The Toxicology Laboratory's Role in Pain Management: Testing for Opiates (by LabCE)

2 P.A.C.E. contact hour(s)

(based on 500 customer ratings)

Author: Kevin F. Foley, PhD, DABCC, MT, SC
Reviewer: Robert E. Moore, MLS(ASCP)CM, SCCM, TC(NRCC)

Course provided by LabCE.

This course will provide an overview of general drugs of abuse testing with an emphasis on urine testing for opiates and other narcotics used in the practice of pain management.

See more courses in: Clinical Chemistry / Urinalysis / Toxicology

Included In These Course Packages

Continuing Education Credits

P.A.C.E.® Contact Hours (acceptable for AMT, ASCP, and state recertification): 2 hour(s)
Course number 578-027-22, approved through 4/30/2024
Florida Board of Clinical Laboratory Personnel Credit Hours - General (Clinical Chemistry/UA/Toxicology): 2 hour(s)
Course number 20-905630, approved through 4/30/2024


  • List the common drugs of abuse that are tested on a routine urine drug screen.
  • Describe the advantages of urine testing versus serum testing in the context of drugs of abuse testing.
  • Describe testing methods used in the clinical toxicology laboratory.
  • Define pain management in a clinical context and explain the lab's role in this practice.
  • Identify parent and metabolite compounds of common opiate medications.
  • Interpret urine drug screen and confirmation results and decide if the result is consistent with the patient's history and current prescriptions.

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(based on 500 customer ratings)

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Course Outline

  • Laboratory Testing Methods For Drugs of Abuse
      • Course Introduction
      • Drugs of Abuse (DOA) Screening Tests
      • Drugs of Abuse (DOA) Screening Tests, continued
      • Cutoff Concentrations for DOA Screening Tests
      • Confirmation of Positives
      • Mass Spectrometry (MS)
      • False-Positive Opiate Results
      • Laboratory Samples for DOA
      • Adulterants
  • The Use of Opiates For Pain Management and the Problem of Drug Abuse
      • Pain Management Contracts
      • Opiates
      • Opiates, continued
      • Opiate Abuse
      • Other Drugs of Interest
      • Pain Management: The Problem
      • The Problem, continued
      • Dependence versus Addiction
      • The Goal of Pain Management (PM)
      • Testing the Pain Management (PM) Patient
  • Interpretation of Drugs of Abuse Testing in Pain Management
      • Pain Management Drug Screen Interpretation Competencies
      • Adulterants and Urine Samples Collected for Prescription Drug Monitoring
      • Opiate Metabolites
      • The Problem with Oxycodone and Oxymorphone (Oxys) In Immunoassay Methods
      • Cross-Reactivities
      • Common Pain Management (PM) Drugs and Trade Names
      • Half-Lives and Windows
      • Frequently Asked Questions (FAQs) To the Toxicology Laboratory
      • Summary
  • References
      • References

Additional Information

Level of instruction: Intermediate

Target audience: Medical laboratory scientists, medical laboratory technicians, and MLS students. This course may also be of interest to other health care professionals who are involved in pain management.
Author information: Kevin F. Foley, PhD, DABCC, MT, SC is the Northwest chemistry, toxicology, immunology and POC director for Kaiser Permanente. He also teaches pharmacology, clinical chemistry, immunology and medicinal chemistry at Oregon Health Sciences University. Dr. Foley earned his PhD in clinical pharmacology and toxicology at East Carolina School of Medicine in North Carolina. His research areas include cardiovascular risk and inflammation markers as well as the neuropharmacology of amphetamine-like compounds. He is a frequent contributor to several clinical laboratory publications and is active in the American Association of Clinical Chemistry.

Reviewer information: Robert E. Moore, MLS(ASCP)CM, SCCM, TC(NRCC) is the lead technologist in the toxicology laboratory at Kaiser Permanente in Portland, Oregon where his responsibilities include review of QC data, instrument troubleshooting, and employee training and competency assessment. In his career as a medical laboratory scientist, he has held the positions of chemistry supervisor, toxicology supervisor, and laboratory director.
Content information: This course will provide an overview of general drugs of abuse testing with an emphasis on urine testing for opiates and other narcotics used in the practice of pain management. 

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