Interpreting urine drug tests: prevalence of morphine metabolism to hydromorphone in chronic pain patients treated with morphine.

摘要: Objective.  Pain medicine practitioners frequently use urine drug testing (UDT) to monitor adherence opioid therapy. It can be difficult interpret a result as normal or abnormal in relation which compounds are expected found the urine. We investigated whether hydromorphone may metabolite of morphine normally appearing UDT patients prescribed morphine. Design.  This is retrospective case-control study toxicology results pain taking only morphine. Inclusion criteria included positive for (controls) and (cases). Demographic medical history variables, any aberrant behavior were recorded related presence absence urine. Results.  Hydromorphone was present 21 32 cases (66%), none whom had behavior. Positive occurred more women, those higher daily doses morphine, with concentrations (P < 0.05). Only concentration significant predictor logistic regression model (P < 0.05). Conclusions.  likely minor finding assists determining abnormal, subsequently patient compliant observation should confirmed by prospective controlled environment. Variables such gender, dose, concentration, genetic determinants metabolism further.