Opiates

Interpretation

• Opiates are the natural or synthetic drugs that have a morphine-like pharmacological action. Medically, opiates are used primarily for relief of pain. Opiates include morphine and drugs structurally similar to morphine (eg, codeine, hydrocodone, hydromorphone, oxycodone).
• Heroin (diacetylmorphine) is a synthetic opiate made from morphine and is rarely detectable in body fluids. It has a half-life of a few minutes. Illicit heroin often contains small amounts of acetylcodeine. The presence of both codeine and morphine in urine does not rule out the use of heroin. However, the ratio of morphine to codeine can be helpful in discriminating between heroin and codeine use.
• Ingestion of bakery products containing poppy seeds can also cause morphine to be excreted in urine. If excessively large amounts are consumed, this can result in urine morphine concentrations up to 2000 ng/mL for a period of 6 to 12 hours after ingestion. Due to first-pass metabolism, no pharmacologic effect is experienced from poppy seed ingestion.
• If there is a question as to a patient's therapeutic compliance, a serum test request for the specific drug of interest may be useful.
• The presence of an opiate > LOQ indicates exposure to that opiate within 2 to 3 days prior to specimen collection.
• The presence of 6-MAM is conclusive evidence of prior heroin use. However, due to its short half-life, it is only detectable in urine for about 8 hours after administration.

Confirmation Tests:

• Opiates Confirmation, Urine
• Morphine Confirmation, Serum

Metabolites

Approximate Detection Times