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HelpTest Code 6MAMU 6-Monoacetylmorphine Confirmation, Random, Urine
Reporting Name
6-MAM Confirmation, UUseful For
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
UrineOrdering Guidance
1. For situations where chain of custody is required, a Chain-of-Custody Kit (T282) is available. For chain-of-custody testing, order 6MAMX / 6-Monoacetylmorphine, Chain of Custody, Random, Urine.
2. If urine creatinine is required or adulteration of the sample is suspected, order ADULT / Adulterants Survey, Random, Urine.
3. Additional drug panels and specific requests are available. Call 800-533-1710 or 507-266-5700.
Specimen Required
Supplies: Urine Tubes, 10 mL (T068)
Container Tube: Plastic, 10-mL urine tube
Specimen Volume: 10 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
Additional Information:
1. No specimen substitutions.
2. STAT requests are not accepted for this test.
Specimen Minimum Volume
2.1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days | ||
| Ambient | 72 hours |
Reference Values
Negative
6-MAM cutoff concentration: <5 ng/mL
Day(s) Performed
Tuesday, Wednesday
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 |
|---|---|---|
| 6MAMU | 6-MAM Confirmation, U | 19593-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 30983 | 6-Monoacetylmorphine by GC/MS | 19593-3 |
| 29898 | 6-MAM Interpretation | 69050-3 |
| 29899 | Chain of Custody | 77202-0 |
Interpretation
The presence of 6-monoacetylmorphine (6-MAM) in urine is definitive for recent heroin use. However, the absence of 6-MAM does not rule-out heroin use because of its short half-life. 6-MAM is typically only detectable within 24 hours of heroin use. 6-MAM is further metabolized into morphine, which may be detected 1 to 2 days after 6-MAM is no longer measurable. Morphine will typically be found in a specimen containing 6-MAM.(2,3)
Clinical Reference
1. Giovannelli M, Bedforth N, Aitkenhead A. Survey of intrathecal opioid usage in the UK. Eur J Anaesthesiol. 2008;25(2):118-1122
2. Principles of Forensic Toxicology. 2nd ed. AACC Press; 2003:187-205
3. Hardman JG, Limbird LE, Gilman AG. Goodman and Gilman's. The Pharmacological Basis of Therapeutics. 10th ed. McGraw-Hill Book Company; 2001:590-592
4. Principles of Forensic Toxicology. 4th ed. AACC Press; 2013
5. Langman LJ, Bechtel LK, Meier BM, Holstege C. Clinical toxicology. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:872
Report Available
3 to 7 daysMethod Name
Gas Chromatography Mass Spectrometry (GC-MS)
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.