In-office Urine Drug Testing (UDT)
In-office (point-of-care) testing can be conducted with CLIA-waived instant-read devices, as well as instrumented devices (e.g. analyzers). These devices perform qualitative immunoassay tests only.
In-office urine drug test devices are used to provide health care professionals with immediate information, particularly on initial patient intake. While providing certain clinical value to the treating health care professional, these qualitative immunoassay tests identify the presence of a drug class, and a few specific drugs. The limitations of point-of-care testing, including cutoff levels and known cross-reactivity, is important to consider. When it is clinically necessary to identify all specific drugs and illicit substances, laboratory quantitation provides more comprehensive results for patient care decisions.
Laboratory Testing with LC-MS/MS Technology
Laboratory testing, such as liquid chromatography tandem mass-spectrometry (LC-MS/MS), is a more specific method, and returns a quantitative analytical result. These results provide precise identification of all drugs and metabolites present or absent. When used alone or in combination with qualitative immunoassay testing, LC-MS/MS testing can provide health care professionals with critical information to support patients’ overall treatment plans.
Laboratory testing by LC-MS/MS uses significantly lower cutoff levels than in-office drug tests and is, therefore, more accurate in determining medications and other substances present in, or absent from, a patient’s system at the time of the test.
LC-MS/MS and In-office Drug Test Cutoff Level* Comparison
In-office UDT cutoff
** In-office UDT may not detect all forms of Buprenorphine