology use only
8
CLR 2012-2013 ? MLO ? clr-
SEDATIVES/HYPNOTICS/ANESTHETICS
ALCOHOLS, DIOLS, & METABOLITES
BARBITURATES
Drug (and
Some common
trade name)
street names
Detectable duration Urine cut?off points
in urine after
for reporting positive
last dose
or limit of quantitation*
Toxic blood level
Pentobarbital (Nembutal)
Secobarbital (Seconal) Butabarbital (Butisol)
Butalbital (Fiorinal)
Phenobarbital
Goof balls,
2 days
Downers,
Nembies,
Yellow jackets,
Yellow submarine
Bullets,
2 days
Pink ladies,
Reds
Goof balls,
2 days
Candy,
Peanuts,
Stoppers
Goof balls,
2 days
Sleepers,
Stoppers,
Peanuts
Barbs,
1-3 weeks
Downers
425 ng/mL (S)(1) 200 ng/mL (C)(3)
200 ng/mL (S)(1) 200 ng/mL (C)(3)
312 ng/mL (S)(1) 200 ng/mL (C)(3)
342 ng/mL (S)(1) 200 ng/mL (C)(3)
505 ng/mL (S)(1) 200 ng/mL (C)(3)
>11 ?g/mL
>10 ?g/mL 20 ?g/mL 20 ?g/mL >40 ?g/mL
Ethanol
Booze,
3.0 ?g/mL
Oxazepam
Tranks,
(Serax)
Downers,
Blues,
Yellows
Single use: Not detected
Prolonged use: 5-7 days
240 ng/mL (S)(1) 100 ng/mL (C)(3)
>1.4 ?g/mL
Alprazolam
Tranks,
(Xanax)
Downers,
Blues,
Yellows
Single use: Not detected
Prolonged use: 5-7 days
240 ng/mL (S)(1) 100 ng/mL (C)(3)
>350 ng/mL
Clonazepam
Tranks,
(Klonopin)
Downers,
Blues,
Yellows
Single use: Not detected
Prolonged use: 5-14 days
540 ng/mL (S)(1) 100 ng/mL (C)(3)
>80 ng/mL
Chlordiazepoxide
Tranks,
(Librium)
Downers,
Blues,
Yellows
Single use: Not detected
Prolonged use: 5-7 days
600 ng/mL (S)(2) 100 ng/mL (C)(3)
>23 ?g/mL
Lorazepam
Tranks,
Single use:
675 ng/mL (S)(1)
(Ativan,
Downers,
Not detected
100 ng/mL (C)(3)
Loraz)
Blues,
Yellows
Prolonged use:
5-7 days
Flunitrazepam
Roofies,
72 hours
12-60 ng/mL (S)(1)
(Rohypnol)
Rib,
(Immunoassay)
Rope,
100 pg/mL (C)(4)
Roach-2,
R-2
0.3-0.6 ?g/mL 0.05-0.24 ?g/mL
50 ng/mL (GC-MS; LC-MS/MS)
GammaHydroxybutyrate (Somatomax)
GHB,
12 hours
1-10 mg/L
G-Caps,
(GC; GC-MS)
Geebers,
Fantasy,
Liquid Ecstasy
>250 mg/L (GC-MS)
Ketamine Hydrochloride (Ketajet)
Special K,
7-27 ?g/mL
Lady Kay,
(Immunoassay)
(highly variable)
Vitamin K,
5-10 ng/mL (GC-MS)
Jet,
Cat Valium
Blood reference (therapeutic) range
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