Cut-Off And Toxicity Levels Chart For Drugs-Of-Abuse Testing printable pdf download

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

Drug (and

Some common

Detectable duration

Urine cut–off points

Toxic

Blood reference

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

trade name)

street names

in urine after

for reporting positive

blood level

(therapeutic) range

of South Florida, in Tampa, FL.

last dose

or limit of quantitation*

Pentobarbital

Goof balls,

2 days

425 ng/mL (S)(1)

>11 µg/mL

<10 µg/mL

Drug (and

Some common

Detectable duration

Urine cut–off points

Toxic

Blood reference

(Nembutal)

Downers,

200 ng/mL (C)(3)

trade name)

street names

in urine after

for reporting positive

blood level

(therapeutic) range

Nembies,

last dose

or limit of quantitation*

Yellow jackets,

Yellow submarine

Heroin

Horse,

1-2 days

2000 ng/mL

>200 ng/mL

None detected

Secobarbital

Bullets,

2 days

200 ng/mL (S)(1)

>10 µg/mL

1-5 µg/mL

(Diacetylmorphine)

Stuff,

(total opiate) (S)(1)

(as morphine)

(Seconal)

Pink ladies,

200 ng/mL (C)(3)

Smack,

150 ng/mL (S)(2)

Reds

Junk

(as 6-monacetyl morphine)

18 ng/mL (C)(3)

Butabarbital

Goof balls,

2 days

312 ng/mL (S)(1)

20 µg/mL

3-25 µg/mL

(as 6-monacetyl morphine)

(Butisol)

Candy,

200 ng/mL (C)(3)

Peanuts,

Morphine

2 days

2000 ng/mL (S)(1)

>200 ng/mL

65-80 ng/mL

Stoppers

(Duramorph)

Junk,

300 ng/mL (C)(3)

Morpho,

Butalbital

Goof balls,

2 days

342 ng/mL (S)(1)

20 µg/mL

5-15 µg/mL

White stuff

(Fiorinal)

Sleepers,

200 ng/mL (C)(3)

Stoppers,

Methadone

Methadose

3 days

300 ng/mL

1-2 µg/mL

For narcotic stabilization:

Peanuts

(Dolophine,

200 ng/mL (C)(3)

300-1000 ng/mL

Amidone)

For pain: 50-100 ng/mL

Phenobarbital

Barbs,

1-3 weeks

505 ng/mL (S)(1)

>40 µg/mL

10-40 µg/ml

Downers

200 ng/mL (C)(3)

Meperidine

Fortis,

2-3 days

200 ng/mL (S)(2)

>1000 ng/mL

70-500 ng/mL

(Demerol, Pethidine)

Demies

200 ng/mL (C)(3)

Ethanol

Booze,

<1 day

10 mg/dL

80-400 mg/dL

100-150 mg/dL

Hooch

(for treatment of toxic

Codeine

Rabo,

2 days

2000 ng/mL (S)(1)

>1.1 µg/mL

13-33 ng/mL

alcohols)

(Analgesics with

School boy

300 ng/mL (C)(3) lethal)

codeine)

Methanol

Wood

<1 day

5 mg/dL (GC)

>20 mg/dL

<0.5 mg/dL

Propoxyphene

Yellow,

6 hours to 2 days

300 ng/mL (S)(1)

>500 ng/mL

100-400 ng/mL

alcohol

(Darvon,

Footballs

200 ng/mL (C)(3)

Isopropanol

Rubbing

<1 day

5 mg/dL (GC)

>50 mg/dL

None detected

Darvocet-N)

alcohol

Oxycodone

Oxy,

1-3 days

100-500 ng/mL (S)(1)

>200 ng/mL

10-100 ng/mL

Acetone

<1 day

5 mg/dL (GC)

>33 mg/dL (GC)

<1.0 mg/dL

(Oxycontin,

OC,

(highly variable)

OxyIR, Percocet,

Oxycotton,

100-300 ng/mL (C)(3)

Percodan)

Killer

(highly variable)

Ethylene Glycol

Antifreeze

<1 day

5 mg/dL (GC)

>50 mg/dL (GC)

None detected

Hydrocodone

Vikes,

1-2 days

300 ng/mL (S)(1)

>100 ng/mL

10-40 ng/mL

(Lorcet, Vicodin,

Hydro,

100 ng/mL (C)(3)

Diazepam

Tranks,

Single use:

160 ng/mL (S)(1)

Drug plus

Lortab, Hycodan)

Norco

50 ng/mL (C)(4)

(Valium)

Downers,

Not detected

100 ng/mL (C)(3)

Metabolite:

Blues,

>3.0 µg/mL

0.2-2.0 µg/mL

Hydromorphone

Dust, Juice, Smack,

1-2 days

300 ng/mL (S)(1)

>100 ng/mL

10-30 ng/mL

Yellows,

Prolonged use:

(Dilaudid)

D, Footballs

100 ng/mL (C)(3)

Blue Magoo,

5-7 days

50 ng/mL (C)(4)

(up to 30 days)

Fentanyl (Sublimaze,

percopop, apache,

1-2 days

1-5 ng/mL (S)(4), (S)(5)

>34 ng/mL

1-3 ng/mL

Oxazepam

Tranks,

Single use:

240 ng/mL (S)(1)

>1.4 µg/mL

0.2-1.4 µg/mL

Duragesic, Actiq,

china girl, china white,

0.2-1 ng/mL (C)(4)

>3 ng/mL

h i g h l y v a r i a b l e

(Serax)

Downers,

Not detected

100 ng/mL (C)(3)

Fentora,)

dance fever, friend,

(naïve patients)

depends on dose

Blues,

goodfella, jackpot,

and route of

Yellows

Prolonged use:

murder 8, TNT,

administration

5-7 days

Tango and Cash.

Alprazolam

Tranks,

Single use:

240 ng/mL (S)(1)

>350 ng/mL

20-30 ng/mL

Lysergic acid,

Acid,

1-5 days

0.5 ng/mL (S)(1)

>2 ng/mL

None detected

(Xanax)

Downers,

Not detected

100 ng/mL (C)(3)

diethylamide

Microdot,

100 pg/mL (C)(4)

5-20 ng/mL

Blues,

(LSD)

White lightning

(clinical studies)

Yellows

Prolonged use:

Marijuana and

Marijuana,

Single use:

100, 50, 25, or

50-200 ng/mL

None detected

5-7 days

cannabinoids

Hashish,

2-7 days

20 ng/mL (S)(1)

Clonazepam

Tranks,

Single use:

540 ng/mL (S)(1)

>80 ng/mL

10-50 ng/mL

Bhang,

(as ∆9-THC-COOH)

15 ng/mL (C)(3)

(Klonopin)

Downers,

Not detected

100 ng/mL (C)(3)

Ganja,

Blues,

Sensemilla

Prolonged use:

Yellows

Prolonged use:

1-2 months

5-14 days

(as ∆9-THC-COOH)

Chlordiazepoxide

Tranks,

Single use:

600 ng/mL (S)(2)

>23 µg/mL

0.1-3.0 µg/mL

Phencyclidine

PCP,

Single use:

25 ng/mL (S)(1)

1 mg/mL

None detected

(Librium)

Downers,

Not detected

100 ng/mL (C)(3)

Angel dust,

1 week

25 ng/mL (C)(3)

Blues,

Killer weed,

Yellows

Prolonged use:

Hog

Prolonged use:

5-7 days

2-4 weeks

Lorazepam

Tranks,

Single use:

675 ng/mL (S)(1)

0.3-0.6 µg/mL

50-240 ng/mL

Cocaine

Coke,

Single use:

300 ng/mL (S)(1)

>1 µg/mL

100-500 ng/mL

(Ativan,

Downers,

Not detected

100 ng/mL (C)(3)

0.05-0.24 µg/mL

Crack,

3 days

150 ng/mL (C)(3)

Loraz)

Blues,

Flake,

Yellows

Prolonged use:

Snow

Prolonged use:

5-7 days

4 days

Flunitrazepam

Roofies,

72 hours

12-60 ng/mL (S)(1)

50 ng/mL (GC-MS;

5-15 ng/mL

Amphetamine

Speed,

Single use:

100 ng/mL (S)(1)

0.5-1.0 µg/mL

30-50 ng/mL

(Rohypnol)

Rib,

(Immunoassay)

LC-MS/MS)

(Benzedrine,

Bennies,

48 hours

500 ng/mL (C)(3)

Rope,

100 pg/mL (C)(4)

Dexedrine)

Uppers,

Roach-2,

Dexies

Prolonged use:

R-2

7-10 days

Gamma-

GHB,

12 hours

1-10 mg/L

>250 mg/L

48-125 mg/L

Methylene-3,4 dioxy-

Ecstasy,

Single use:

3000-5000 ng/mL (S)(1)

0.1-1.0 µg/mL

20-30 ng/mL

Hydroxybutyrate

G-Caps,

(GC; GC-MS)

(GC-MS)

(for narcolepsy)

Methamphetamine

Adam,

Urine: 24 hours

5 ng/mL (C)(3)

(Somatomax)

Geebers,

(MDMA)

XTC,

Plasma: 5-6 hours

Fantasy,

Love drug,

Liquid Ecstasy

Hug drug

Ketamine

Special K,

<72 hours

15 ng/mL (S)(5)

>7-27 µg/mL

0.5-6.3 µg/mL

Methamphetamine

Speed,

Single use:

100 ng/mL (S)(1)

0.1-1.0 µg/mL

20-30 ng/mL

Hydrochloride

Lady Kay,

(Immunoassay)

(highly variable)

(Desoxyn,

Meth,

48 hours

500 ng/mL (C)(3)

(Ketajet)

Vitamin K,

5-10 ng/mL (GC-MS)

Methedrine)

Crystal ice,

Jet,

Crank

Prolonged use:

Cat Valium

7-10 days

NOTE: Refer to manufacturer’s insert for information on other benzodiazepines and metabolites.

(S) =

Screening cut-off (C) = Confirmation cut-off or Limit of Quantitation (LOQ)

(1) Screening single-use immunoassay device (consult package insert for specific method)

*Commonly accepted cut-off values; may be different for specific jurisdictions and methods.

(2) High-performance liquid chromatography (HPLC)

Sensitivities to various drugs are method-specific. Sensitivity/cut-off data are from method

(3) Gas Chromatography-Mass Spectrometry (GC-MS)

literature and package inserts.

(4) Liquid Chromatography - Mass Spectrometry/Mass Spectrometry (LC-MS/MS)

(5) Screening single-use ELISA device - Forensic toxicology use only

CLR 2012-2013 • MLO •

• MLO • CLR 2012-2013 9

Cut-Off And Toxicity Levels Chart For Drugs-Of-Abuse Testing

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