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Naltrexone and Its Noroxymorphone Minor Metabolite - A Case Report
Cornel N Stanciu1, Samantha Gnanasegaram2
1Dartmouth Geisel School of Medicine, Director of Addiction Services, New Hampshire Hospital , Concord, USA.
Abstract:
As part of substance use maintenance programs, individuals are monitored for sobriety through urine drug screens. A positive screen, and its confirmation and interpretation, can have devastating consequences, sometimes even leading to termination from the program and relapse. Naltrexone metabolism involves several steps and metabolites - one minor metabolite with very little mention in medical literature being noroxymorphone. This is also the final intermediate in the metabolic pathway of oxycodone; hence, detection is naturally presumed by clinicians to be attributed to oxycodone use. Through this case report, we alert clinicians that, depending on individual pharmacogenomics, it is possible to obtain a positive confirmation of this component alone (without any oxycodone pathway intermediates) with naltrexone administration.
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