Recap:  Which Opioid was Ingested???

Dr. Joseph E. Graas Scientific Director
Dr. Edward Moore, Medical Director
Dr. Paul Robandt, Scientific Director

In the May 2018 edition of the Toxicology Times, we discussed  that opioid metabolism can produce some unexpected, and sometime incongruous, results when comparing urine drug screen  results to what was actually ingested.  It is always a good idea to call the laboratory to interpret results in these cases.  To recap:

^*Morphine may be present but below the cutoff and therefore not reported
^**Codeine greater than morphine
^***6-Acetylmorphine may not be detected

Below please find a schematic on the interrelationship of opioids derived from natural sources.  This explains the results found in the table above very well.  Note that oxycodone and oxymorphone do not share in any of these metabolic pathways, although some of the same enzymes are used.