Full list

76-drug confirmation panel

The LabX confirmation tests every sample for all 76 compounds below by LC-MS/MS — whether or not the 12-panel screen flags anything. Available with a 12-panel urine ($89) or fingerstick blood ($99) test for +$89.

76Compounds tested

LC-MS/MSMethod

$178 / $188Urine / blood with confirmation

9Drug families

A 12-panel screen is a fast, presumptive test that detects drug classes. Confirmation is the laboratory's definitive method: liquid chromatography separates the sample, and tandem mass spectrometry identifies each compound by its mass. Each compound is reported as detected only at or above the laboratory's cut-off, shown next to it below. The cut-offs listed are the lower limits printed on the laboratory's urine confirmation report; confirmation can be added to either the urine or the fingerstick blood 12-panel order.

Many compounds appear as pairs: a medicine and the metabolite the body makes from it, such as fentanyl and norfentanyl, or buprenorphine and norbuprenorphine. Measuring both shows a drug was actually processed by the body. Tap any compound for its own page.

The 76 compounds

Opioids and their metabolites (16)

Prescription opioid pain medicines, heroin markers and the compounds the body makes from them. Measuring metabolites alongside parent drugs shows a drug was actually processed by the body.

6-MAM — breakdown product specific to heroin (cut-off 20 ng/mL)
Codeine — opioid prescribed for pain and cough; partly converted to morphine (cut-off 50 ng/mL)
Morphine — opioid pain medicine; also formed from heroin and codeine (cut-off 50 ng/mL)
Hydrocodone — opioid pain medicine (Norco, Vicodin) (cut-off 50 ng/mL)
Norhydrocodone — breakdown product of hydrocodone (cut-off 50 ng/mL)
Hydromorphone — opioid pain medicine (Dilaudid); minor hydrocodone metabolite (cut-off 50 ng/mL)
Oxycodone — opioid pain medicine (OxyContin, Percocet) (cut-off 50 ng/mL)
Noroxycodone — breakdown product of oxycodone (cut-off 50 ng/mL)
Oxymorphone — opioid pain medicine; minor oxycodone metabolite (cut-off 50 ng/mL)
Tramadol — opioid-type pain medicine (Ultram) (cut-off 50 ng/mL)
O-desmethyltramadol — breakdown product of tramadol (cut-off 50 ng/mL)
Tapentadol — opioid-type pain medicine (Nucynta) (cut-off 50 ng/mL)
N-desmethyltapentadol — breakdown product of tapentadol (cut-off 50 ng/mL)
Meperidine — opioid pain medicine (Demerol) (cut-off 50 ng/mL)
Methadone — opioid used in addiction treatment and for pain (cut-off 50 ng/mL)
EDDP — breakdown product of methadone (cut-off 50 ng/mL)

Fentanyl and novel opioids (4)

Fentanyl and its metabolite, plus the main alkaloids in kratom. These are not reliably found by general opiate screens, which is why confirmation measures them directly.

Fentanyl — synthetic opioid; prescribed and found in the illicit supply (cut-off 2 ng/mL)
Norfentanyl — breakdown product of fentanyl (cut-off 8 ng/mL)
Mitragynine — main active alkaloid in kratom (cut-off 10 ng/mL)
7-OH-mitragynine — breakdown product of mitragynine (kratom) (cut-off 50 ng/mL)

Opioid treatment and reversal (5)

Medicines used to treat opioid and alcohol use disorder or to reverse an overdose, with their metabolites, as monitored in treatment programs.

Buprenorphine — opioid use disorder treatment (Suboxone, Sublocade) (cut-off 5 ng/mL)
Norbuprenorphine — breakdown product of buprenorphine (cut-off 10 ng/mL)
Naloxone — overdose reversal medicine (Narcan) (cut-off 5 ng/mL)
Naltrexone — alcohol and opioid use disorder treatment (Vivitrol) (cut-off 10 ng/mL)
6β-naltrexol — breakdown product of naltrexone (cut-off 10 ng/mL)

Stimulants (8)

Prescription ADHD and weight-management stimulants, a common decongestant, and illicit stimulants including the cocaine metabolite benzoylecgonine and MDMA.

Amphetamine — ADHD stimulant (Adderall, Vyvanse); methamphetamine metabolite (cut-off 50 ng/mL)
Methamphetamine — stimulant; mostly illicit (cut-off 50 ng/mL)
MDMA — ecstasy / molly (cut-off 50 ng/mL)
Benzoylecgonine — breakdown product of cocaine (cut-off 20 ng/mL)
Phentermine — weight-loss stimulant (Adipex-P) (cut-off 50 ng/mL)
Methylphenidate — ADHD stimulant (Ritalin, Concerta) (cut-off 50 ng/mL)
Ritalinic acid — breakdown product of methylphenidate (cut-off 50 ng/mL)
Pseudoephedrine — decongestant (Sudafed) (cut-off 50 ng/mL)

Benzodiazepines and Z-drugs (8)

Prescription sedatives and sleep medicines and their metabolites. Standard screens detect individual benzodiazepines unevenly, so confirmation identifies each one.

Alprazolam — benzodiazepine (Xanax) (cut-off 30 ng/mL)
Alpha-OH-alprazolam — breakdown product of alprazolam (Xanax) (cut-off 30 ng/mL)
7-Aminoclonazepam — breakdown product of clonazepam (Klonopin) (cut-off 50 ng/mL)
Lorazepam — benzodiazepine (Ativan) (cut-off 50 ng/mL)
Nordiazepam — breakdown product of diazepam (Valium) and related benzodiazepines (cut-off 50 ng/mL)
Oxazepam — benzodiazepine; also a diazepam metabolite (cut-off 50 ng/mL)
Temazepam — benzodiazepine sleep medicine (Restoril) (cut-off 50 ng/mL)
Zolpidem — metabolite of zolpidem (Ambien), measured as zolpidem PCA (cut-off 10 ng/mL)

Antidepressants (14)

Commonly prescribed antidepressants and their metabolites. They are not part of standard drug screens and are identified when a clinician needs a full medication picture.

Amitriptyline — tricyclic antidepressant (cut-off 50 ng/mL)
Nortriptyline — tricyclic antidepressant; amitriptyline metabolite (cut-off 50 ng/mL)
Desipramine — tricyclic antidepressant; imipramine metabolite (cut-off 50 ng/mL)
Imipramine — tricyclic antidepressant (Tofranil) (cut-off 50 ng/mL)
Citalopram — SSRI antidepressant (Celexa) (cut-off 50 ng/mL)
Fluoxetine — SSRI antidepressant (Prozac) (cut-off 50 ng/mL)
Norfluoxetine — breakdown product of fluoxetine (Prozac) (cut-off 50 ng/mL)
Paroxetine — SSRI antidepressant (Paxil) (cut-off 50 ng/mL)
Sertraline — SSRI antidepressant (Zoloft) (cut-off 50 ng/mL)
Venlafaxine — SNRI antidepressant (Effexor) (cut-off 50 ng/mL)
O-desmethylvenlafaxine — breakdown product of venlafaxine (Effexor) (cut-off 50 ng/mL)
Duloxetine — SNRI antidepressant (Cymbalta) (cut-off 50 ng/mL)
Bupropion — antidepressant and smoking-cessation aid (Wellbutrin) (cut-off 40 ng/mL)
Trazodone — antidepressant often prescribed for sleep (cut-off 40 ng/mL)

Antipsychotics and mood (6)

Medicines prescribed for psychiatric conditions and anxiety, identified by confirmation when a medication list needs to be checked.

Aripiprazole — antipsychotic (Abilify) (cut-off 40 ng/mL)
Quetiapine — antipsychotic (Seroquel) (cut-off 20 ng/mL)
Risperidone — antipsychotic (Risperdal) (cut-off 40 ng/mL)
9-Hydroxyrisperidone — breakdown product of risperidone (Risperdal) (cut-off 50 ng/mL)
Haloperidol — antipsychotic (Haldol) (cut-off 50 ng/mL)
Buspirone — anti-anxiety medicine (Buspar) (cut-off 10 ng/mL)

Muscle relaxants, sedatives and analgesics (9)

Muscle relaxants, barbiturates, nerve-pain medicines and acetaminophen, several of which are monitored in pain management and treatment programs.

Carisoprodol — muscle relaxant (Soma) (cut-off 200 ng/mL)
Meprobamate — breakdown product of carisoprodol (Soma) (cut-off 200 ng/mL)
Cyclobenzaprine — muscle relaxant (Flexeril) (cut-off 50 ng/mL)
Baclofen — muscle relaxant for spasticity (cut-off 200 ng/mL)
Butalbital — barbiturate in headache combinations (Fioricet) (cut-off 100 ng/mL)
Phenobarbital — barbiturate anti-seizure medicine (cut-off 100 ng/mL)
Gabapentin — anti-seizure and nerve-pain medicine (Neurontin) (cut-off 500 ng/mL)
Pregabalin — nerve-pain medicine (Lyrica) (cut-off 500 ng/mL)
Acetaminophen — pain and fever reliever (Tylenol) (cut-off 500 ng/mL)

Dissociatives, adulterants and exposure markers (6)

Dissociative drugs, the street-supply adulterant xylazine, and markers of cannabis and alcohol exposure.

PCP — phencyclidine, dissociative drug (cut-off 10 ng/mL)
Ketamine — dissociative anesthetic (cut-off 50 ng/mL)
Norketamine — breakdown product of ketamine (cut-off 50 ng/mL)
Xylazine — veterinary sedative found as a fentanyl adulterant (cut-off 10 ng/mL)
THC — cannabis (measured as the THC-COOH metabolite) (cut-off 100 ng/mL)
ETS — ethyl sulfate, a marker of recent alcohol use (cut-off 250 ng/mL)

What it does not test for

GHB (gamma-hydroxybutyrate)
Rohypnol (flunitrazepam)
Scopolamine
Diphenhydramine
Nicotine or cotinine
Alcohol by breath — alcohol exposure is assessed through the ETS marker instead

Several drugs on the panel have been reported in cases where drinks were spiked, but no test can show how or when a substance was taken, and many compounds leave the body within hours to days. If you believe you were drugged, seek medical care and contact law enforcement right away. At-home collection is not a forensic chain-of-custody test.

How results appear

When the laboratory releases your results, you will get an email or text saying they are ready — never the results themselves. Sign in to your secure LabX account to open an interactive lab report, where each compound and each sample check can be tapped to see what it is and what its cut-off means, together with the signed laboratory report as a PDF you can download or print.

Order a 12-panel drug test with confirmation

Urine $89 or fingerstick blood $99 · add the 76-drug confirmation for +$89.

At-home drug tests and test kits are not currently available to addresses in New York, New Jersey, Rhode Island or California. Results are not a diagnosis — review them with a licensed physician.

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Common questions

What does the LabX confirmation test for?

It tests your sample for all 76 compounds listed on this page by LC-MS/MS, whether or not the 12-panel screen flags anything. The compounds are grouped into nine families, from opioids and fentanyl to antidepressants and markers of cannabis and alcohol use.

How much does confirmation cost?

Confirmation adds $89 to a 12-panel drug test: $178 with the urine test ($89) or $188 with the fingerstick blood test ($99).

Does the confirmation test for GHB or Rohypnol?

No. The panel does not include GHB, Rohypnol (flunitrazepam) or scopolamine. If you believe you were drugged, seek medical care and contact law enforcement as soon as possible; this is not a forensic chain-of-custody test.

Why test for everything instead of only what the screen flags?

A screen detects drug classes and can miss individual compounds or react to related substances. Testing every sample for all 76 compounds gives a definitive result for each one, including drugs that standard screens do not cover.

How will I see my confirmation results?

Results appear in your secure LabX account as an interactive lab report, where you can open each compound to see what it is and its cut-off, together with the signed laboratory report as a PDF.

Talk to a licensed physician. LabX Diagnostics and Vantage provide laboratory testing only. The information on this page is educational and is not medical advice, diagnosis or treatment. Always consult a licensed physician or other qualified healthcare provider about test results, symptoms or medicines, and before making any health decision. If you think you may have a medical emergency, call 911. Read our medical disclaimer.