Drug testing for opiates
Originating from the poppy plant, codeine and morphine are examples of naturally-occurring opiates which provide pain relief and depress the central nervous system in the human body. Semi-synthetic opiates are derived from compounds found in the poppy plant which include hydrocodone, oxycodone, hydromorphone and oxymorphone. The term ’opioid’ refers to drugs that are chemically synthesized to mimic the physical effects of pain relief seen with opiates. Opioids include all drugs that act at opioid receptors and have pharmacological effects similar to opiates.
- Codeine is an opiate pain medication. It can commonly be found in prescription cough syrups dispensed for mild to moderate pain, cough and diarrhea. Side effects include dizziness, sleepiness and shortness of breath. Codeine use can be habit-forming even in regular doses.
- Morphine is the most abundant opiate derived from the opium plant. With hundreds of brand names, morphine is an analgesic drug that acts directly on the central nervous system. It is a schedule II (or III, depending on formulation) narcotic often used before and after surgical procedures to alleviate severe pain. Side effects include constipation, loss of appetite, nausea, vomiting, stomach pain, headache, and trouble sleeping. Morphine has a high potential for addiction and dependence.
- Hydrocodone, a schedule II narcotic, is an opiate analgesic derived from codeine. Predominantly prescribed within the United States, it is used for a variety of dental and injury-related pain. Common side effects include nausea, vomiting, constipation, dizziness, dry mouth, anxiety and moodiness. Yet, some users report euphoria and a pleasant numbing sensation at higher doses. Its trade names are Vicodin®, Lorcet®, Lortab® and Hycodan®.
- Hydromorphone, a schedule II narcotic, is used for the relief of moderate to severe, chronic pain due to surgery, cancer, trauma/injury and burns. It is approximately eight times more potent on a per milligram basis than morphine. Side effects include nausea, vomiting, headache, dry mouth, loss of appetite and dizziness. Its trade name is Dilaudid®.
- Oxycodone is used to treat moderate to severe pain and can be habit forming. Side effects can include breathing problems, cold sweats, headaches, low blood pressure, confusion, drowsiness or fainting and fever. Recent DTI data reported that oxycodone positivity declined for the second consecutive year. Its trade names include OxyContin®, Endocet®, Endodan®, Percoset®, Percodan®,OxyFast®, OxyIR®, Roxicet® and Tylox®. Richard Simpson, Director of Science at our Norristown, PA laboratory, authored a Name That Drug article in DATIA Focus magazine about the history and science of oxycodone.
- Oxymorphone is a narcotic used for the relief of moderate to severe pain and is prescribed in immediate and extended release formulations. Side effects include nausea, constipation, lightheadedness or drowsiness. Oxymorphone can have a high risk for abuse and severe, possibly fatal, breathing problems. Its trade names are Opana® and Numorphan®.
- Methadone is a synthetic, narcotic analgesic used for pain relief and for the treatment of heroin addiction. The drug shares some of the characteristics of morphine, yet the gradual onset helps to prevent users from getting high. Although methadone is intended to prevent addiction and dependence along with associated withdrawal symptoms, there is still the possibility of illicit diversion and addiction. Side effects include restlessness, nausea, vomiting, itchy skin, constipation and slowed breathing. Randy Clouette, Forensic Laboratory Director at our Lenexa, KS laboratory authored a Name That Drug article in DATIA Focus magazine about the history and science of methadone.
- Fentanyl is a powerful synthetic opioid that is similar to morphine but is 50 to 100 times more potent. Physicians prescribe this Schedule II drug to treat patients with severe pain and to manage post-surgery pain. The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl according to the National Institute on Drug Abuse. The White House Office of National Drug Control Policy called illicit fentanyl, “an urgent public health crisis” that is compounding the ongoing prescription drug epidemic in the U.S.
View the Quest Diagnostics Drug Testing Index™ for positivity and trends in workplace drug testing.