TRENDS IN DRUG USE BY JOHN HAWES, SUREHIRE OCCUPATIONAL HEALTH TESTING
An Introduction to Opiates and POCT Drug Testing
D
rug testing covers a wide array of substances and methods. To better understand how opiates
and synthetic opiates test positive on a POCT (point of collection testing) urine drug test, we must first take a look at the different classes that comprise the opioid family. Below is a list of opiate classes, their sub-classes, and common names for drugs that contain these substances. Opiates fall under both prescription and illicit classes.
Natural Opiates Natural opiates are the three natural components that can be extracted from the opium plant. • Diacetylmorphine(Heroin) • Morphine • Codeine • Tebaine (Tebaine is not used for therapeutic or recreational purposes, but is converted industrially into a variety of compounds, including oxycodone, oxymorphone, nalbuphine, naloxone, naltrexone, buprenorphine and etorphine.
Semi-Synthetic Opiates Semi-synthetic opiates are substances partially derived from the opium plant. • Hydrocodone • Hycodan • Vicodin • Oxycodone • OxyContin • Percocet • Percodan • Hydromorphone • Dilaudid • Oxymorphone • Numorphan • Buprenorphine • Subutex
30 datia focus
Synthetic Opioids Synthetic opioids/narcotics have opiate- like reactions within the body but are not derived from opium. • Methadone • Propoxyphene (no longer produced or approved for use in the US)
• Darvocet (no longer produced or approved for use in the US)
• Fentanyl • Darvon • Duragesic • Actiq • Meperidine • Demerol Te most common drugs tested for in
POCT tests are the ones most likely to be abused and affect workplace safety. Tese substances are: • Morphine • Codeine • Hydrocodone • Oxycodone • Hydromorphone • Oxymorphone • Propoxyphene • Heroin • Fentanyl
Test Types POCT tests include various sensitivities. Two of these are the 5 panel and the 12 panel test cards. Each test/card looks at different drug substances and is utilized in different situations, such as DOT testing.
5 Panel Test Cards Te only test available for opiates on this card is the opiate 2000 ng/mL test. Tis card works well for morphine and codeine drug classes and can detect them at 2000 ng/mL. For semi-synthetic and synthetic opioids, the detection levels are as follows: • Hydrocodone—12,500 ng/mL • Hydromorphone—5,000 ng/mL • Oxycodone—25,000 ng/mL • Oxymorphone—25,000 ng/mL • Propoxyphene—not detected • Heroin—see below As you can see, a standard opiate test (5
panel) is relatively ineffective when trying to detect natural, synthetic and semi-synthetic opioids, as the detection levels are so high that it is very unlikely to detect opioids in a person unless they ingested a very large dose recently. As for heroin, 6-monoacetylmorphine is detected at 5000 ng/mL, which is an
winter 2018
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