Test codes: 13086, 13793, 13794, 13795, 13796, 13797, 13798
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.
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 other illicit additives like xylazine, phenibut, medetomidine, and tianeptine.
Testing for multiple NPS drug classes is recommended, as drug trends change over time and differ locally and data shows that NPS are more frequently found in combination with other agents, so testing with a panel that covers multiple NPS classes is important. For example, if there is a concern about xylazine or illicit drug use, testing for all NPS drug classes, not just a few that may be of concern, is important as xylazine may not be present in the sample where other designer drugs are detected.
The test code for Drug Monitoring Novel Psychoactive Substances (NPS), Qualitative, Urine is 13086. This is a panel test code that includes all relevant NPS compounds from 6 different classes. Other standalone NPS class test codes are available (Table 1).
When NPS use is a concern, there is clinical utility in ordering the panel (13086) or all 6 NPS class codes as detection of an NPS may be missed if only one or a few standalone class codes are ordered.
Standalone NPS class test codes that are available.
Click the table to open in new window (enlarged).
NPS testing is performed at the Quest Diagnostics Nichols Institute, Chantilly, Virginia laboratory. Measurement is done by liquid chromatography tandem mass spectrometry (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.
Specimen
Stability requirements
Rejection criteria
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. Click HERE to see the table showing analytes and cutoffs within the NPS, Qualitative, Urine test.
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. Click HERE to see the table showing analytes and cutoffs within the NPS, Qualitative, Urine test.
Individual compound cutoffs within a class may range from 1 ng/mL to 20 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.
References
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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