Urinalysis Testing Using Enzyme Immunoassay (EIA)
Urine toxicology screening testing is an important standard of care in the addiction and pain treatment setting, offering a reproducible, unbiased, and accurate laboratory test to monitor patients and provide objective support for clinical observations.
Enzyme immunoassay (EIA) is a biochemical methodology that detects the presence of multiple drugs and/or drug metabolites. By utilizing cloned analyte-specific enzyme donors, EIA offers consistent reproducibility of results. The outcomes are therefore more accurate and dependable.
EIA is used for qualitative detection of medications and illicit substances. The EIA methodology involves a specialized enzyme mixed with analyte-specific antibodies. If the analyte (drug) is present in the specimen, an active enzyme forms, creating a change in color that can be measured on a device called a spectrophotometric analyzer. The amount of enzyme formed is proportional to the amount of analyte that is present in the specimen.
Urinalysis Result Confirmation Using LCMS
Liquid chromatography–mass spectrometry (LCMS, or alternatively HPLC-MS) is an analytical chemistry technique that combines the physical separation capabilities of liquid chromatography (or HPLC) with the mass analysis capabilities of mass spectrometry (MS).
Liquid chromatography/tandem mass spectrometry (LCMS) is a confirmatory technique that allows a laboratory to confidently identify and quantify a range of compounds. Unlike point of care urine cups or immunoassay screening techniques, the LCMS allows for determination of a specific compound. The extensive validation prior to patient sample analysis ensures that interferences do not occur and the identification of individual drug analytes can be completed with certainty. The LC is a technique in which a small volume of the urine sample is injected through a column which allows for separation of each individual analyte present in the patient sample from one another. This occurs based on the interaction between each compound with the polarities of both the solvent and chromatographic columns.
The MS portion allows for the identification by fragmenting the compounds and detecting their mass to charge ratios. The individualization is structure dependent and because every analyte has a unique structure, these compounds can be identified. The determination is made by comparing the unique fingerprint of an analyte against that of a reference standard. The combination of the LC with the MS allows for highly sensitive and specific determination of drugs and their metabolites.
The limits of detection used in clinical testing such as pain management or drug treatment testing is lower than the limits used in workplace drug testing. This is particularly true for opiates where the workplace threshold of 2000 ng/mL would be much too high for monitoring opiates in drug treatment facilities. For most drugs, the limits of detection using the LCMS will identify drug use for at least several days after last use. This may be extended further when metabolites are also monitored.
Blood Testing To Check Patient's Overall Health
Blood tests can be used in a number of ways, such as helping to diagnose a condition, assessing the health of certain organs or screening for some genetic conditions.
Typical routine blood tests include the complete blood count, also called CBC, to measure your red and white blood cell numbers as well as hemoglobin and other numbers. This test can uncover anemia, infection, and even cancer of the blood.
Another common blood test is the basic metabolic panel to check your heart, kidney and liver function by looking at your blood glucose, calcium, and electrolyte levels. And to check for heart disease risk, you may have a lipoprotein panel that measures levels of fats in your blood, like good cholesterol (HDL), bad cholesterol (LDL), and triglycerides.
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