1-Panel Urine Test:
OPI

Item: DOP-114

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Panel Target Compound Cutoff Level
OPI Morphine 2,000 ng/mL
OPI Panel: Specifications

Summary - OPI Drug Test Panel

  • The opiates are a group of CNS depressant drugs derived from the opium poppy, belonging to the broader opioid drug family. Generally, opiates are classified as analgesics and have both licit and illicit origins. Licit opiates are dispensed by prescription, including morphine and codeine. Illicit opiates include heroin and raw opium, in addition to diverted prescriptions for otherwise licit opiates. Over the years, opioid use and misuse has become endemic in the United States. As of 2011, the US accounted for 75% of the world's opioid prescriptions. [1] Many opioid misusers are likely to combine the drug with a benzodiazepine such as Xanax in order to enhance the effects of the opioid. When potent CNS drugs are combined in such fashions, or when combined with alcohol, results can be unpredictable and at worst fatal. [2]

  • Opioids are attractive to recreational users due to the euphoric effects they produce. Opioids can be powerfully addictive and are prone to strong physical dependence. Many opioid addictions begin with legitimate prescriptions for painkillers, such as oxycodone. When prescriptions are terminated, many patients have difficulty coping with the harsh withdrawal symptoms and continue using painkillers obtained through diverted sources. When high cost or lack of availability prevents this, many turn to cheaper opioid alternatives, such as heroin or diverted buprenorphine (Suboxone). For the opioid addicted attempting abstinence, withdrawal symptoms can be debilitating and long lasting, often requiring professional assistance. [1]

  • Morphine is the target compound for the OPI One Step Opiate Drug Test, detected at a cutoff level of 2,000 ng/mL. Morphine is prescribed for treating pain: in oral tablet form under generic labels and brand names Arymo, MorphaBond, and MS Contin[3] in oral capsule form under generic labels and brand names Kadian and Embeda; in oral liquid form under generic labels; and in injectable form under generic labels and brand names Astramorph, Duramorph, and Infumorph[4] Following a morphine dose, approximately 45–55% is excreted in the urine as morphine 3-B-D-glucuronide (M3G), 10–15% as morphine 6-B-D-glucuronide (M6G), and less than 10% as free morphine. [5]

  • Morphine 3-B-D-glucuronide (M3G) cross-reacts with this test at 2,000 ng/mL. M3G is morphine's (and heroin's) major urinary metabolite, with approximately 45–55% of a morphine dose excreted in the urine as M3G. [5]

  • Heroin misuse has reached epidemic numbers in the United States, with an estimated 435,000 heroin users during the year 2014. [6] From 2002 through 2013, heroin-related overdose deaths nearly quadrupled, with over 8,200 deaths in the US in 2013. [7] Heroin is found in the form of a white to brown powder and is typically snorted or liquefied and injected. Heroin is illegal in the United States, with no accepted medical purpose. Following heroin use, approximately 57% is excreted in the urine as conjugated morphine (primarily morphine 3-B-D-glucuronide (M3G) and morphine 6-B-D-glucuronide (M6G)), 5% as free morphine, and less than 1% as 6-monoacetylmorphine (6-MAM). [8]

  • Codeine cross-reacts with this test at 2,000 ng/mL. Codeine is available primarily in combination with other drugs (coformulations), in the form of oral tablets, capsules, and liquid solutions. Some combinations are indicated for treating pain, and some are indicated for treating coughs and respiratory symptoms associated with allergies and the common cold. Codeine formulas indicated for treating varying levels of pain include codeine only (monoproduct) and codeine combined with one or more of the following: acetaminophen; aspirin, butalbital, caffeine; and carisoprodol. These formulas are dispensed under many generic labels and the brand names Tylenol with Codeine, Fioricet with Codeine, and Fiorinal with Codeine[9] Formulas indicated for treating coughs and respiratory symptoms include codeine combined with one or more of the following: chlorpheniramine, phenylephrine; promethazine; pseudoephedrine, and triprolidine. These combinations are dispensed under many generic labels and the brand names Prometh VC with Codeine, Triacin, and Tuzistra[10] Approximately 5–17% of a codeine dose is excreted in the urine as free codeine. [11]

  • Purple drank, also known as sizzurp or lean, is commonly found in many United States urban regions. Recipes vary, but the concoction begins with an opiate-based cough syrup, such as codeine with promethazine. The cough syrup is diluted with a sweet beverage, such as Sprite, 7Up, or Kool-Aid. Crushed candies, such as Jolly Ranchers, might be added. These liquid potions can be deceptively dangerous. As with any opioid, the potential for addiction and physical dependence is significant. In recent times, many high profile athletes and musicians have been arrested and charged with possession of purple drank or codeine syrup. [12]

  • Opium tincture, also known as laudanum, is a potion that dates back to Victorian times. Opium tincture contains anhydrous morphine in an alcohol solution and is indicated for treating diarrhea. Opium tincture is not an FDA approved drug, yet is still available in the United States by prescription. With any morphine product, the risk of addiction and physical dependence is a concern. [13]

  • Oxycodone cross-reacts with this test at 25,000 ng/mL. However, this cutoff level is prohibitively high for the reliable detection of oxycodone use. Instead, an oxycodone test device should be employed, such as the OXY One Step Oxycodone Drug Test, which targets oxycodone at 100 ng/mL.

Specificity - OPI Drug Test Panel

The following compounds are detected positive in urine by the OPI One Step Opiate Drug Test at 5 minutes. Cutoff represents the concentration of each compound required to yield a positive reading, expressed in nanograms of compound per milliliter of urine (ng/mL). A lower cutoff indicates a greater ability to detect the compound.

Compound Description / Synonyms / Brand Names Cutoff
(ng/mL)
Morphine Morphin, Morfina / Arymo, Astramorph, Duramorph, Embeda, Infumorph, Kadian, Morphabond, MS Contin 2,000
Codeine Methylmorphine, Codein, Codeina / Fioricet with Codeine, Fiorinal with Codeine, Prometh VC with Codeine, Triacin, Tuzistra, Tylenol with Codeine 2,000
Ethylmorphine EM, Codethyline, Ethylmorphin 5,000
Hydrocodone HC, Dihydrocodeinone, Hydrocodon, Hidrocodona, Idrocodone / Anexsia, Flowtuss, Hycofenix, Hysingla, Norco, Reprexain, Rezira, TussiCaps, Tussigon, Tussionex, Vantrela, Vituz, Zohydro, Zutripro, Zyfrel 12,500
Hydromorphone HM, Dihydromorphinone, Hydromorphon, Hydromorfona, Hidromorfona, Idromorfone / Dilaudid, Exalgo 5,000
Levorphanol Levorphan, Levorfanol 75,000
6-Monoacetyl-morphine Heroin metabolite / 6-Acetylmorphine, 6-AM, 6-MAM 5,000
Morphine 3-B-D-glucuronide Morphine and heroin metabolite / M3G, Morphine glucuronide, Morphine 3-beta-D-glucuronide, Morphine 3-β-D-glucuronide 2,000
Norcodeine Codeine metabolite / NC, Norcodeina 12,500
Normorphone Morphine and heroin metabolite / NM, Normorphine, Normorfina 50,000
Oxycodone OC, Oxycodon, Oxicodona, Ossicodone / Oxaydo, Oxycet, OxyContin, Percocet, Percodan, Roxicet, Roxicodone, Roxybond, Troxyca, Xtampza 25,000
Oxymorphone OM, Oxymorphine, Oxymorphon, Oximorfona / Opana 25,000
Procaine Procain, Procaina 150,000
Thebaine Paramorphine 100,000