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Chicago, Rockford 312-573-8248 815-965-1106 Opiates Drug Class: Narcotics Street Names: Codeine: Captain Cody, Schoolboy, Doors & Floors, Loads, Pancakes & Syrup. Morphine: M, Miss Emma, monkey, white stuff Heroin: Brown Sugar, Dope, H, Horse, Junk, Skag, Skunk, Smack, White Horse Opium: Big O, Black Stuff, Block, Gum, Hop. Paregoric Oxycodone: Oxy, O.C., Killer Hydrocodone: Vicodin, Vike, Watson-387 Detection Time: Codeine & Morphine - generally 1-3 days. Oxycodone - generally 1-3 days. Hydrocodone - generally 1-3 days. Heroin - Can be as long as 3 - 5 days for heavy users. Heroin exists in the body for only a brief period of time. About one-half of the heroin dose is converted to the heroin metabolite 6-acetylmorphine (6AM or 6MAM)in about 9-10 minutes! This means in one hour, less than 2% of the original heroin dose is present. The (6AM or MAM) is then converted to morphine, which takes about 4 to 7 Hours for it to no longer be detected. So the detection window for identifying heroin is very limited. Screening Cutoff: 300 ng/ml Confirmation Cutoff: 300 ng/ml Linearity: Up to 2000 ng/ml Confirmation LOD: Confirmation Identifies: TASC-Arizona: Codeine, Morphine, Hydrocodone, Hydromorphone, Oxycodone, Oxymorphone and Heroin (6-MAM). Quest Diagnostics: Codeine, Morphine, Hydrocodone and Hydromorphone. NOTE: Oxycodone or Heroin require additional request. Expectations: The assay will detect opiates and their synthetic counterparts called opioids in the sample. In 2002, the Department of Transportation raised the cut-off from 300 ng/ml to 2,000 ng/ml for transportation workers to compensate for those situations where a driver may be taking certain cold medications or pain medication, such as Tylenol #3. Typically, a Heroin user will only produce a positive result of >2,000 ng/ml for a day after single use. TASC Labs retained the 300 ng/ml cut-off because our focus is to detect any opiate like substance use by a client. If the opiate level is greater than 2,000 ng/ml and heroin use is suspected, ordering the Heroin Metabolite (6-AM) assay is suggested before ordering a confirmation on the same sample. The reason is 6-AM is converted to morphine in about 6-8 hours after drug use. If it is positive, then heroin use is established. However, depending upon when heroin was used, it is possible to have a high opiate level and a negative 6-AM. Thus, a high opiate and negative 6-AM does NOT preclude possible heroin use by the client. 748958894 Eff: 01/19/12 Doc. No. 18.308 Page 1 of 2 TASC Laboratories Many clients have made claims that their high opiates are due to taking Tylenol #3. Typically, the opiate results seem to fall in the 700 – 800 ng/ml range, but could be higher around 1000 ng/ml, depending upon when the drug was taken. Upon confirmation testing, use of Tylenol #3 will usually result in Codeine AND Morphine being present in the sample. If morphine is the only drug present in a high quantity upon confirmation, it is most likely due to heroin. Codeine as a source of the morphine cannot be ruled out. Effects: Symptoms may include Euphoria, drowsiness, respiratory depression, nausea, confusion, constricted pupils, constipation, sedation, or coma. There may be depressed appetite, thirst, reflexes and sexual desire, and/or an increased tolerance for pain. Codeine tends to have less drug effects than morphine. Heroin use will cause a staggering gait. (Ref: www.drugabuse.gov/drugpages - 4/8/04) Heroin addiction requires persistent and repeated use of the drug. Like alcohol, it requires increasingly higher doses to achieve the same effect. Medical Uses: In general, provides pain relief and sedation. Terminal cancer patients were once treated with "Brompton's Cocktail", which is a combination of morphine, codeine and other opiates in a flavored liquid. The intent was to provide a painkiller that could be administered at home, to ease to final days of the person's life. Codeine is usually combined with an analgesic for pain relief (Tylenol #3) or as part of liquid medications to relieve cough or diarrhea. Morphine is primarily used in hospitals for pain relief and is also available if pill form for home administration. Heroine is an illegal drug and no longer used medically in the United States. Substances That Cause Positive Results: Tylenol #3 (Codeine, which converts to morphine) Dilaudid (Hydromorphone - synthetic morphine) Hycodan (Hydrocodone - synthetic codeine) Contin (Morphine) Nyquil & Similar Products (Dextromethorphan) Paregoric (tincture of opium) Poppy Seeds (Thebaine is a mild opiate) - Results might be just above the cutoff levels. Robitussin A-C (Codeine) Vicodin (Hydrocodone) Ref: Drug & Human Performance Fact Sheets – Nat’l Highway Traffic Safety Admin. – April 2004 748958894 Eff: 01/19/12 Doc. No. 18.308 Page 2 of 2