Opiate Metabolism

Opiates are a class of natural and semi-synthetic compunds derived from the opium poppy plant, Papaver somnifreum.  These compounds are used primarily for pain relief (analgesia) and in some cases, for their anti-tussive properties.  The nautrally occuring opiates are morphine and codeine; the other members of the opiate family are the semi-synthetic derivatives (hydrocodone, hydromorphone, oxycodone, oxymorphone).  These drugs exert their analgesic and other effects by binding to specific opiate receptors in the central nervous system.  There are other drugs that act on opiates receptors, but are structurally unrelated to the natural and semi-synthetic opiates (i.e. buprenorphine, fentanyl, methadone).  These are known as narcotic analgesics.

Opiates and narcotic analgesics have important therapeutic uses, but are widely subject to abuse.  Heroin, a semi-sythetic derivative of morphine, is a highly addictive substance that has no known medical applications and it use, manufacture and possesion is illegal.   Hydrocodone and oxycodone are two semi-synthetic opiates used as medications that are commonly abused.  One challenge in urine drug testing, especially for pain management programs, is correlating positive urine drug test results for opiates with the medication that is prescribed to the patient.  Understanding the metabolism of natural and semi-synthetic opiates is helpful in making proper judgements about medication compliance and misuse.  Here is a schematic of natural and semi-synthetic opiate metabolism obtained from the San Fransisco General Toxicology Laboratory. 

For additional information on opiate and narcotic analgesic metabolism please consult the following resource:                                                                                                                                           

Smith, Howard. Opioid Metabolim. Mayo Clinic Proceedings 2009: July 84 (7): 613-624

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704133/

These should be used a reference tool only; please contact Options Lab, Inc for assistance in interpreting urine drug test results