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Morphine/Codeine Ratio, a Key in Investigating a Case of Doping
Tohid Seif-Barghi1, Navid Moghadam2, Farzad Kobarfard3
1Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, IR Iran ; Iran Football Medical Assessment and Rehabilitation Center (IFMARC), Tehran, IR Iran.
Asian Journal of Sports Medicine
|December 31, 2015
Summary
Codeine consumption can cause a positive morphine test in athletes. The morphine/codeine ratio helps differentiate codeine use from illicit narcotic abuse, but metabolism rates and CYP2D6 alleles require consideration.
Area of Science:
- Sports Medicine
- Forensic Toxicology
- Pharmacogenomics
Background:
- Codeine is a common medication, while morphine is a prohibited doping agent.
- Athletes may test positive for morphine after consuming codeine.
- The morphine/codeine ratio is a key metric in doping control.
Observation:
- A case of an athlete with a positive urine test for morphine, who had a history of codeine consumption.
- The athlete's disciplinary committee cleared them based on the morphine/codeine ratio, indicating no doping violation.
Findings:
- The morphine/codeine ratio can be influenced by individual metabolism rates.
- CYP2D6 genetic variations significantly affect codeine metabolism.
- Ultra-rapid CYP2D6 metabolizers may present atypical morphine/codeine ratios.
Implications:
- Metabolism analysis is crucial for accurate interpretation of the morphine/codeine ratio in doping cases.
- WADA (World Anti-Doping Agency) should consider CYP2D6 genotyping for codeine-related doping investigations.
- Understanding individual metabolic profiles is essential for fair anti-doping enforcement.
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