Pain Management Testing by Liquid Chromatography Tandem Mass Spectrometry

For appropriate pain medication monitoring, the analytical method must be sensitive enough to detect the prescribed medication and metabolites at a sufficiently low concentration to recognize compliance, even with a low-dose prescription. The method must also provide excellent selectivity to identify simultaneously present drugs even with similar chemical structures. The analytical method should uncover common illicit drugs/nonprescribed medications. Traditional immunoassays cannot satisfy these criteria, but liquid chromatography tandem mass spectrometry can. It requires expensive instrumentation, careful test design, and extensive validation and produces a large amount of data that must be interpreted according to the clinical context.