Kratom may cause false positives for methadone in drug screens

[Snafu in the Void]

A Kratom Metabolite Causes False Positive Urine Drug Screening Results for Methadone

AbstractBackground. The synthetic opioid methadone is utilized in pain management and opioid addiction therapy. Patients with methadone prescriptions are m

academic.oup.com

I was shocked to read this...

"Our studies suggest that a Kratom metabolite can cause false positive results in the Thermo Scientific CEDIA Methadone Metabolite (EDDP) immunoassay."

It's likely due to cross reactivity to antibody agents and not structural similarity

 

[Skorpio]

Very interesting, and definately a good thing for people undergoing UAs to know about.

It is hard to predict antibody cross reactivity as the region an antibody binds (the epitope) is often fairly random based on the orientation of the drug in the animal/system the antibody is raised.

Also, i did a cursory look to see if common drug tests are monoclonal (a single antibody, typically generated from a tumor in an animal then grown in culture) or polyclonal (a mix of antibodies that bind to the target antigen, typically made by injecting an animal with the antigen then separating out all the antibodies in their serum).

If these tests are polyclonal, identifying the motifs that cause cross reactivity will be nigh impossible. If they are monoclonal it is just extremely difficult.

 

[simstim]

This happened to me. I was trying to get into a methadone clinic to get away from my 100g/kratom habit and they wouldn't let me in because the only drug I tested positive for was methadone and not a street opioid.

I ended up getting into another clinic. Didn't help with pain 24 hours with once daily dosing so I went back to the kratom.

 

[Fertile]

I am guessing that it's 7-hydroxymitragynine. Mitragynine is a prodrug, itself it has no affinity for the opiate receptors.

I suspect that 7-OHM acts like a rigid analogue of the 4-acetoxy-4-phenyl-1-methylpiperidine class of opioids. That the rest of the molecule simply increases the LogP and is the reason why the bare -OH rather than an ester of same is so active.

That said, it's worth noting that their will be a hydrogen-bond between the methoxy of the aromatic and the tertiary hydroxyl. This is important to the potency of drugs like (dihydro)etorphine. The (dihydro)etorphine homologues with the 6-methoxy removed display MUCH lower activity in spite of the fact that in simpler (4-ring) phenanthracene opioids, the 6-methoxy and 6-desmethoxy homologues is almost the same.

Does anyone know if people have carried out research in which partial structures of 7-hydroxymitragynine were tested. That hydrogen bonding is also seen in a lot of the phenylpiperidine opioids with the piperidine being in the boat conformer and the 4-O & the 1-N interact. Active conformation used to be a matter of guesswork. It's more modern research that has revealed such details. I suspect it explains why azaprocin is so much more potent than buccinazine (AP-237) and why adding cis methyl groups to the 2 & 6 position increase the potency (I guess it would be called AP-239.

 

[allone]

i was in the hospital for overdose of kratom and tianeptine and those dumb ass doctors couldnt figure shit out at all after taking my blood i tested negative for opiates and they let me go wow. i know tianeptine is hard to test for but i thought kratom will at least show opiate positive, no?? so anyway i guess maybe i had shit quality then lol

 

[simstim]

i was in the hospital for overdose of kratom and tianeptine and those dumb ass doctors couldnt figure shit out at all after taking my blood i tested negative for opiates and they let me go wow. i know tianeptine is hard to test for but i thought kratom will at least show opiate positive, no?? so anyway i guess maybe i had shit quality then lol

Structurally tianeptine is a tricyclic antidepressant and kratom is an atypical opioid not an opiate so they're both unlikely to show up in a drug screen.

 

[Nas47]

Yeah.probably chromatographic analyzes only

 

[allone]

Structurally tianeptine is a tricyclic antidepressant and kratom is an atypical opioid not an opiate so they're both unlikely to show up in a drug screen.

not sure if this is good though. they didnt want to threat me in the hospital because they couldnt figure out anything was actually in my system! wow

 

[THCified]

Well, what about your personal experiences with this?!

Has anybody else tested (false) positive cuz of Kratom when having your urine tested? I mean I already heard of a few cases where ppl reported about it, but honestly I'm hesitant to believe it's a (more) common/regular outcome that one's being tested positive for methadone because of prior (prolonged) Kratom consumption, am I correct?

Any input would be much appreciated!

 

[Anonymous Dissident]

Given the structural dissimilarity of methadone vs mitragynine, this seems like an unlikely outcome in my minimally educated mind. Wouldn't yohimbine be likely to have a similar issue? I do think that this would be a very well known problem if it wasn't a fluke occurrence, considering how many people utilize kratom to get around testing for opiates.

 

[jaime76]

I am guessing that it's 7-hydroxymitragynine. Mitragynine is a prodrug, itself it has no affinity for the opiate receptors.

I suspect that 7-OHM acts like a rigid analogue of the 4-acetoxy-4-phenyl-1-methylpiperidine class of opioids. That the rest of the molecule simply increases the LogP and is the reason why the bare -OH rather than an ester of same is so active.

That said, it's worth noting that their will be a hydrogen-bond between the methoxy of the aromatic and the tertiary hydroxyl. This is important to the potency of drugs like (dihydro)etorphine. The (dihydro)etorphine homologues with the 6-methoxy removed display MUCH lower activity in spite of the fact that in simpler (4-ring) phenanthracene opioids, the 6-methoxy and 6-desmethoxy homologues is almost the same.

Does anyone know if people have carried out research in which partial structures of 7-hydroxymitragynine were tested. That hydrogen bonding is also seen in a lot of the phenylpiperidine opioids with the piperidine being in the boat conformer and the 4-O & the 1-N interact. Active conformation used to be a matter of guesswork. It's more modern research that has revealed such details. I suspect it explains why azaprocin is so much more potent than buccinazine (AP-237) and why adding cis methyl groups to the 2 & 6 position increase the potency (I guess it would be called AP-239.

What about what happened with me ... I am on methadone through a MAT program and I recently tested positive for kratom and I have never taken it ...ever... do u have any info on why this may have happened?

 

[RDP89]

Given the structural dissimilarity of methadone vs mitragynine, this seems like an unlikely outcome in my minimally educated mind. Wouldn't yohimbine be likely to have a similar issue? I do think that this would be a very well known problem if it wasn't a fluke occurrence, considering how many people utilize kratom to get around testing for opiates.

Methadone isn’t commonly found on opioid drug panels.