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Test Code PDSOX Pain Clinic Drug Screen, Chain of Custody, Urine

Useful For

Detecting drug abuse involving amphetamines, barbiturates, benzodiazepines, cocaine, ethanol, methadone, opiates, phencyclidine, and tetrahydrocannabinol


Detection and identification of prescription or over-the-counter drugs frequently found in drug overdose or used with a suicidal intent


This test is intended to be used in a setting where the identification of the drug is required.


Chain of custody is required whenever the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that it was under the control of personnel involved with testing the specimen at all times; this control implies that the opportunity for specimen tampering would be limited.

Profile Information

Test ID Reporting Name Available Separately Always Performed
CDA7X Confirmed Drug Abuse Panel9, CoC, U Yes Yes
OXYSX Oxycodone Screen, CoC, U Yes Yes
PDSUX Drug Scrn, Prescription/OTC, CoC, U Yes Yes

Additional Tests

Test ID Reporting Name Available Separately Always Performed
COCH Chain of Custody Processing No Yes
ADLTX Adulterants Survey, CoC, U Yes Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
AMPHX Amphetamines Confirmation, CoC, U Yes No
COKEX Cocaine and metabolite Conf, CoC, U Yes No
BENZX Benzodiazepines Conf, CoC, U Yes No
BARBX Barbiturates Confirmation, CoC, U Yes No
MTDNX Methadone Confirmation, CoC, U Yes No
PCPX Phencyclidine Confirmation, CoC, U Yes No
THCX Carboxy-THC Confirmation, CoC, U Yes No
ETOHX Ethanol, CoC, U No No
OPATX Opiate Confirmation, CoC, U Yes No
OXYCX Oxycodone w/metabolite Conf, CoC, U Yes No

Testing Algorithm

Testing begins with screening tests for alcohol and drugs of abuse. Positives are confirmed and quantitated by definitive methods (gas chromatography-flame ionization detector for ethanol; gas chromatography-mass spectrometry for barbiturates, benzodiazepines, cocaine and metabolites, methadone, phencyclidine, and tetrahydrocannabinol metabolite; liquid chromatography-tandem mass spectrometry for amphetamines and opiates) at an additional charge. If only oxycodone screens positive, only confirmation of oxycodone with metabolite will be performed. Any other opiate positive screen will result in the full opiate confirmation being performed.


The drug screen, prescription/OTC will be performed by gas chromatography-mass spectrometry. Qualitative results will be reported.


Adulterants testing will be performed on all chain of custody urine samples as per regulatory requirements.

Method Name

CDA7X, OXYSX: Alcohol Screened by an Enzymatic Assay/All Others Screened by Immunoassay

PDSUX: Gas Chromatography-Mass Spectrometry (GC-MS)

ETOHX: Gas Chromatography-Flame Ionization Detector (GC-FID) (if appropriate)

Reporting Name

Pain Clinic Drug Screen, CoC, U

Specimen Type


Specimen Required

Supplies: Chain-of-Custody Kit (T282) containing the specimen containers, seals, and documentation required.

Specimen Volume: 30 mL

Collection Instructions: Collect specimen in the container provided, seal, and submit with the associated documentation to satisfy the legal requirements for chain-of-custody testing.

Additional Information:

1. Submitting less than 30 mL will compromise our ability to perform all necessary testing.

2. Not intended for use in employment-related testing.

Specimen Minimum Volume

25 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Refrigerated (preferred) 14 days
  Frozen  14 days
  Ambient  72 hours

Reject Due To









Clinical Information

This panel was designed to screen for and confirm by gas chromatography-mass spectrometry (GC-MS) or gas chromatography-flame ionization detection (GC-FID) the following drugs:









Confirmation by liquid chromatograph-tandem mass spectrometry (LC-MS/MS) is completed for all opiates and amphetamines.


This panel uses the screening technique that involves immunoassay testing for drugs by class. All positive screening results are confirmed by GC-MS, GC-FID, or LC-MS/MS, and quantitated, before a positive result is reported.


The panel includes PDSUX / Drug Screen, Prescription/OTC, Chain of Custody, Urine, which looks for a broad spectrum of prescription and over-the-counter drugs. It is designed to detect drugs that have toxic effects, as well as known antidotes or active therapies that a clinician can initiate to treat the toxic effect. The test is intended to help physicians manage an apparent overdose or intoxicated patient, to determine if a specific set of symptoms might be due to the presence of drugs, or to evaluate a patient who might be abusing these drugs intermittently. The test is not designed to screen for intermittent use of illicit drugs.


Chain-of-custody is a record of the disposition of a specimen to document who collected it, who handled it, and who performed the analysis. When a specimen is submitted in this manner, analysis will be performed in such a way that it will withstand regular court scrutiny.

Reference Values



Screening cutoff concentrations

Amphetamines: 500 ng/mL

Barbiturates: 200 ng/mL

Benzodiazepines: 100 ng/mL

Cocaine (benzoylecgonine-cocaine metabolite): 150 ng/mL

Ethanol: 10 mg/dL

Methadone metabolite: 300 ng/mL

Opiates: 300 ng/mL

Phencyclidine: 25 ng/mL

Tetrahydrocannabinol carboxylic acid: 50 ng/mL


This report is intended for use in clinical monitoring or management of patients. It is not intended for use in employment-related testing.


A positive result indicates that the patient has used the drugs detected in the recent past. See individual tests (eg, AMPHX / Amphetamines Confirmation, Chain of Custody, Urine) for more information.


For information about drug testing, including estimated detection times, see Drugs of Abuse Testing at


Not intended for use in employment-related testing.

Clinical Reference

1. Physician's Desk Reference. 61st edition. Montvale, NJ. Thomson PDR, 2007

2. Goodman and Gilman's The Pharmacological Basis of Therapeutics. Tenth edition. New York, NY. McGraw-Hill Professional, 2001

3. Langman LJ, Bechtel L, Holstege CP: Chapter 35. In Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Edited by CA Burtis, ER Ashwood, DE Bruns. WB Saunders Company, 2011, pp 1109-1188

4. Principles of Forensic Toxicology. Second edition. Washington DC. AACC Press, 2003, p 385

Method Description

Drug classes are screened by an immunoassay technique. All positive screening results are confirmed by gas chromatography-mass spectrometry, gas chromatography-flame ionization detector, or liquid chromatography-tandem mass spectrometry.(Unpublished Mayo method)

Day(s) and Time(s) Performed

Monday through Sunday

Analytic Time

2 days

Specimen Retention Time

2 weeks

Performing Laboratory

Mayo Medical Laboratories in Rochester

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
PDSOX Pain Clinic Drug Screen, CoC, U In Process


Result ID Test Result Name Result LOINC Value
36262 Alcohol 42242-8
61727 Oxycodone 58430-0
36235 Drugs detected: 12286-1
36236 Suspect Drug In Process
36027 Chain of Custody No LOINC Needed
36253 Amphetamines 43983-6
36258 Barbiturates 70155-7
36237 Chain of Custody No LOINC Needed
36259 Benzodiazepines 14316-4
36254 Cocaine 43984-4
36260 Methadone metabolite 41858-2
36255 Opiates 70151-6
36256 Phencyclidine 14310-7
36257 Tetrahydrocannabinol 14312-3
36261 Chain of Custody No LOINC Needed