title: Forensic drug testing for opiates. VI. Urine testing for hydromorphone, hydrocodone, oxymorphone, and oxycodone with commercial opiate immunoassays and gas chromatography-mass spectrometry.
abstract: Opiate testing for morphine and codeine is performed routinely in forensic urine drug-testing laboratories in an effort to identify illicit opiate abusers. In addition to heroin, the 6-keto-opioids, including hydromorphone, hydrocodone, oxymorphone, and oxycodone, have high abuse liability and are self-administered by opiate abusers, but only limited information is available on detection of these compounds by current immunoassay and gas chromatographic-mass spectrometric (GC-MS) methods. In this study, single doses of hydromorphone, hydrocodone, oxymorphone, and oxycodone were administered to human subjects, and urine samples were collected before and periodically after dosing. Opiate levels were determined in a quantitative mode with four commercial immunoassays, TDx opiates (TDx), Abuscreen radioimmunoassay (ABUS), Coat-A-Count morphine in urine (CAC), and EMIT d.a.u. opiate assay (EMIT), and by GC-MS. GC-MS assay results indicated that hydromorphone, hydrocodone, oxymorphone, and oxycodone administration resulted in rapid excretion of parent drug and O-demethylated metabolites in urine. Peak concentrations occurred within 8 h after drug administration and declined below 300 ng/mL within 24-48 h. Immunoassay testing indicated that hydromorphone, hydrocodone, and oxycodone, but not oxymorphone, were detectable in urine by TDx and EMIT (300-ng/mL cutoff) for 6-24 h. ABUS detected only hydrocodone, and CAC failed to detect any of the four 6-keto-opioid analgesics. Generally, immunoassays for opiates in urine displayed substantially lower sensitivities for 6-keto-opioids compared with GC-MS. Consequently, urine samples containing low to moderate concentrations of hydromorphone, hydrocodone, oxymorphone, and oxycodone will likely go undetected when tested by conventional immunoassays.
authors.affiliation: Office of the Armed Forces Medical Examiner, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
authors.forename: M L
authors.initials: ML
authors.lastname: Smith
authors.forename: R O
authors.initials: RO
authors.lastname: Hughes
authors.forename: B
authors.initials: B
authors.lastname: Levine
authors.forename: S
authors.initials: S
authors.lastname: Dickerson
authors.forename: W D
authors.initials: WD
authors.lastname: Darwin
authors.forename: E J
authors.initials: EJ
authors.lastname: Cone
mesh_terms: D017248:Enzyme Multiplied Immunoassay Technique; D005554:Forensic Medicine / Q000379:methods*; D008401:Gas Chromatography-Mass Spectrometry; D003932:Heroin; D006801:Humans; D006853:Hydrocodone / Q000737:chemistry / Q000652:urine*; D004091:Hydromorphone / Q000737:chemistry / Q000652:urine*; D008297:Male; D010098:Oxycodone / Q000737:chemistry / Q000652:urine*; D010111:Oxymorphone / Q000737:chemistry / Q000652:urine*; D011786:Quality Control; D011863:Radioimmunoassay; D012015:Reference Standards; D019966:Substance-Related Disorders
chemical_list: D006853:Hydrocodone; D003932:Heroin; D010111:Oxymorphone; D010098:Oxycodone; D004091:Hydromorphone