Urine drug testing (UDT) is an emerging standard of care in the evaluation and treatment of chronic non- @entity5 @entity158 @entity1 with opioid analgesics. UDT may be used both to verify adherence with the opioid analgesic regimen and to monitor abstinence from non-prescribed or illicit controlled substances. In the former scenario, it is vital to determine whether the drug is present in the urine, even at low concentrations, because failure to detect the drug may lead to accusations of @entity4784 or diversion. Opiate immunoassays typically are developed to detect @entity1286 and are most sensitive to @entity1286 and @entity10425 . Although many opiate immunoassays also detect @entity1287 (HC) and/or @entity10748 (HM), sensitivities for these analytes are often much lower, increasing the possibility of negative screening results when the drug is present in the urine. We selected 112 urine specimens from @entity1 who had been prescribed HC or @entity10748 but were presumptive negative by the Roche Online DAT Opiate II    urine drug screening assay, which is calibrated to 300 ng/mL @entity1286 . Using a GC/MS confirmatory method with a detection limit of 50 ng/mL both for HC and for HM, one or both of these opiates were detected in 81 (72.3%) of the urine specimens. Examination of the raw data from these presumptive negative opiate screens revealed that, in many cases, the turbidity signal was greater than the signal obtained for the negative control, but less than the signal for the 300 ng/mL ( @entity1286 ) threshold calibrator. A receiver operating characteristic curve generated for the reciprocal of the ratio of turbidity measurements in the @entity1 specimens and negative (drug-free) controls, against the presence or absence of HC and/or HM by confirmatory analyses, produced an area under the curve of 0.910. We conclude that this opiate immunoassay has sufficient sensitivity to detect HC and/or HM in some urine specimens that screen presumptive negative for these commonly prescribed opiates at the established threshold.

Sensitivity of an Opiate Immunoassay for Detecting XXXX and @entity10748 in Urine from a Clinical Population: Analysis of Subthreshold Results.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity4784 :: ('MESH:D009293', 'Disease') :: ['opioid abuse'] @entity1287 :: ('MESH:D006853', 'Chemical') :: ['hydrocodone'] @entity1286 :: ('MESH:D009020', 'Chemical') :: ['morphine'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity10748 :: ('MESH:D004091', 'Chemical') :: ['hydromorphone'] @entity10425 :: ('MESH:D003061', 'Chemical') :: ['codeine']
@entity1287 :: (MESH:D006853,Chemical) :: ['Hydrocodone']
