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Does naloxone cause a positive urine opiate screen?
A B Storrow1, F H Wians, S L Mikkelsen
1Department of Emergency Medicine, Wilford Hall Medical Center, San Antonio, Texas.
Annals of Emergency Medicine
|December 1, 1994
Summary
Naloxone hydrochloride, an opiate antagonist, did not cause false positive results on urine drug screens for opiates. This study confirms naloxone does not interfere with opiate detection via urine toxicologic screens.
Area of Science:
- Pharmacology
- Toxicology
- Clinical Chemistry
Background:
- Naloxone hydrochloride is an opioid antagonist used to reverse opioid overdose.
- The structural similarity of naloxone metabolites to oxymorphone raises concerns about potential false positive urine drug screens.
- Accurate drug screening is critical in clinical and forensic settings.
Purpose of the Study:
- To investigate whether naloxone hydrochloride metabolites trigger positive urine toxicologic screens for opiates.
- To assess the clinical significance of naloxone metabolite excretion on standard drug testing.
Main Methods:
- A prospective, randomized, double-blinded human study.
- Fourteen healthy adult volunteers received either 2 mg or 4 mg of intravenous naloxone.
- Urine samples were collected pre-administration and at 60 minutes, 6 hours, and 48 hours post-administration for opiate screening.
Main Results:
- All urine drug screens, utilizing the enzyme-multiplied immunoassay technique, were negative for opiates at both naloxone dosage levels.
- The study achieved high statistical power (>0.99) to detect differences between positive and negative samples.
Conclusions:
- Despite structural similarities between naloxone metabolites and oxymorphone, naloxone administration did not result in false positive opiate urine screens.
- These findings indicate that naloxone hydrochloride does not interfere with the reliability of enzymatic urine screens for opiates.