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Family Physician
Family Physician, Board Certified MRO
Category: Drug Testing
Satisfied Customers: 12816
Experience:  Medical Review Officer - Physician Trained and certified in drug test interpretation
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Please interpret this drug test. Barbiturates and Morphine

Customer Question

Please interpret this drug test. Barbiturates and Morphine positive. This employee provided information about being in rehab for some drug addiction which might explain barbiturates. But doies it explain Opiates? Any rehab related drugs might cause opiates positive or false positive?
AMPHETAMINES Negative 1000 ng/mL 500 ng/mL
BARBITURATES POSITIVE 300 ng/mL 200 ng/mL
PHENOBARBITAL POSITIVE
BENZODIAZEPINES Negative 300 ng/mL 200 ng/mL
COCAINE METABOLITES Negative 300 ng/mL 150 ng/mL
MARIJUANA METABOLITES Negative 50 ng/mL 15 ng/mL
METHADONE Negative 300 ng/mL 200 ng/mL
METHAQUALONE Negative 300 ng/mL 200 ng/mL
OPIATES 2000 ng/mL
MORPHINE POSITIVE 2000 ng/mL
CODEINE Negative 2000 ng/mL
PHENCYCLIDINE Negative 25 ng/mL 25 ng/mL
PROPOXYPHENE Negative 300 ng/mL 200 ng/mL
Submitted: 1 year ago.
Category: Drug Testing
Expert:  Family Physician replied 1 year ago.
Was this test done with GC/MS confirmation?
Was this test reviewed by a certified Medical Review Officer (MRO)?
What medications is the person legally prescribed?
Why was this test done?
Customer: replied 1 year ago.
yes this is info from MRO Drug Detail Report . Test is employment related. We are not sure what medications are prescribed. Employee only provided letter from rehab about being treated. No further details. GC/MS confirmation - please explain that one.
Expert:  Family Physician replied 1 year ago.
There are two types of tests - screening tests that rely on immunoassay and confirmation tests (using GC/MS technology) that eliminates any issues with false positives from chemical interference from other medications.
Without specific information on any medications being prescribed, it is not possible to determine if the positive tests are the result of legal prescription use OR if they are the result of illicit use/abuse.
The report does need to be reviewed by a MRO who would interview the employee and verify any reported legal prescription use.
Customer: replied 1 year ago.
Gotcha. But the question was. Might any rehab facility legal drug administration procedure cause opiates positive result?
Customer: replied 1 year ago.
Also I guess they sent us 10 panel test and MRO will follow it seems like. MRO was also ordered. Is it possible that the person filled questionnaire at the collection facility and this MRO will be based on it? I think we do not have MRO yet seems like. We have info that this was MRO but looks like a clerical mistake and this is 10 panel retest ( we initially ordered 5 panel and then retest in 10 panel)
Expert:  Family Physician replied 1 year ago.
Yes - a rehab might prescribe an opiate for pain.
The interpretation of these tests MUST be done by a MRO who interviews the donor.
Poppy seeds can also theoretically cause low levels of morphine - but the actual concentration on the GC/MS confirmation would be needed.
You really MUST get this reviewed by a MRO. Your local hospital occupational medicine department would likely have a MRO.
If not, you could find one through AAMRO
https://www.aamro.com/
or
MROCC
https://www.mrocc.org/Search.cfm
These are the two national MRO certication organizations
Customer: replied 1 year ago.
So then - employee must be contacted? Or it will rely on his questionnaire or MRO must actually get in actual (call or in person) contact with the donor?
Expert:  Family Physician replied 1 year ago.
The MRO would need to contact the donor directly. The fact that someone says "I'm taking X, Y or Z" medications is not the same as a MRO review and VERIFICATION (from the pharmacy, physician or rehab DIRECTLY) by the MRO.
Customer: replied 1 year ago.
o. Lastly - is it possible for a person treated for opiates addiction to be administered any opiates at rehab for medicinal purposes?
Expert:  Family Physician replied 1 year ago.
I'm very sorry for the delay - I had some emergencies I needed to attend to.
YES - in rare cases, opiates could be appropriately used.

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