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HelpTest ID OPATU Opiates Confirmation, Urine
Useful For
Detection and quantification of codeine, hydrocodone, oxycodone, morphine, hydromorphone, and oxymorphone in urine
Method Name
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Opiate Confirmation, USpecimen Type
UrineContainer/Tube: Plastic, 60-mL urine bottle
Specimen Volume: 20 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
Additional Information:
1. For situations where chain of custody is required, a Chain-of-Custody Kit (T282) is available. For chain-of-custody testing, order OPATX / Opiates Confirmation, Chain of Custody, Urine.
2. If urine creatinine is required or adulteration of the sample is suspected, the following test should be requested, ADULT / Adulterants Survey, Urine. For additional information, refer to ADULT / Adulterants Survey, Urine.
3. Submitting <20 mL will compromise our ability to perform all necessary testing.
Forms:
1. If not ordering electronically, complete, print, and send a General Test Request Form (T239) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/general-request-form.pdf).
2. Chain-of-Custody Request Form is included in the Chain-of-Custody Kit (T282). A copy of this form is also available at http://www.mayomedicallaboratories.com/it-mmfiles/chain-of-custody-request-form.pdf.
Specimen Minimum Volume
2.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerated (preferred) | 14 days |
| Frozen | 14 days | |
| Ambient | 72 hours |
Clinical Information
Codeine is converted by hepatic metabolism to morphine and norcodeine with a half-life of 2 to 4 hours. If codeine is ingested, the ratio of codeine to morphine generally exceeds 1.0 in urine during the first 24 hours. The ratio may fall below 1.0 after 24 hours; and after 30 hours, only morphine may be detected.
Morphine is a naturally occurring narcotic analgesic obtained from the poppy plant, Papaver somniferum. Morphine is converted by hepatic metabolism to normorphine with a half-life of 2 to 4 hours. The presence of morphine in urine can indicate exposure to morphine, heroin, or codeine within 2 to 3 days. 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 2,000 ng/mL for a period of 6 to 12 hours after ingestion.
Hydrocodone exhibits a complex pattern of metabolism including O-demethylation, N-demethylation and 6-keto reduction to the 6 beta hydroxymetabolites. Hydromorphone is a metabolite of hydrocodone. The presence of hydrocodone >100 ng/mL indicates exposure within 2 to 3 days prior to specimen collection.
Hydromorphone is metabolized primarily in the liver and is excreted primarily as the glucuronidated conjugate, with small amounts of parent drug and minor amounts of 6 hydroxy reduction metabolites. The presence of hydromorphone >100 ng/mL indicates exposure within 2 to 3 days prior to specimen collection. Hydromorphone is also a metabolite of hydrocodone, therefore the presence of hydromorphone could also indicate exposure to hydrocodone.
Oxycodone is metabolized to noroxycodone, oxymorphone and their glucuronides and is excreted primarily via the kidney. The presence of oxycodone >100 ng/mL indicates exposure to oxycodone within 2 to 3 days prior to specimen collection.
Oxymorphone is metabolized in the liver and excreted via the kidney primarily as the glucuronide conjugates. Oxymorphone is also a metabolite of oxycodone and therefore the presence of oxymorphone could also indicate exposure to oxycodone.
The detection interval for the opiates is generally 2 to 3 days after last ingestion.
Reference Values
Negative
Cutoff concentrations
Codeine by LC-MS/MS: <100 ng/mL
Hydrocodone by LC-MS/MS: <100 ng/mL
Hydromorphone by LC-MS/MS: <100 ng/mL
Oxycodone by LC-MS/MS: <100 ng/mL
Oxymorphone by LC-MS/MS: <100 ng/mL
Morphine by LC-MS/MS: <100 ng/mL
Cautions
This test detects drugs structurally similar to morphine. Other drugs in the opioid class, such as fentanyl, meperidine, methadone, and opiate antagonists such as naloxone, are not detected.
Day(s) Performed
Monday through Friday
Report Available
2 daysPerforming Laboratory
Mayo Medical Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
80361
80365
G0480 (if appropriate)