On what basis does the MRO verify test results for 6-acetylmorphine (6-AM)?

As the MRO, you must proceed as follows when you receive a laboratory confirmed 6-AM test result:

(a) If the laboratory confirms the presence of 6-AM in the specimen and there is also any level of quantitation of morphine, you must verify the test result positive.

(b) When a laboratory 6-AM confirmed positive result is reported and morphine for that specimen is not reported at or above the 2000 per ng/mL confirmed positive cutoff, you must confer with the laboratory to determine if there was confirmed morphine below 2000 ng/mL.

(1) If there was confirmed morphine below 2000 ng/mL, you must verify the test result positive.

(2) If morphine was not confirmed below 2000 ng/mL, you and the laboratory must determine whether further testing is needed to quantify the amount of morphine present.

(c) If a laboratory finds detectable morphine at its LOD upon further testing, you must verify the test result positive.

(d) If a laboratory finds no detectable morphine at its LOD upon further testing, you and the laboratory must report that fact to the ODAPC immediately. Following your discussion with ODAPC, you will make a verified result determination.

[75 FR 49863, Aug. 16, 2010]