Clinical Toxicology

PacTox fully embraces its role as a member of the team managing the complex treatment of chronic or acute pain and addiction. About 50 million people suffer chronic pain and an additional 25 million suffer acute pain, which translates to $100 billion yearly in treating pain. Lost productivity is estimated to be $60 billion and the societal impacts are immeasurable.

The major drugs that are available for pain management have limitations and have a high potential for abuse or misuse. Clinical guidelines have been published to assist providers in managing the treatment of patients with chronic non-cancer pain.

One of the many concerns in pain management is the identification of patients that have aberrant drug-related behavior or a potential for same. The pain management plan may include personal and family medical histories, screening surveys and/or treatment agreements with patients. The patient information you provide is important in driving the laboratory work flow as well as the correct interpretation of the lab results.

PacTox provides clinical toxicology testing for drugs and their metabolites principally in urine, but also in blood and saliva. Qualitative and quantitative testing is performed utilizing test methods with the highest sensitivity such as Gas Chromatography/Mass Spectroscopy (GC/MS) and Liquid Chromatography-Mass Spectrometry/Mass Spectrometry (LC-MS/MS). This high complexity testing is considered a “Gold Standard” with high accuracy and low cut-off points.

Alcohol Biomarkers

Ethyl glucuronide/Ethyl Sulfate

Anticonvulsants

Gabapentin
Pregabalin

Barbiturates

Amobarbital
Butalbital
Phenobarbital
Pentobarbital
Secobarbital

Benzodiazepines

Temazepam
Oxazepam
Alprazolam/ Alpha-hydroxyalprazolam
Diazepam/ Nordiazepam
Lorazepam
Clonazepam/ 7- Aminoclonazepam

Illicit Drugs

Cocaine
THC-CBD (Cannabidiol)
Phencyclidine
6-MAM
MDMA

Muscle Relaxants

Carisoprodol
Meprobamate
Cyclobenzaprine

Nonsteroidal Anti-inflammatory

Salicylic Acid
Meloxicam
Celecoxib
4-Hydroxydiclofenac
Ibuprofen
Naproxen
Nabumetone

Opiates

Codeine
Morphine
Hydrocodone
Hydromorphone
Oxycodone

Stimulants

Amphetamine
Methamphetamine
Methylphenidate or
Ritalinic Acid

Selective Serotonin Reuptake Inhibitor (SSRI)

Citalopram
Duloxetine
Fluoxetine
Venlafaxine
Paroxetine
Sertraline

Synthetic Cannabinoids (K-2 Spice)

WH-018/AM-2201
UR-144/XLR-11
AKB-48-(APINACA)
BB-22
PB-22-(CUPIC)
5-Fluro-PB-22-(5F-PB-22)
AB-FUBINACA
ADB-PINACA
AB CHMINACA
AB PINACA/5-F-AB-PINACA
ADBICA

Synthetic Opioids

Fentanyl
Propoxyphene
Methadone/ EDDP
Buprenorphine
Tapentadol
Tramadol
Meperidine

Tricyclic Antidepressants

Amitriptyline
Nortriptyline
Doxepin/ Desmethyldoxepin
Clomipramine
Desipramine
Imipramine

Bath Salts

Cathinone
Methcathinone
Methylone
Flephedrone
Butylone
Ethylone
Mephedrone
MDPBP
ALPHA-PVP
3,4-DMMC
MDPV
Pyrovalerone
Naphyrone

Other

Alcohol
Ketamine
Nicotine
Acetaminophen
Zolpidem
Trazadone
Loperamide