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From the Lab: Fentanyl added to four drug screen panels

02 Jun 2022

Benefit: Drug rapidly metabolizes to Norfentanyl

By: Andrew Judd, MD, and Amanda Jacobson, senior lab specialist

The Salem Health Laboratory is pleased to announce the addition of Fentanyl to all in-house drug screen panels shown below:

Epic test code

Panel code

Panel name



Drug Screen 9, reflex to Confirmation, Urine



Emergency Drug Screen 9, Urine



Drug Endangered Child Drug Screen, reflex to Confirmation, Urine



Pediatric Urine Drug Screen

The new Fentanyl II Immunoassay is a diagnostic test for the qualitative determination of Norfentanyl in human urine. It has a cutoff value of 5 ng/mL.

Why target Norfentanyl?

The drug Fentanyl is rapidly and extensively metabolized to Norfentanyl (its main metabolite). I.e. Fentanyl disappears as time passes and at the later part of the window of detection only Norfentanyl becomes detectable. Norfentanyl concentrations in the urine are generally higher than Fentanyl concentrations, by about 3-4 times. 

Reflex testing for confirmation:

If confirmation testing is indicated, the order will reflex to:

ARUP test code 0092570 Fentanyl and Metabolite, Urine Quantitative

Link: Fentanyl and Metabolite, Urine, Quantitative | ARUP Laboratories Test Directory


(DePriest, A., Heltsley, R., Black, D.L., Cawthon, B., Robert, T., Moser, F., Caplan, Y.H., and E.J. Cone, Urine Drug Testing of Chronic Pain Patients. III. Normetabolites as Biomarkers of Synthetic Opioid Use. Journal of Analytical Toxicology)