Does Hydromorphone Show Up As Just Morphine In Lab Work?

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I receive a monthly script for Dilaudid (Hydromorphone) due to Chronic Back pain... Recently I got bit by pitbull & a friend shared some of their medication which I took for a few days till I felt better. She said after 24 hrs it transforms in body into Morphine (so if i take hydromorphone regularly & waited 34-48 hrs Id be fine for my UA if i got one)...

So when I got in trouble for having Morphine in my UA I was upset and shocked! The other drug came up as Morphine, now I'm in trouble cause there saying I tested positive for Morphine - but I thought that Hydromorphone was supposed to come up on pee/blood tests as morphine, & never heard of any issues? Are they giving me a different test that shows a difference between morphine and hydromorphone? & I honestly haven't touched the other drugs since, but it truly saved me at the time... I love my pain management place and am not sure how to handle this, but having the facts and knowing if they can tell difference between Dilaudid and Morphine would help, and any ideas id appreciate....Thank you!

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Yes, there are different tests, while the initial metabolites of these tests might come up questionable, they can send them to an outside lab which can perform further checks that will enable them to determine what you actually took.

The FDA warns that these medications carry the risk of being habit forming and may cause side effects, such as nausea, dizziness, headache, constipation, and dry mouth.

What it comes down to is the fact that while they do share some metabolites, there are always some differences that will show what you actually ingested.

Is there anything else I can help with?

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Hydromorphone and morphine show up the same on drug test.
After hydromorphone enters your body, your body metabolizes it into morphine. So if u take a dilauded (hydromorphone)... then it could show as hydromorphone and morphine or just morphine. But either way you are good. If they said otherwise then they are confused.

It only works with those two drugs though... if u were to take an oxycodone or something else then it would show totally different and you'd be screwed.

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Re: Blahblahblah (# 2) Expand Referenced Message

Pain doctors these days will not take action based solely on imprecise screening tests. They follow guidelines which say to use Gas (or Liquid) Chromatography combined with Mass spectroscopy, Each compound has a spectrographic signature which indicates which elements (like Carbon, Nitrogen, Oxygen, Hydrogen) are present, and the relative quantities of each. The lab uses a standardized library of compound descriptions containing specs which are compared against the relative quantities of each element detected. If the library contains signature specs of all compounds of the kind the doctor cares about, one of those library specs will compare closer to the detected signature than any other spec in the library. Six common opioid drugs have structures that are very slight modifications of a structure usually referred to as the morphine structure, and which differ much more from other opioids (such as fentanyl). These six are: morphine, codeine, oxymorphone, hydromorphone, oxycodone, hydrocodone. For example, the structures of oxymorphone and hydromorphone differ from each other by one oxygen atom. While oxycodone and hydrocodone differ from those, they differ from each other by an oxygen atom in the same position. Similarly, oxymorphone has the same structural difference from oxycodone that hydromorphone has from hydrocodone.

If you are taking a drug that has a signature very similar to one of those six, if the drug in question does not have a spec in the library, it is possible that it will be reported as another drug with a very similar signature. For this reason, you should make sure that the doctor tells the lab of all of the drugs that you are taking, not just the ones that he wants to know whether or not you are taking. If an unexpected result still occurs, make sure that the lab is using a library that includes the drug that may have a similar spec.

For example, When a doctor requests a list of the opioids that testing indicates you are taking, Millennium Labs will use a library of opioid specs. When presented with urine containing naloxegol (Movantik) this lab reported it as hydromorphone until after the date the lab told the doctor that naloxegol had been added to their opiate library.

Smaller libraries are normally preferred, as it takes a non zero amount of time to make a comparison against each spec in the library. With huge libraries containing every known compound, each test would take an inordinate amount of time, and consequently be inordinately expensive.

It should be noted that the entire molecule is not involved. There is an ionization stage in which, for example, morphine sulfate may be split into morphine and sulfate ions. The morphine ion is what is to be detected. This can help explain what happened with naloxegol. Naloxegol combines naloxone (which uses a minor variant of the morphine structure) with a PEG sequence. After ionization, only the naloxone ion is considered. The PEG ion is effectively discarded. Since pain doctors never cared about the presence of naloxone, it was not present in the library, but since it uses a variant of the morphine structure, tit was reported as the closest variant known in the library.

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