Opiates Urine Test

An opiate urine test is the preferred test to check for opiate abuse in legal cases (such as for granting child custody) or for employment testing. This is because opiates can be detected in the urine for up to several days after intake, even though the blood opiate levels start to decline within a few hours. However, different opiates stay for a different duration in the urine. Following are some of the drugs that can be detected using the opiates urine test, along with the time frame:

• Heroin: Heroin can be detected in the urine up to seven days after the last use
• Hydrocodone: Hydrocodone can be tested up to four days after the last use
• Fentanyl: Fentanyl can be detected in the urine only for eight to 24 hours after the last use
• Methadone: Methadone can be easily detected in the urine from one hour of taking the drug up to two weeks
• Morphine: Morphine can be detected only up to three days after the last use
• Codeine: Codeine, the fastest opiate, is detectable only for 24-48 hours after use

Your doctor may also order this test for monitoring opiate use during the treatment of chronic pain. It helps the healthcare provider to assess the right dosage of the medication and prevent dependence.

During sports tournaments, athletes are asked to undergo an opiates urine test to check if they are abusing these drugs for performance enhancement. 

Additionally, an opiates urine test may be ordered for people who show the following signs and symptoms suggestive of opiate use/abuse:

• Slurred speech 
• Dilated or small pupils
• Lethargy
• Anxiety
• Nausea
• Difficulty breathing
• Hallucinations
• Seizures
• Changes in blood pressure or heart rhythm (Read more: Arrhythmia symptoms)

You do not require any special preparation for this test. Fasting is not required either. Inform your doctor if you are taking any prescribed, non-prescribed or illicit medications. Drugs such as verapamil, quetiapine, diphenhydramine, doxylamine, rifampicin and quinolone antibiotics have been reported to interfere with the test results. Do not stop any medication without consulting the doctor. Avoid poppy seeds-containing foods before the test.

A sterile urine sample is required for this test. You’ll be provided with a special container to collect the sample.

• First, wash and clean your hands thoroughly using disinfectant
• Clean your genital area using cleaning wipes to ensure the collection of a clean sample
• Let the first few drops of your urine drain away and then hold the container under the stream of urine
• Collect the urine in the container up to the marking indicated, which would be around 30-50 millilitres
• Submit the sample to the laboratory for testing

Normal results:

A normal result in opiate urine test is reported as negative, absent or undetected. This indicates that there is no opiate present in the given sample or the concentration of opiate is less than the cut-off value. Cut-off value is a standard concentration of a drug in the body which separates the normal levels of that drug from abnormal levels. The cut-off value for a urine test is measured in nanograms per millilitre (ng/mL). The following is a list of cut-off values for some of the opiates:

• Methadone: 300 ng/mL
• Fentanyl: 2ng/mL
• Oxycodone: 100 ng/mL
• Tramadol: 10 ng/mL

However, false-negative results are also possible, which may be due to the addition of bleach or an adulterant to the sample. In such cases, the result is reported as invalid or adulterated. Sometimes, the urine sample is much diluted due to a medical condition or the addition of water; in such cases, the test will be reported as diluted.

Abnormal results:

An abnormal test result is reported as positive, detected or present. This indicates that opiate is present in the sample provided. 

It is important to note that this test only confirms the presence of opiate in the body and does not give information about when or how much opiate was consumed by the individual. However, sometimes the test may give false-positive results. False-positive results can be due to:

• Poppy seed-containing foods
• Quinolone antibiotics
• Rifampicin
• Verapamil
• Quetiapine
• Diphenhydramine
• Doxylamine

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.