Home
HelpTest Code 6MAMM 6-Monoacetylmorphine (6-MAM), Confirmation, Meconium
Reporting Name
6-MAM Confirmation, MUseful For
Detection of in utero heroin exposure up to 5 months before birth
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
MeconiumOrdering Guidance
For chain-of-custody testing, order MAMMX / 6-Monoacetylmorphine (6-MAM) Confirmation, Chain of Custody, Meconium.
Specimen Required
Supplies: Stool container, Small (Random), 4 oz (T288)
Container/Tube: Stool container
Specimen Volume: 1 g (approximately 1 teaspoon)
Collection Instructions:
1. Collect entire random meconium (newborn's first bowel movements) specimen.
2. Send specimen frozen.
Additional Information: When refrigerated, a significant percentage of 6-monoacetylmorphine (MAM) will convert to morphine in less than 24 hours.
Specimen Minimum Volume
0.3 g (approximately 1/4 teaspoon)
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Meconium | Frozen | 14 days |
Reference Values
Negative
Positive results are reported with a quantitative liquid chromatography tandem mass spectrometry result.
Cutoff concentration: 5 ng/g
Day(s) Performed
Monday through Sunday
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80356
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| 6MAMM | 6-MAM Confirmation, M | 29345-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 31874 | 6-Monoacetylmorphine | 29345-6 |
| 31875 | Interpretation | 69050-3 |
Interpretation
The presence of 6-monoacetylmorphine (6-MAM) in meconium is definitive for heroin use by the mother. However, the absence of 6-MAM does not rule-out heroin use because of its short half-life and stability.
Clinical Reference
1. Giovannelli M, Bedforth N, Aitkenhead A. Survey of intrathecal opioid usage in the UK. Eur J Anaesthesiol. 2008;25:118-122
2. Levine B, ed. Principles of Forensic Toxicology. 4th ed. AACC Press; 2013
3. Brunton LL, Hilal-Dandan R, Knollmann BC, eds. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 13th ed. McGraw-Hill; 2018
4. Szeto HH. Kinetics of drug transfer to the fetus. Clin Obstet Gynecol. 1993;36:246-254
5. Kwong TC, Ryan RM. Detection of intrauterine illicit drug exposure by newborn drug testing. Clin Chem. 1997;43(1):235-242
6. Ostrea EM Jr, Brady MJ, Parks PM, et al. Drug screening of meconium in infants of drug-dependent mothers: an alternative to urine testing. J Pediatr. 1989;115(3):474-477
7. Ahanya SN, Lakshmanan J, Morgan BL, Ross MG. Meconium passage in utero mechanisms, consequences, and management. Obstet Gynecol Surv. 2005;60(1):45-56; quiz 73-74
8. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43
9. Baselt RC. Disposition of Toxic Drugs and Chemical in Man. 12th ed. Biomedical Publications; 2020
Report Available
2 daysMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.