Amphetamine testing

• Why isn't MDMA detected in my standard amphetamine screen?

  MDMA is a synthetic amphetamine structure and does cross-react with existing amphetamine immunoassays. However, the cross-reactivity of MDMA in amphetamine assays is generally less than 100%, so it may not be picked up at commonly-used testing cut-offs. To enable detection of MDMA following normal exposures, LabCorp uses reagents developed specifically for MDMA detection.² 

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• What is the drug MDMA/Ecstasy?

  Ecstasy is a commonly used street-name for MDMA (3,4-methylenedioxymethamphetamine). MDMA is an illegal drug with characteristics of both stimulants and hallucinogens. In the mid-1980s, MDMA was being used at all-night dance parties, now referred to as "raves." In 1985, the US Drug Enforcement Administration moved the drug to Schedule 1 status with no accepted medical use. 

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• What do the percentages mean in methamphetamine "d" and "l" isomer test results?

  In order to help determine whether a methamphetamine positive may be due to an illicit source, it is helpful to determine the percentage of "d" and “l” isomers. For example, following an individual's use of Vick's Vapor Inhaler, the expected result would be nearly 100% "l" methamphetamine. Based on current laboratory guidelines, if the laboratory report indicates more than 80% "l" methamphetamine, the results are consistent with Vick's Vapor Inhaler use or one of the prescription medications metabolized to l-methamphetamine. If the laboratory reports more than 20% "d" methamphetamine present, the result indicates the use of "d" methamphetamine as either a prescription or illicit preparation. Illegally-produced methamphetamine and amphetamine may contain mixtures of "d" and "l" isomers. LabCorp recommends use of a medical review officer (MRO) to review all non-negative test results.¹ 

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• What is methamphetamine "d" and "l" isomer testing?

  Methamphetamine is available in two forms: "d" and "l." These compounds are stereoisomers (chemical mirror images). They have the same chemical formula and similar chemical properties. The "d" form is a prescription stimulant and appetite suppressant. The "l" form is available over-the-counter as the active ingredient of the Vick's inhaler and is a metabolite of certain prescription medications. Both "d" and "l" forms test positive by both immunoassay and most confirmation assays; a special d,l isomer confirmation test is available to determine how much of each form is present in a specimen.¹ 

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