| Our laboratory confirms urine opioids by GC-MS. Objectives: Develop a LC-MS/MS assay to detect codeine, morphine, hydromorphone, hydrocodone, oxymorphone, oxycodone, and glucuronide metabolites with increased sensitivity and decreased sample preparation. Results: Using a 10ng/mL LC-MS/MS cut-off, of 33 patient urines, 30% were morphine-3-B-D-glucuronide positive but morphine negative. Of 33 patient urines, 24% were hydromorphone-3-B-D-glucuronide positive but hydromorphone negative. Of 22 patient urines, 14% were codeine-6-B-D-glucuronide positive but codeine negative. No urines were oxymorphone-3-B-D-glucuronide positive and oxymorphone negative (n=18). Conclusions: Our LC-MS/MS assay detects the above opioids and glucuronide metabolites. Detection of free drug only would lead to false negative confirmations. |
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