Mayo Clinic Laboratories > Therapeutics > Controlled substance monitoring

Controlled substance monitoring

Mitigate risks for patients and physicians

Controlled substances are widely prescribed for a number of clinical indications; however, these substances have a high risk for misuse and diversion. To help clinicians manage the challenges of abuse presented by controlled substances, the American Association for Clinical Chemistry Academy developed Laboratory Medicine Practice Guidelines that recommend using clinical laboratory tests to monitor drug therapy in pain management patients.

The Clinical and Forensic Toxicology Laboratory at Mayo Clinic offers the industry’s most comprehensive evidence-based urine drug testing menu. Our profiles were developed with consistency to practice guidelines and help clinicians identify specific prescription drugs, adulterants, and illicit substances.

10.1 million

10.1 million people misused prescription drugs in 20191

38

38 people die every day from overdose including opioids2

50%

50% reduction in substance misuse when clinical UDT is combined with other risk-mitigation strategies3

Testing services

Comprehensive urine profiles Comprehensive urine profiles
Comprehensive urine profiles

The use of emerging technologies in our comprehensive profiles enables increased specificity to detect the lowest levels of substances, which correlates to a reduction in false positives. This decreases the need for unnecessary confirmatory testing often required with traditional immunoassay screens.

Confirmatory testing Confirmatory testing
Confirmatory testing

Our dual approach to definitive testing gives providers the flexibility to perform immunoassay screening locally while enabling confidence through confirmatory testing.

Oral fluid panel Oral fluid panel
Oral fluid panel

Our immunoassay panel uses oral fluid to screen for 20 drug analytes across 11 drug classes, including opioids, benzodiazepines, stimulants, and other commonly prescribed or abused controlled substances. Oral fluid is now recognized as an appropriate alternative by the American Society of Addiction Medicine.

Precision pain management Precision pain management
Precision pain management

Precision pain management is among the most common legitimate uses for controlled substance therapy. Our streamlined approach to controlled substance monitoring ensures accurate results through validity testing and interpretive reports.

Result interpretations Result interpretations
Result interpretations

Analysis of drug testing results by our experts, who apply the most up-to-date scientific data, enables further transparency and clear answers that illuminate patients’ drug use. Learn more about interferences and impurities that might impact controlled substance simple screening results.

Targeted mass spectrometry screening Targeted mass spectrometry screening
Targeted mass spectrometry screening

Mayo Clinic Laboratories’ definitive testing approach utilizes mass spectrometry technology to accurately identify parent drugs and metabolites of substances, which, because of complex metabolic processes, similar chemical structures, and pharmaceutical impurities, could interfere with the results of immunoassay screening. Our fast and cost-effective definitive tests are available in a variety of configurations — including individually — for opioids, stimulants, and benzodiazepines.

Testing by drug class Testing by drug class
Testing by drug class

Therapeutics testing covers a wide range of areas from controlled substance monitoring to pharmacogenomics (PGx). Our testing delivers clarity on drug use to advance understanding and improve patient outcomes. We provide access to Mayo Clinic experts and a test menu developed through evidence-driven clinical innovation to help clinicians guide patient care.

News and updates

The latest

Improving outcomes through comprehensive controlled substance monitoring

Controlled substance testing options vary in the details they provide about patient drug use, painting an incomplete picture of usage patterns that can hinder accurate prescription monitoring and treatment outcomes. However, a new comprehensive Controlled Substance Monitoring Panel, developed by the Clinical and Forensic Toxicology Laboratory at Mayo Clinic Laboratories, offers in-depth analysis on more than 70 different prescription medications and illicit substances to provide clinicians with details and interpretations on patients’ controlled substance use lacking in other laboratory assays.

Learn more
When is it Cool to Drool? Oral Fluid Testing for Controlled Substance Monitoring

PACE/State of FL - Substance use disorders and the common laboratory tests and matrices used for controlled substance monitoring.

Visit Mayo Clinic Laboratories at the APA Annual Meeting

Visit Mayo Clinic Laboratories at booth #2047 to learn about our comprehensive therapeutics test offerings. Developed by board-certified experts in clinical chemistry, molecular, and toxicology testing, our testing is designed to detect and monitor therapeutic and illicit drugs across several relevant specimen types.

Interpretation of qualitative and quantitative urine opiate tests for pain management patients

In this month’s “Hot Topic,” Paul Jannetto, Ph.D., discusses the use of qualitative urine screening assays and quantitative confirmatory testing to determine compliance in pain management patients.

High-resolution targeted stimulant and phencyclidine (PCP) screen

In this month’s “Hot Topic,” Paul Jannetto, Ph.D., discusses the high-resolution targeted stimulant and PCP screening test from Mayo Clinic Laboratories, which offers sensitivity and specificity for use in the monitoring and management of patients who are prescribed CNS stimulant medications.

Improving outcomes through comprehensive controlled substance monitoring

Controlled substance testing options vary in the details they provide about patient drug use, painting an incomplete picture of usage patterns that can hinder accurate prescription monitoring and treatment outcomes. However, a new comprehensive Controlled Substance Monitoring Panel, developed by the Clinical and Forensic Toxicology Laboratory at Mayo Clinic Laboratories, offers in-depth analysis on more than 70 different prescription medications and illicit substances to provide clinicians with details and interpretations on patients’ controlled substance use lacking in other laboratory assays.

New High-Resolution Targeted Opioid Screen: Superior Sensitivity and Specificity to Evaluate Adherence to Prescribed Opioid Therapy

In this month’s “Hot Topic,” Paul Jannetto, Ph.D., discusses the high-resolution targeted opioid screening test from Mayo Clinic Laboratories, which offers sensitivity and specificity for use in the monitoring and management of patients who are prescribed opioid pain-relieving medication.

Resources
Download now American Association for Clinical Chemistry Laboratory Medicine Practice Guidelines
Learn more CDC Clinical Practice Guideline for Prescribing Opioids for Pain
Learn more CDC Opioid Data Analysis and Resources
Learn more Opioids Risk Tool
Learn more The origins of the modern pain clinic at the Mayo Clinic
Learn more Pain management at Mayo Clinic
Learn more Mayo Clinic pain medicine CME opportunities
References
  1. Argoff CE, Kahan M, Sellers EM. Preventing and managing aberrant drug-related behavior in primary care: systematic review of outcomes evidence. J Opioid Manag. 2014;10(2):119–134.
  2. Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health
  3. U.S. Food & Drug Administration: Online Opioid Summits
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