Ameritox

Rx Guardian Technology & Process

To make effective chronic pain treatment decisions, you need the most detailed information available on your patients’ pain medication use. Ameritox’s specialized laboratory technology delivers the highest degrees of accuracy, specificity and sensitivity so you have the best information for your chronic pain care.

Most routine urine drug testing simply determines the absence or presence of a certain class of drugs. To develop the best treatment plans and identify potential pain medication abuse or misuse, you need to know more. Our advanced analytical technology delivers results and detection levels that exceed the most demanding urine drug testing standards. The Ameritox Rx GuardianSM process identifies and quantifies the specific drug or metabolite present for a broad range of medications and illicits. Using our patented methods, we then further analyze certain results. All of this information helps you determine if a patient is taking his or her medication as prescribed.

Only Ameritox combines superior laboratory science and proprietary methods of analysis for an unmatched level of insight into your patients’ pain medication use. With this information you may learn that a patient didn’t understand how to take the medication or is afraid of potential side effects. It’s information and insight that often reveals new opportunities for achieving better outcomes.

behind the scenes

Once a urine specimen is received in our lab, it is scanned into the system and receives a unique Lab Accession Number for the most reliable identification and tracking. Then an alliquoted sample undergoes validity testing for specific gravity and pH value levels.

Initial Screening

Initial tests screen for the presence of opiates, benzodiazepines, illicits and other prescribed or unprescribed medications. The following tests utilize antigen antibody reactions to provide fast, reliable results:

  • Enzyme Immunoassay (EIA)
  • Enzyme-Linked Immunosorbent Assay (ELISA)

Confirmation Testing & Proprietary Methods of Analysis

Rx Guardian Algorithm Review and Interpreting the Rx Guardian Results Report

If positive, these immunoassays are followed by confirmation testing. Gas chromatography-mass spectrometry (GC/MS) is used to create a fingerprint-like match for each detected prescription medication or illicit. This technology’s superior sensitivity can detect drugs or metabolites at some of the lowest levels in the industry—making it the gold standard of pain medication monitoring.

When optimal specificity and sensitivity are required, immunoassays are followed by liquid chromatography – tandem mass spectrometry (LC/MS/MS). LC/MS/MS is the most advanced analytical method available for detecting the absence or presence of your patients’ prescribed medications as well as the presence of non-prescribed medications or illicits.1,2 Ameritox was one of the first in the industry to offer this platinum standard of urine drug testing.

In addition, Ameritox specifies the amount of prescribed medications, non-prescribed medications or illicits detected. Ameritox then further analyzes certain medications using our patented methods. A normalized patient value is calculated based on patient specific factors and urine drug test results. This normalized result is then compared to a set of expected ranges for some of the most common prescribed drugs. The Ameritox Rx GuardianSM results report informs you as to whether the normalized value is above or below the expected range. This information, taken as a whole, helps you determine whether your patient is likely to be taking his or her medication in a manner that is consistent with the prescribed regimen3,4.

After testing is complete, Ameritox Certifying Scientists review and certify each result for a final check of accuracy.

Using the Ameritox Virtual ToxicologistSM (V-Tox), the Rx Guardian results report also provides helpful explanations of any findings inconsistent with the prescribed medication treatment plan. If you have questions, Ameritox Toxicology Specialists SM are available to help you interpret results. It all adds up to unique insight that only Ameritox can provide—insight that is informing thousands of chronic pain treatment conversations every day.

Notes

1. Katz N, Fanciullo GJ. Role of urine toxicology testing in the management of chronic opioid therapy. Clin J Pain. 2002;18(4 suppl):S76–S82.

2. Bhamb B, Brown D, Hariharan J, Anderson J, Balousek S, Fleming MF. Survey of select practice behaviors by primary care physicians on the use of opioids for chronic pain. Curr Med Res Opin. 2006;22(9):1859–1865.

3. Kell MJ. Utilization of plasma and urine methadone concentrations to optimize treatment in maintenance clinics: I. measurement techniques for a clinical setting. J Addict Dis.1994;13(1):5–26.

4. Kell MJ. Utilization of plasma and urine methadone concentration measurements to limit narcotics use in methadone maintenance patients: II. generation of plasma concentration response curves. J Addict Dis. 1995;14(1):85–108.