Understanding Opioid Metabolism: for Urine Drug Testing Interpretation
Interpreting urine drug test results in patients prescribed opioids can be challenging. A solid understanding of opioid metabolism provides clarity and aids in clinical decision-making. Opioids are metabolized primarily in the liver through complex biochemical pathways. This video provides practical insights to help busy medical professionals understand the fundamentals of opioid metabolism, enabling them to effectively interpret urine drug testing results for opioids.
WATCH FOLLOWING YOUTUBE VIDEO ON:
Understanding Opioid Metabolism: for Urine Drug Testing Interpretation
Key Considerations for Urine Drug Testing (UDT):
UDTs detect both parent drugs and their metabolites. Understanding these pathways can clarify whether test results reflect adherence, misuse, or another scenario.
Common Opioids and Their Metabolites:
(a) Codeine:
- Metabolized into morphine and hydrocodone.
- Absence of metabolites may indicate poor CYP2D6 metabolism or tampering.
(b) Morphine:
- Metabolized into hydromorphone.
- If hydromorphone appears without morphine, consider direct hydromorphone use.
(c) Heroin (Diacetylmorphine):
- Rapidly metabolized to 6-monoacetylmorphine (6-MAM) and then morphine.
- 6-MAM presence is a definitive marker for heroin use.
(d) Hydrocodone:
- Metabolized to hydromorphone and norhydrocodone.
- Hydromorphone without hydrocodone suggests hydromorphone misuse.
(e) Oxycodone:
- Metabolized into oxymorphone.
- Presence of oxymorphone without oxycodone may indicate oxymorphone misuse.
FOR ACADEMY MEMBERS:
INTERESTED IN ACCESS TO THIS & OTHER CLINICALLY RELEVANT LECTURE SERIES?
JOIN ACADEMY MEMBERSHIP:
This is a closed membership for medical professionals only.
- 400+ Clinically Relevant Chapters: Each chapter within these sections is of direct clinical relevance for your daily practice. (Table of Content)
- Journal Club: we will post the most recently published psychiatry articles relevant to your daily clinical practice. (Read Content)
- Clinical Case Discussion: Dr. Singh (Psychiatry) and Dr. Kaur (Family Medicine) discuss clinical cases to integrate the clinical cases from Psychiatry and Medicine. (Read Content)
- Monthly Insights: Gain access to our monthly sessions featuring the latest on recent publications, new medication approvals, FDA updates, and more. (Monthly Insights)
- Discussion Forum & Community: Connect with other medical professionals and discuss your difficult-to-treat clinical cases. (Academy Network)
- Goal: is to have all important clinically relevant topics in one place for ease of access.
DISCOUNTS AVAILABLE FOR: Residents & Students ONLY.
Email us your student information (program information and way to confirm your student status) to: HSingh@PsychiatryEducationForum.com
© 2025 All Rights Reserved.
Responses