Unexpected urine drug testing results in a hospice patient on high-dose morphine therapy

Clinical Chemistry

Volumn 55, Issue 10, 2009, Pages 1765-1768

  Reisfield, Gary M ^a   Chronister, Chris W ^b   Goldberger, Bruce A ^b   Bertholf, Roger L ^a  

^a UNIVERSITY OF FLORIDA HEALTH SCIENCE CENTER   (United States)

^b UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

DRUG METABOLITE; HYDROMORPHONE; MORPHINE SULFATE; MSCONTIN; UNCLASSIFIED DRUG;

ADULT; ARTICLE; ARTIFICIAL EMBOLISM; CANCER PAIN; CASE REPORT; CONTROLLED DRUG RELEASE; DRUG ABUSE; DRUG CONTAMINATION; DRUG DOSE ESCALATION; DRUG MEGADOSE; DRUG METABOLISM; DRUG MONITORING; DRUG SCREENING; DRUG URINE LEVEL; ERYTHROCYTE TRANSFUSION; FEMALE; HOSPICE PATIENT; HUMAN; MASS FRAGMENTOGRAPHY; QUANTITATIVE ASSAY; SOLID PHASE EXTRACTION; URINALYSIS; UTERINE CERVIX CANCER; VAGINA BLEEDING;

ADULT; ANALGESICS, OPIOID; FATAL OUTCOME; FEMALE; HOSPICE CARE; HUMANS; HYDROMORPHONE; MORPHINE; NEOPLASM INVASIVENESS; NEOPLASM METASTASIS; PAIN; UTERINE CERVICAL NEOPLASMS;

EID: 70349671206     PISSN: 00099147     EISSN: 15308561     Source Type: Journal    
DOI: 10.1373/clinchem.2008.122754     Document Type: Article

References (9)

1. Substance Abuse and Mental Health Services Administration (SAMHSA). Results from the 2007 National Survey on Drug Use and Health: national findings. Rockville (MD); SAMHSA, Office of Applied Studies; 2008. 209 p. NSDUH Series H-34, DHHS Publication No. SMA08-4343.
2. Paulozzi LJ, Budnitz DS, Xi Y. Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiol Drug Saf 2006;15:618-627 (Pubitemid 44404658)
3. Reisfield GM, Bertholf R, Barkin RL, Webb F, Wilson G. Urine drug test interpretation: what do physicians know? J Opioid Manag 2007;3:80-86
4. Cone EJ, Heit HA, Caplan YH, Gourlay D. Evidence of morphine metabolism to hydromorphone in pain patients chronically treated with morphine. J Anal Toxicol 2006;30:1-5. (Pubitemid 44270335)
5. Cone EJ, Caplan YH, Moser F, Robert T, Black D. Evidence that morphine is metabolized to hydromorphone but not to oxymorphone. J Anal Toxicol 2008;32:319-323 (Pubitemid 351679824)
6. Wasan AD, Michna E, Janfaza D, Greenfield S, Teter CJ, Jamison RN. Interpreting urine drug tests: prevalence of morphine metabolism to hydromorphone in chronic pain patients treated with morphine. Pain Med 2008;9:918-923
7. Hall S, Gallagher RM, Gracely E, Knowlton C, Wescules D. The terminal cancer patient: effects of age, gender, and primary tumor site on opioid dose. Pain Med 2003;4:125-134 (Pubitemid 36949869)
8. Chronister CW, Gund AL, Goldberger BA. Rapid detection of opioids in vitreous humor by enzyme immunoassay. J Anal Toxicol 2008;32:601-604
9. Oyler JM, Cone EJ, Joseph RE Jr, Huestis MA. Identification of hydrocodone in human urine following controlled codeine administration. J Anal Toxicol 2000;24:530-535