Screens & Confirmations

We understand that when it comes to drug treatment, every case is different. So we empower you with options. We offer several drug testing methods for initial screening, including immunoassay urine testing and oral fluid swabbing. You can also choose to test for one drug, a complete panel, or a custom mix that’s tailored for your patient.

Immunoassay Urine Testing

Our enzyme immunoassay (EIA) screening for drugs in urine is highly accurate and allows for rapid results reporting. We offer a 24-hour turnaround time for all screens.

All of our urine tests also provide you baseline data points, such as creatinine levels, pH levels, specific gravity and general oxidant, that would indicate when someone might be trying to beat a drug test by overhydrating, diluting or substituting urine, or "spiking" their urine with prescribed substances, such as suboxone, that they may not be taking as directed.

Oral Fluid Testing

Oral fluid testing is an easy, noninvasive drug testing method that doesn’t require gender-specific personnel for specimen collection. However, there is a shorter detection window and a limited amount of sample.

Oral fluid testing indicates what drugs are currently active in the body. Most of the time oral fluid has only parent compounds, which, unlike metabolites, yield a dramatically shorter detection window. Oral fluid can give us hours of information, where urine can give us days of information.

Sometimes oral fluid testing is used as a replacement for urine testing, but it is not a direct comparison.

Directed Analysis (aka "Confirmations")

A lot can ride on the results of a drug screen, from a person’s employment status, to whether children can remain with their parents. When it comes to interpreting those results, you want to be absolutely sure. And when an initial screen comes back positive, you may find you have even more questions than before. This is where directed analysis, commonly known as “confirmation testing,” can be incredibly helpful.

Initial screens don’t always tell you exactly what drug is in urine. Sometimes they suggest the presence of a “class” of drugs (ie "opiates" versus "hydrocodone"). Screens also don’t show if the drug metabolites are present in the urine sample, which would prove that a particular medication is being taken as prescribed.

A confirmation test is a secondary analysis performed on the same specimen using completely different technology than the initial method. It is used to confirm the presence of a drug, or further pinpoint which drug made the initial result positive.

We perform targeted extractions on most of our samples instead of a “dilute and shoot” analysis. This provides a cleaner sample that has optimized the withdrawal of the drug out of the urine. The cleaner the sample, the better the instrument can see it, and the more confident you can be in the identification of the drug and its quantitation.

These directed analyses may also be performed on analytes for which an immunoassay screen is not available.

Our assays are performed with GC/MS and LC/MS/MS technology. These two techniques are considered the gold standard of the toxicology industry.

Confirmations are excellent for:

  • When a person tests positive for a “family of drugs,” such as opiates, confirmation testing can help pinpoint which drug triggered the positive result. This is a great tool for when a patient is taking oxycodone and has a positive result for opiates. You may have questions about whether the prescribed oxycodone caused the positive opiate result. Confirmation testing can help identify if there are any other reasons why that individual might have tested positive.
  • When you want to be absolutely sure a drug is present, a confirmation test will employ a different method of testing than the initial screen. Also, in many cases, the cutoff numbers for confirmation testing are lower than the initial screen cutoffs, making the test more sensitive. Confirmation tests are often completed when any results might be used as evidence in court.
  • When you want to eliminate environmental factors as a possible cause of a positive result, confirmation testing can give more detailed information. For example, if the patient claims that they tested positive because they were at a party over the weekend with exposure to marijuana smoke, a confirmation test will be able to conclude whether the initial positive result was from exposure or consumption.
  • When you want to be sure that prescribed medication is being taken appropriately, confirmatory testing can help to establish a pattern of use. This is helpful information for patients in pain management programs who are taking prescribed painkillers like oxycodone and hydromorphone. It is also essential for patients in drug replacement therapy programs, using prescription medications like buprenorphine, suboxone or subutex.