Cannabinoid (THC), Screen and Confirmation, Urine

CPT: 80307
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Test Details

Test Includes

Cannabinoid (THC), qualitative, urine. Confirmation by MS is automatically performed on positive samples for additional charge.

Use

Detect and confirm the presence of cannabinoids

Methodology

Initial testing by immunoassay (IA); confirmation of positives by mass spectrometry (MS).

Additional Information

A positive test for cannabinoids indicates the presence of cannabinoid metabolites; 11-nor-9-carboxy-δ-9-THC is the major metabolite (carboxy THC) in urine but is not related to source, time of exposure, amount, or impairment. Unless the test is confirmed by MS, a positive result is presumptive and an unconfirmed test should not be used in workplace drug testing programs. Urine may contain carboxy THC for a week or 10 days after light or moderate use and as long as a month to six weeks after heavy use. Rapid storage of THC metabolites in body fat occurs after use. These substances are then released from storage sites slowly over time.

A marijuana cigarette is made from the dried leaves of the plant, Cannabis sativa. The immediate effects of smoking marijuana include a faster heartbeat and pulse rate, bloodshot eyes, and a dry mouth and throat. The drug can impair or reduce short-term memory, alter sense of time, and reduce the ability to do things that require concentration, swift reactions and coördination, such as driving and operating machinery.

Driving experiments show that marijuana affects a wide range of skills needed for safe driving. Thinking and reflexes are slowed, making it hard for drivers to respond to sudden unexpected events. Furthermore, a driver's ability to “track” through curves, brake quickly, and maintain speed and proper distance between vehicles is affected. Research shows that these skills are impaired for at least four to six hours after smoking a single marijuana cigarette. If a driver drinks alcohol along with using marijuana, the risks of an accident greatly increase.

Specimen Requirements

Specimen

Urine

Volume

20 mL

Container

Use plastic urine drug bottle and evidence tape or tamper-evident container for forensic specimen. Collection kits are available by request from the laboratory.

Collection

Urine temperature monitoring is recommended for samples to be tested for medicolegal purposes.

Storage Instructions

Maintain specimen at room temperature. If arrival at lab will extend beyond seven days, refrigerate.

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Clinical Information

Special Instructions

Chain-of-custody documentation is required for samples submitted for preëmployment, random employee testing, and forensic purposes. For other applications, use the standard request form. Please mark chain-of-custody test number on the request form.

References

Chiang CN, Barnett G. Marijuana pharmacokinetics and pharmacodynamics. In: Redda KK, Walker CA, Barnell G, eds. Cocaine, Marijuana, Designer Drugs: Chemistry, Pharmacology and Behavior. Boca Raton, Fla: CRC Press;1989:113-126.
El-Sohly MA, El-Sohly HN. Marijuana: Analysis and detection of use through urinalysis. In: Redda KK, Walker CA, Barnett G, eds.Cocaine, Marijuana, Designer Drugs: Chemistry, Pharmacology and Behavior. Boca Raton, Fla: CRC Press;1989:145-162.
Hawks RL, Chiang CN. Examples of specific drug assays: Marijuana/cannabinoids. Urine Testing for Drugs of Abuse. NIDA Research Monograph 73. Rockville, Md;1986:85-92.
Hollister LE. Health aspects of cannabis. Pharmacol Rev. 1986; 38(1):1-20. 3520605
Mason AP, McBay AJ. Cannabis: Pharmacology and interpretation of effects. J Forensic Sci. 1985; 30(3):615-631. 2993473
Morland J, Bugge A, Skuterud B, et al. Cannabinoids in blood and urine after passive inhalation of Cannabis smoke. J Forensic Sci. 1985; 30(4):997-1002. 2999292
Schucket MA. Cannabinols. Drug and Alcohol Abuse. New York, NY: Plenum; 1989:143-157.
Wells DJ, Barnhill MT Jr. Comparative results with five cannabinoid immunoassay systems at the screening threshold of 100 micrograms/L. Clin Chem. 1989; 35(11):2241-2243. 2582623
Zuckerman B, Frank DA, Hingson R, et al. Effects of maternal marijuana and cocaine use on fetal growth. N Engl J Med. 1989; 320(12):762-768. 2784193

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
074435 Cannabinoid, Qual, Urine 716019 Cannabinoid ng/mL 18282-4
Reflex Table for Cannabinoid
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 071316 Cannabinoid Confirmation, Ur 777151 Cannabinoid 19289-8
Reflex Table for Cannabinoid
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 071316 Cannabinoid Confirmation, Ur 071753 Carboxy THC GC/MS Conf ng/mL 14313-1
Reflex Table for Cannabinoid
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 071316 Cannabinoid Confirmation, Ur 070474 Documentation N/A
Reflex Table for Cannabinoid
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 071316 Cannabinoid Confirmation, Ur 711786 Cannabinoid GC/MS Holding N/A

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