Mayo Clinic Laboratories > Therapeutics > Controlled substance monitoring > Pain management

Pain management

Comprehensive testing to mitigate risks

The use of controlled substances to manage pain is widely accepted by healthcare professionals, but these prescriptions correlate with an increased risk for abuse and overdose. Because many patients on long-term controlled substance therapy struggle with addiction, objective measures are needed to identify recent use and evaluate for misuse.

Our patient-centric approach to controlled substance monitoring is backed by more than 150 years of medical knowledge and developed by an award-winning team of pain medicine, primary care, addiction experts, and laboratory scientists. Our tests align with the American Association for Clinical Chemistry Academy’s practice guidelines and provide clinicians with assistance to ensure patients who receive controlled substance therapy remain within regulatory parameters.

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Full-spectrum approach to pain management testing

  • Controlled substance monitoring
    • Specimen validity testing
    • Targeted mass spectrometry screening profiles
    • Select immunoassay screening
    • Confirmatory testing with quantification
    • Result interpretations
  • Pharmacogenomic testing
  • Therapeutic drug monitoring
  • Clinical research
  • Expert support and education 

Pain management testing services

Comprehensive monitoring Comprehensive monitoring
Routine monitoring Routine monitoring
Targeting screening Targeting screening

Comprehensive monitoring

Key testing

*To better meet the needs of our clients, this profile is available with the quantification of presumptive positive results (Mayo ID: CSMPU) or without (Mayo ID: CSMHU) for the drug classes screened by immunoassay (i.e., barbiturates, cocaine, and THC).

**Ethyl glucuronide (EtG) and ethyl sulfate (EtS) are direct biomarkers of ethanol and are detectable in urine for up to five days following alcohol consumption. EtG/EtS results should be interpreted in the context of all available clinical and behavioral information.

Learn more Mayo Clinic pain medicine CME opportunities
Learn more Pain management at Mayo Clinic
Learn more The origins of the modern pain clinic at the Mayo Clinic

Routine monitoring

Key testing

  • CSMPU | Controlled Substance Monitoring Panel, Random, Urine
    • Identifies drug use involving amphetamines, barbiturates, benzodiazepines, cocaine, opioids, phencyclidine (PCP) and carboxy-tetrahydrocannabinol (COOH-THC).
    • Includes specimen validity testing.
    • Results reported with interpretative comments.

Please note: If the limited immunoassay screen is positive in this profile (Mayo ID: CSMPU), confirmation with quantification of presumptive positives for barbiturates, cocaine and metabolites, and/or tetrahydrocannabinol metabolite will be performed at an additional charge. If the quantification of presumptive positive results is not required, refer to Controlled Substance Monitoring Hybrid Drug Profile, High-Resolution Mass Spectrometry, and Immunoassay Screen, Random, Urine (Mayo ID: CSMHU).

Targeted screening

Key testing

  • CSMTU | Controlled Substance Monitoring Targeted Profile, 17 Drug Classes, Mass Spectrometry, Random, Urine
    • Identifies drug use involving amphetamines, benzodiazepines, opioids, and PCP where immunoassays are not adequate.
    • Includes specimen validity testing.
    • Results reported with interpretative comments.
  • TBSU | Targeted Benzodiazepine Screen, Random, Urine
    • Uses high-resolution accurate mass spectrometry to identify 27 different benzodiazepines and metabolites (including clobazam, zolpidem, and all commonly prescribed benzodiazepines) where immunoassays are not adequate.
    • Detects spiked specimens.
    • Results reported with interpretative comments.
  • TSPU | Targeted Stimulant Screen, Random, Urine
    • Uses high-resolution accurate mass spectrometry to identify 11 different stimulants and metabolites (including amphetamines, methylphenidate, ritalinic acid, 3,4-methylenedioxymethamphetamine [MDMA], and PCP) where immunoassays are not adequate.
    • Detects spiked specimens.
    • Results reported with interpretative comments.
  • TOSU | Targeted Opioid Screen, Random, Urine
    • Uses high-resolution accurate mass spectrometry to identify 33 different opioids and metabolites (including buprenorphine, codeine, fentanyl, heroin, hydrocodone, hydromorphone, methadone, morphine, naloxone, oxycodone, tapentadol, and tramadol) where immunoassays are not adequate.
    • Detects spiked specimens.
    • Results reported with interpretative comments.
Learn more CDC Opioid Data Analysis and Resources
Learn more CDC Clinical Practice Guideline for Prescribing Opioids for Pain
Learn more Opioids Risk Tool

Highlights

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.

Learn more
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.

Learn more
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