title: Excretion profile of opiates in dependent patients in relation to route of administration and type of drug measured in urine with immunoassay.
abstract: It is accepted that opiates are detectable in urine within three days from the last dose at a cut-off value of 300 ng/mL. In our clinical practice, some patients tested positive for morphine even after a week of detoxification. The present study evaluates the time course of opiate excretion in urine of dependent subjects (F11.25 according to ICD-10) in relation to route of administration and a kind of street heroin. The group comprised 71 men treated for opiate dependency: 33 of them used heroin exclusively by inhalation; 26 i.v.; 12 used i.v. homemade poppy straw decoctions. Opiate levels were measured once a day by fluorescence polarization immunoassay (TDx Abbott). Detection time ranged from 3 to 10 days for cut-off value 300 ng/mL and from less than one up to seven days for cut-off value 2000 ng/mL. The increases in urine drug concentration that result from changes in urinary output may be mistakenly interpreted as a new drug use. Normalization of drug excretion to urine creatinine concentration reduces the variability of drug measurement attributable to urine dilution. The time function of creatinine normalized opiate concentration has a log-linear character, and decreases at a rate of 2.5 per day on average. New "normalized" cut-off values were proposed: 225 ng/mg creatinine, 1500 ng/mg creatinine, and 3750 ng/mg creatinine that corresponds to 300 ng/mL urine, 2000 ng/mL urine, and 5000 ng/mL urine.
authors.affiliation: Department of Neurochemistry, Institute of Psychiatry and Neurology, Warsaw, Poland. taracha@ipin.edu.pl
authors.forename: Ewa
authors.initials: E
authors.lastname: Taracha
authors.forename: Boguslaw
authors.initials: B
authors.lastname: Habrat
authors.forename: Karina
authors.initials: K
authors.lastname: Chmielewska
authors.forename: Helena
authors.initials: H
authors.lastname: Baran-Furga
mesh_terms: D003404:Creatinine / Q000652:urine; D004333:Drug Administration Routes; D003932:Heroin / Q000008:administration & dosage / Q000652:urine; D006556:Heroin Dependence / Q000652:urine*; D006801:Humans; D013287:Illicit Drugs / Q000652:urine; D007118:Immunoassay / Q000379:methods*; D008297:Male; D009294:Narcotics / Q000008:administration & dosage / Q000652:urine; D012016:Reference Values; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D013287:Illicit Drugs; D009294:Narcotics; D003932:Heroin; D003404:Creatinine