Explanation

Morphine (urine): what is measured?

The analysis looks for morphine and related opiates in urine. Morphine is a strong painkiller that is also prescribed as a medicine. In addition, morphine is formed in the body from heroin and from codeine. The test therefore looks at a group of substances and not at one source.

What can it detect?

The presence of morphine or related opiates in the urine, after use of morphine as a medicine, of codeine or of heroin

Result

What does the result mean?

Positive result

A positive result means that there is morphine or a related substance in the urine above the laboratory's limit. According to the Dutch Society for Clinical Chemistry (NVKC), opiates can be detected about 2 to 3 days after use; the Trimbos Institute gives 2 to 4 days for heroin. There are more explanations than drug use: morphine and codeine as medicines, oxycodone and hydromorphone, the drug ranitidine and eating poppy seeds can give a positive result or a cross-reaction. A positive result shows that a substance is in the body; it is not a diagnosis and says nothing about dependence, the amount or the time of use.

Negative result

A negative result means that no morphine or related substance was found above the laboratory's limit. This does not completely rule out use: after a few days the substance has disappeared, and very shortly after use the result can still be negative. Diluted urine from drinking a lot can bring the value below the limit.

After an abnormal result

With a positive result that may have consequences, the laboratory has the result confirmed with a second analysis method that can distinguish morphine, codeine and other opiates from each other. The GP then goes over the medicines and food of the past few days.

Reliability

How reliable is the test?

An opiate test in urine shows that morphine or a related substance was present, but not where it came from. The Dutch Society for Clinical Chemistry (NVKC) writes that a positive result of a screening test must be confirmed with a second, different analysis method. Without knowing which medicines someone takes and what someone has eaten, a positive result cannot be interpreted. This text does not cover workplace testing or agreements with an employer; other rules and procedures apply to those.

What can affect the result?

Poppy seeds, for example on bread or in pastries, can give a positive result without any drugs having been used.
Prescribed medicines such as morphine, codeine, oxycodone and hydromorphone give a positive result.
A screening test can give cross-reactions; confirmation with another method is needed before a result can carry much weight.
Fluid intake determines how concentrated the urine is; diluted urine can give a negative result.

Preparation

Do not eat poppy seeds in the 3 days before collecting, not even on bread or in pastries. Poppy seeds can give a positive result.

Who it is for

Who is the test useful for?

Useful for

Useful for a medical question from a treating doctor, for example in addiction care, in pain treatment with opiates or when poisoning is suspected. In people without such a question, the result adds little. A result can only be assessed if it is known which medicines someone takes.

How common is it?

Heroin use is uncommon in the Netherlands and mainly concerns a small, often older group of long-term users. Morphine and related opiates are, in addition, much more often prescribed as painkillers, for example after surgery or for severe pain.

Trimbos Institute and Farmacotherapeutisch Kompas

Drawbacks and risks

Poppy seeds or a prescribed painkiller can lead to a positive result that is wrongly read as drug use.
A result without a confirmation test can have major consequences that are out of proportion to the certainty of the test.

Get tested

Morphine (urine): test panels

Morphine (urine) is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.

Urine
Morphine
Morphine and metabolites in urine; medication monitoring or use.
€ 35,00

Evidence

Sources

This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.

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