What drugs do tests detect?

Why the panel determines everything

A drug test does not detect "drugs" generically. Each analyte on a test panel is a separate immunoassay, calibrated to a specific antibody and a specific cutoff for a specific compound or metabolite. The panel — the set of analytes the device screens for — is the single most important specification when buying a device. A donor using a substance that is not on the panel will pass the test by definition, even if the substance is present at high concentration.

That is why panel selection is a substantive program-design decision, not a procurement detail. A program designed to deter recreational drug use among a non-safety-sensitive workforce has different panel needs than a substance-use-disorder treatment program managing patients with poly-substance histories. A pre-employment screen has different needs than post-accident testing. This article walks through what each tier of panel actually covers and where the gaps are.

The reference panels below describe industry-standard configurations. Exact analytes vary modestly by manufacturer; the Magenta panels referenced here reflect our current product line.

The SAMHSA-5 panel — the regulatory baseline

The SAMHSA Mandatory Guidelines establish a five-substance panel as the required minimum for federally regulated workplace urine testing. The SAMHSA-5 is the panel used for federal civilian employees, DOT-regulated transportation workers under 49 CFR Part 40, and contractors covered by the Drug-Free Workplace Act. It is also the most common configuration in private-sector pre-employment screening because it covers the substances of historical regulatory interest at standardized cutoffs.

The five SAMHSA-mandated analyte groups are: marijuana (THC, detected as the THC-COOH metabolite), cocaine (detected as the benzoylecgonine metabolite), amphetamines (covering amphetamine, methamphetamine, and MDMA), opiates (morphine, codeine, and the heroin-specific metabolite 6-monoacetylmorphine), and phencyclidine (PCP). These five categories define the federal panel — and notably, they do not include fentanyl, benzodiazepines, oxycodone, methadone, or buprenorphine.

The expanded 10-panel — the workplace standard

The 10-panel has been the dominant configuration in non-federal workplace testing for decades. It includes the SAMHSA-5 plus five additional analytes that capture commonly diverted prescription medications and recreational substances not covered by the federal panel. The typical additions are benzodiazepines (BZO), barbiturates (BAR), methadone (MTD), MDMA (broken out separately from amphetamines), and one of either propoxyphene (PPX, now largely historical since the U.S. market withdrawal) or oxycodone (OXY).

Benzodiazepines are widely prescribed for anxiety and insomnia and are a frequent finding in workplace and clinical testing. Detection windows extend up to 30 days in chronic users of long-half-life benzodiazepines like diazepam. Barbiturates are less common in modern medical practice but remain on many panels for historical reasons; short-acting barbiturates clear in days while long-acting agents like phenobarbital can be detectable for weeks.

Methadone is screened because of its widespread use both as an opioid-use-disorder maintenance medication and as a treatment for chronic pain. It is structurally distinct from morphine-class opiates and is not detected by the opiate assay — programs that need methadone coverage must include a methadone-specific analyte. Oxycodone is similarly under-detected by the morphine-class opiate immunoassay at standard cutoffs and is broken out as its own analyte on most modern panels.

Modern 12- to 17-panel devices — the substance-use-treatment standard

The synthetic-opioid crisis and broader changes in the drug supply have driven panel expansion well beyond the legacy 10-panel. Magenta's 12-, 13-, 14-, 15-, 16-, and 17-panel cups add analytes targeted at modern clinical and substance-use-treatment programs: fentanyl (FEN), buprenorphine (BUP), oxycodone (OXY), tramadol (TRA), K2/Spice synthetic cannabinoids (K2), and EtG (ethyl glucuronide, the alcohol metabolite used for abstinence monitoring).

Fentanyl coverage is the single most important addition for any program operating in an environment with significant illicit-fentanyl exposure. CDC overdose surveillance data have shown synthetic opioids — a category dominated by illicit fentanyl — accounting for the largest share of overdose deaths. Fentanyl immunoassays at the industry-standard 1 ng/mL cutoff detect parent fentanyl and the norfentanyl metabolite; cross-reactivity with several Schedule I analogs varies by manufacturer.

Buprenorphine (the active ingredient in Suboxone and Subutex) is essential coverage for treatment programs and pain-management clinics. EtG screening extends alcohol detection from the few-hour window of direct ethanol assays to roughly 80 hours, making it the analyte of choice for abstinence-oriented monitoring. K2/Spice immunoassays cover a family of synthetic cannabinoids that are not detected by THC assays — these compounds remain a significant concern in correctional, probation, and treatment populations.

Analytes not on most standard panels

Several substances of clinical or forensic interest are not on most standard workplace panels. Ketamine immunoassays are available but not common; ketamine is a Schedule III dissociative anesthetic with growing recreational and therapeutic (low-dose IV for treatment-resistant depression) use. Kratom (mitragynine) is an opioid-receptor-active botanical that is not detected by standard opiate or fentanyl immunoassays — Magenta supplies a dedicated kratom dip card for programs that need it. GHB and the so-called "date-rape drugs" require specialized testing rarely included on routine panels.

Designer stimulants (cathinones — "bath salts"), novel benzodiazepines (etizolam, flualprazolam), and emerging novel psychoactive substances often evade standard immunoassays because they fall outside the antibody cross-reactivity profile. Programs in populations with high novel-substance use should consider periodic broad-spectrum laboratory mass-spectrometry screening to characterize what is actually in their population's drug exposure.

Nicotine (cotinine metabolite) testing is widely used for tobacco-cessation programs and life-insurance screening. Magenta supplies a dedicated nicotine/cotinine dip card. This analyte is generally not bundled into workplace drug panels because nicotine use is lawful and typically out of scope.

How to map panels to program design

For DOT-regulated transportation and federal-employee testing, the panel is set by regulation — follow 49 CFR Part 40 and the SAMHSA Mandatory Guidelines. For non-federal pre-employment screening, the SAMHSA-5 or a 10-panel is typically sufficient. For substance-use-disorder treatment and methadone-maintenance programs, a 12- to 17-panel device that includes fentanyl, buprenorphine, methadone, and EtG is the contemporary standard.

For pain-management practices, panel selection should reflect the prescribed medications a clinician needs to monitor — typically including oxycodone, methadone, buprenorphine, and benzodiazepines, plus the SAMHSA-5 baseline. For sober-living facilities and probation/court-mandated monitoring, EtG is essential for alcohol-abstinence verification, and fentanyl coverage is essential in any modern program given current overdose patterns.