Mitigate risks for clinicians and patients.    

Identify specific prescription drugs, metabolites, and illicit substances.

The Clinical and Forensic Toxicology Laboratory at Mayo Clinic developed a controlled substance monitoring panel, which is consistent with the American Association for Clinical Chemistry Academy's Laboratory Medicine Practice Guideline, to help clinicians manage the challenges of misuse and diversion presented by controlled substances.

By the numbers


of people reported obtaining a prescription drug from a friend or relative.1


people misused controlled substances in 2017.3


increase in drug overdose deaths from the year 2000 to 2016.2

Evidence-based, definitive testing

Using high-resolution accurate mass spectrometry, the controlled substance monitoring panel identifies more than 70 parent drugs and metabolites where immunoassays are not adequate. The comprehensive panel screens for 33 different opioids, 27 benzodiazepines, 10 stimulants, and PCP, which minimizes the need for additional confirmatory testing.

Mayo Clinic's algorithmic approach

Using Mayo Clinic's algorithm approach to testing, each specimen undergoes a multi-step evaluation to check for the presence of controlled substances. To ensure a valid result, all specimens are tested first for adulterants. If adulterants are absent, testing begins using a combination of accurate, high-resolution mass spectrometry screening assays and immunoassays. Definitive mass spectrometry assays are used to confirm all positive results. Results are communicated in a concise report that clearly identifies the presence of substances and provides interpretive comments.

Accurately detect recent drug use

CSMPU | Controlled Substance Monitoring Panel, Random, Urine

  • Identifies and confirms the presence of amphetamine-type stimulants, barbiturates, benzodiazepines, cocaine metabolite, opioids, phencyclidine, and tetrahydrocannabinol metabolite in the urine.
  • Measures levels of creatinine, specific gravity, pH, and oxidants (e.g., nitrites) to identify adulterated specimens.
  • Identifies at-risk patients for adverse drug events due to polysubstance use.

Panel components included in CSMPU:

Tests available separately

Reflex test components

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.


  1. Preuss CV, Kalava A, King KC. Prescription of controlled substances: benefits and risks. Treasure Island, FL: StatPearls Publishing; 2019.
  2. Rudd RA, Aleshire N, Zibbel JE, Gladden RM. Increases in drug and opioid overdose deaths—United States, 2000–2014. Am Soc Transplantation and Am Soc Transplant Surg. 2016;64(50):1378–1382.
  3. Substance Abuse and Mental Health Services Administration. Results from the 2017 national survey on drug use and health: detailed tables on the prevalence estimates, standard errors, p values, and sample sizes. Published September 14, 2018. Accessed December 13, 2019.

Learn more about how to order these tests at your institution.