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The page below is a sample from the LabCE course The Toxicology Laboratory's Role in Pain Management. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Opiate Metabolites

In PM, a confirmation should be performed if a screening result is positive. Since confirmatory methods use mass spectrometry, specific compounds can be identified and quantitated. However, we need to be able to make sense of the specific compounds that are found.
The accompanying diagram and table contain essentially all that is needed to know about opiate metabolism for routine PM testing. Posting this information in the laboratory is very useful. Laboratory testing personnel may find that they quickly memorize the parent and metabolite relationships when reviewing opiate confirmation results.
The information contained in the table may be included with opiate confirmation results to help clinicians understand the results.

Detected Drug
Possible Parent Drug
Detection Window
2-3 days
Hydrocodone, codeine, dihydrocodeine
2-3 days
Hydromorphone, hydrocodone, morphine
2-3 days
Morphine, codeine, heroin
2-3 days
2-3 days
Oxymorphone, oxycodone
2-3 days