Does naloxone cause a positive urine opiate screen?
OBJECTIVE
To determine whether the excreted metabolites of naloxone hydrochloride cause positive urine toxicologic screens for opiates.


METHODS
Prospective, randomized, double-blinded human protocol.


METHODS
Urban Level I military emergency department.


METHODS
Fourteen adult volunteers who took no routine medications, were not pregnant, had no known sensitivity to naloxone, and who were negative for a pretest urine and serum toxicologic screen.


METHODS
We administered either 2 or 4 mg IV naloxone to 14 subjects. Urine drug screening was obtained before administration and at 60 minutes, 6 hours, and 48 hours after administration.


RESULTS
All urine drug screens using the enzyme-multiplied immunoassay technique were negative for opiates at both dosage levels. The sample size of 14 yielded a power of more than .99 to detect the difference between positive and negative samples.


CONCLUSIONS
Although the metabolites of naloxone hydrochloride are similar in structure to oxymorphone and are excreted in human urine for several days, naloxone was not associated with a positive enzymatic urine screen for opiates.
Department of Emergency Medicine, Wilford Hall Medical Center, San Antonio, Texas.
A B
AB
Storrow
F H
FH
Wians
S L
SL
Mikkelsen
J
J
Norton
D000328:Adult; D004311:Double-Blind Method; D004630:Emergencies; D017248:Enzyme Multiplied Immunoassay Technique; D005189:False Positive Reactions; D006801:Humans; D008875:Middle Aged; D009270:Naloxone / Q000737:chemistry / Q000493:pharmacokinetics / Q000652:urine*; D009294:Narcotics / Q000652:urine*; D010111:Oxymorphone / Q000737:chemistry / Q000652:urine; D010865:Pilot Projects; D011446:Prospective Studies; D015813:Substance Abuse Detection / Q000379:methods*
D009294:Narcotics; D009270:Naloxone; D010111:Oxymorphone