Drug Testing For Opiate Use

Recent statistics from the National Center for Drug Abuse Statistics show that approximately 2.5 million Americans currently suffer from opioid use disorder, with over 10 million people misusing prescription opioids in the past year_¹. Let us examine the basics of drug testing for opiate use, including a brief history, effects of the drug, testing requirements, windows of detection and cutoff levels.

A syringe that is used for shooting up heroin. Heroin is one of several types of opiates & opioids. — A heroin syringe in the street

What Are Opiates?

Opiates are naturally derived from opium which is produced from the poppy plant “Papaver somniferum”. Opium has been used for over 3,000 years as a powerful pain reliever. Today, most opium is produced in countries like Myanmar and Afghanistan, where it is sold for profit and distributed around the world.

The term “Opioids” encompasses both natural and synthetic versions of opiates. These opioids are typically prescribed by a doctor for pain relief. However, they are also used by many people to get high.

Heroin is a Schedule I controlled substance due to its high risk for abuse and non-existent medical use. Whereas the rest of the opiates and opioids range from Schedule II to Schedule V since they do have a legitimate medical use.

Common opiates and opioids include_²:

Natural Opiates:

– Morphine

– Codeine

– Thebaine

Semi-synthetic Opioids:

– Heroin

– Hydrocodone

– Oxycodone

– Hydromorphone

Synthetic Opioids:

– Fentanyl

– Methadone

– Tramadol

– Meperidine

Common routes of administration include:

– Oral consumption (pills/tablets)

– Intravenous injection

– Intranasal use (snorting)

– Transdermal application (patches)

– Smoking

Opiates and opioids are commonly found in the following forms:

-Powder

-Tablets/Capsules

-Liquid

-Black tar-like substance

Opiates’ Effect On The Body

Opiates primarily work by binding to specific receptors in the brain and throughout the body_³:

1. Mu-opioid receptors: Primary target for pain relief and euphoria

2. Delta-opioid receptors: Contribute to analgesic effects

3. Kappa-opioid receptors: Influence perception and mood

These interactions produce effects within:

– 10-30 seconds when injected

– 2-5 minutes when smoked

– 4-5 minutes when snorted

– 15-30 minutes when taken orally

– 1-2 hours when using transdermal patches

Effects will last between 2-5 hours, depending on the method of administration. Injection will only last 2-3 hours, whereas smoking and snorting will last around 4-5 hours.

Users commonly experience:

– Pain relief

– Intense euphoria

– Drowsiness

– Constipation

– Slowed breathing

– Pinpoint pupils

– Mental confusion

– Nausea

– Itching sensations

Severe adverse effects include:

– Respiratory depression

– Physical dependence

– Withdrawal symptoms

– Overdose

– Death

When Is Drug Testing For Opiate Use Required?

Testing is commonly performed for various reasons_⁴:

Clinical Settings:

– Pain management monitoring

– Addiction treatment programs

– Emergency department screening

– Routine medical care

Workplace Testing:

– Pre-employment screening

– Random testing programs

– Post-accident investigation

– Reasonable suspicion testing

The Department of Transportation (DOT) performs drug testing for opiate use in their employees. Opiates are one of the five mandatory testing categories for the DOT, alongside marijuana, cocaine, amphetamines and PCP.

Additional Reasons For Testing:

– Probation/parole monitoring

– Child custody cases

– DUI investigations

– Law enforcement investigations

– Military screening

What Specimen Types Are Used For Opiate Drug Testing?

Opiates can be detected in various biological specimens. The type of specimen chosen depends on testing factors like purpose, desired detection window, method availability and cost.

Urine is the most commonly used specimen for opiate drug testing. Blood, hair and oral fluid (saliva) are options as well, although they are rarely used.

What Are The Test Cutoffs Used For Drug Testing For Opiate Use?

Standard cutoff levels vary by testing method₅:

Initial Cutoff Levels:

– Morphine/Codeine: 2000 ng/mL

– Hydrocodone/Hydromorphone: 300 ng/mL

– Oxycodone/Oxymorphone: 100 ng/mL

– 6-Acetylmorphine (Heroin): 10 ng/mL

Confirmatory Cutoff Levels:

– Morphine/Codeine: 2000 ng/mL

– Hydrocodone/Hydromorphone: 100 ng/mL

– Oxycodone/Oxymorphone: 100 ng/mL

– 6-Acetylmorphine (Heroin): 10 ng/mL

How Long Are Opiates Detectable?

Detection windows vary by drug type and specimen. Here are the detection windows for urine specimens₆:

– Fentanyl: 1-3 days

– Morphine: 2-3 days

– Codeine: 2-3 days

– Heroin: 2-4 days

– Oxycodone: 2-4 days

– Hydrocodone: 2-4 days

– Methadone: 3-7 days

Factors Affecting Detection

Several variables can influence opiate detection windows₇:

Physiological Factors:

– Metabolism rate

– Hydration level

– Body mass

– Age/Gender

– Kidney function

– Liver health

– Overall health status

Drug-Related Factors:

– Dose amount

– Frequency of use

– Route of administration

– Drug purity

– Concurrent medications

– Duration of use

Who Are The Main Users of Opiates?

Based on recent data, the demographics of illicit opiate users show several patterns₈:

Primary User Groups:

– Young adults aged 18-25 have the highest rates of non-medical use

– Adults aged 26-34 represent the second most affected group

– Predominantly White and Native American populations

– Higher prevalence among lower-income individuals

Risk Factors₉:

– History of prescription opioid use for pain

– Mental health conditions, particularly depression and anxiety

– Previous substance use disorders

– Limited access to healthcare

– Chronic pain conditions

Geographic Patterns₁₀:

– Rural and semi-rural communities, particularly in Appalachia

– Northeast and Midwest regions show higher rates

– Areas with high unemployment rates

– Communities with limited addiction treatment resources

Recent trends indicate₁₁:

– Increasing use among suburban populations

– Growing numbers of young professionals

– Rising rates among women of childbearing age

– Significant overlap with methamphetamine use

Conclusion

Understanding opiate drug testing is crucial for healthcare providers, employers, and individuals involved in monitoring programs. With the ongoing opioid crisis, accurate and appropriate testing remains a vital tool for both clinical care and public health efforts. If you or someone you know struggles with opiate use, seek professional medical help immediately.