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Drug monitoring, Novel Psychoactive Substances (NPS), Urine

Test code: 13086  

Novel psychoactive substances (NPS), also known as designer or synthetic drugs or “legal highs,” are designed to have similar effects to illicit drugs while circumventing national and international drug scheduling laws.1,2 NPS may cause accidental overdose through interactions with other prescription medications or have unintended consequences when used in counterfeit prescriptions. Several drugs and metabolites within different NPS classes are included in the Quest Diagnostics test. 

  • Designer benzodiazepines, such as bromazolam, clonazolam, and metabolites
  • Designer fentanyl analogs, such as acetyl fentanyl, carfentanil, and fluorofentanyl
  • Designer opioids, such as isotonitazene, protonitazene, metonitazene, and metabolites
  • Designer stimulants, such as α-PVP,  pentylone, and eutylone
  • Synthetic cannabinoids, such as ADB-5Br-PINACA, ADB-FUBIATA, and ADB-BUTINACA
  • Other illicit additives, such as xylazine and tianeptine

NPS are rapidly evolving. Assessing for NPS presence is important for identifying signs of drug misuse and abuse in patients. The results from this NPS test may enable providers to have a discussion with their patients about the risks associated with exposure to NPS. Individuals may knowingly or unknowingly be exposed to NPS through counterfeit prescription drugs intended to mimic common drugs, such as oxycodone, hydrocodone, and alprazolam, among others; such NPS include illicit fentanyl or analogs; designer opioids, stimulants, and benzodiazepines; and xylazine. 

The NPS test code is 13086. 

Test code 13086 is performed at Quest Diagnostics Nichols Institute, Chantilly Laboratory, Virginia. Measurement is done by LC-MS/MS. This is a qualitative, definitive test that is used to identify NPS classes in urine. Updates and enhancements to the tested drug list are made from time to time based on surveillance data from multiple sources.3

Sample collection for this test is via urine cup. Specimens can be collected in-office or at a local Quest Patient Service Center.


  • The preferred specimen type is 3 mL urine collected in a urine collection container, minimum volume 2 mL

Stability requirements

  • Room temperature: 7 days
  • Refrigerated: 14 days
  • Frozen: 30 days

Rejection criteria

  • Preserved specimens

A “positive” NPS class result indicates that 1 or more drugs or metabolites within that class have been definitively detected at, or above, the cutoff value for the individual compound (Table).

A “negative” NPS class result indicates that all drugs and metabolites within that class were not present at levels at or above the cutoff value for each individual compound (Table).

Individual compound cutoffs within a class may range from 1 to 10 ng/mL. The NPS class cutoffs listed on the report are a representation of the highest cutoff within a class.

The NPS test is not designed to determine clinical impairment, and results should be interpreted in conjunction with the clinical presentation of the patient.

Yes. NPS testing is considered a clinical test; therefore, multiple clinical specimens from one patient may be placed in the same bag. However, specimens from another patient should be placed in a separate bag.

For any questions regarding this information or assistance with interpreting these drug test results, please contact a Quest toxicology specialist at 1.877.40.RX TOX (1.877.407.9869). Specialists are available to assist Monday through Friday from 8 AM to 10 PM ET.


  1. Peacock A, Bruno R, Gisev N, et al. New psychoactive substances: challenges for drug surveillance, control, and public health responses. Lancet. 2019;394(10209):1668-1684.
  2. Mohr ALA, Logan BK, Fogarty MF, et al. Reports of adverse events associated with use of novel psychoactive substances, 2017–2020: a review. J Anal Toxicol. 2022;46(6):e116-e185.
  3. Center for Forensic Science Research & Education. Trend reports. Updated 2023. Accessed July 12, 2023. 


This FAQ is provided for informational purposes only and is not intended as medical advice. A physician’s test selection and interpretation, diagnosis, and patient management decisions should be based on the physician’s education, clinical expertise, and assessment of the patient.


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