Table II.

2021 Recommended Scope and Cutoffs for Tier I Drugs/Drug Classes (ng/mL) for Screening and Confirmation in Blood, Urine and Oral Fluid

	Blood		Urine		Oral fluid
Drug	Screen	Confirm	Screen	Confirm	Screen	Confirm
DRE category; cannabinoids
∆9-THC	–	1	–	–	4	1
Carboxy-THC	10	5	20	5	–	–
11-hydroxy-THC	–	1	–	–	–	–
DRE category; CNS stimulants
Methamphetamine	20	20	200	50	20	20
Amphetamine	20	20	200	50	20	20
MDMAa	–	20	–	50	20	20
MDAa	–	20	–	50	20	20
Cocaine	–	10	–	20	15b	8
Benzoylecgonine	50	50	150	50	15b	8
Cocaethylene	–	10	–	20	–	8
DRE category; CNS depressants
Carisoprodol	1,000	1,000	1,000	1,000	500	500
Meprobamatea	–	500	–	500	–	500
Zolpidem	10	10	20	20	10	10
Low-dose benzodiazepines	10	–	50	–	5	–
Alprazolam	–	10	–	50	–	1
Alpha-hydroxyalprazolam	–	–	–	50	–	–
Clonazepam	–	10	–	50	–	1
7-Aminoclonazepam	–	10	–	50	–	1
Lorazepam	–	10	–	50	–	1
High-dose benzodiazepines	50	–	100	–	5	–
Diazepam	–	20	–	50	–	1
Nordiazepam	–	20	–	50	–	1
Oxazepam	–	20	–	50	–	1
Temazepam	–	20	–	50	–	1
DRE category; narcotic analgesics
Codeinea	–	10	–	50	30	5
6-Acetylmorphine	–	5	–	10	–	1
Buprenorphine	1	0.5	5	1	1	2
Norbuprenorphine	–	1	–	1	–	–
Fentanyl	1	0.5	1	1	1	0.5
Hydrocodonea	–	10	–	50	30	5
Hydromorphonea	–	5	–	50	30	5
Methadone	50	20	300	50	20	10
Morphine	10	10	200	50	30	5
Oxycodonea	10	10	100	50	30	5
Oxymorphonea	–	5	–	50	30	5
Tramadol	100	50	100	50	50	10
O-Desmethyltramadol	–	50	–	50	–	–

^aMust have ≥80% cross-reactivity if using immunoassay for blood and urine.

^bScreening for either benzoylecgonine or cocaine in oral fluid is acceptable.