I think they do send it for lab analysis.
I had a whole issue because I had taken over the counter paramol the last test and didn’t mention it cuz they were only asking about what I was prescribed and I kinda consider it the same as codeine even though it’s technically “dihydrocodeine”
I ended up having to pay a solicitor to appeal it and an expert to conclude that paramol is indeed available as an over the counter medication and would explain the DHC.
I remember they did have a breakdown of metabolites and their concentrations which is why I’m a little worried about it.
I think my best bet should they make an issue again is as a previous poster suggested that I must just be a fast metaboliser.
Ah, that info definitely would have been useful before lol. I think it’s very hard to tell the difference unless you’ve been taking a lot of morphine, even under lab analysis. I’ll post the portion of the article I just read that seems to state that
“orphine is also a product of codeine and heroin metabolism [
36]. Distinguishing morphine use versus metabolic conversion is sometimes difficult. Detection of the heroin-specific metabolite, 6-monoacetyl-morphine, while not always present especially at remote times relative to drug use, confirms the use of heroin [
40]. The presence of morphine may also occur simply due to eating baked goods containing poppy seeds, which naturally contain small amounts of morphine and codeine [
41]. Quantitative analysis may aid in the interpretation of urine drug screening results involving morphine and other drugs. Poppy seeds rarely yield urine morphine concentrations >2,000 ng/mL [
42]. Morphine or heroin abuse generally yields concentrations much higher [
40]. The ratio of morphine to codeine can also be helpful in cases where both drugs are detected [
43–
46]. A ratio of morphine to codeine that is >2:1 is consistent with heroin or poppy seed ingestion. Hydromorphone concentrations from metabolism of morphine rarely exceed ∼2 % of the morphine concentration in urine [
37]. Thus, higher concentrations relative to morphine would suggest use of hydromorphone rather than metabolic conversion from morphine.
Codeine, another widely available prescription opioid drug, derives its primary analgesic effect through metabolic conversion to morphine via the action of the CYP450 enzyme, CYP2D6 [
47,
48]. It is therefore expected that most patients taking codeine will have significant quantities of morphine in their urine; however, poor metabolizers may have significantly less or no detectable morphine. Although the majority of codeine is metabolized to morphine, a small quantity of codeine is also converted to hydrocodone with concentrations that can exceed 100 ng/mL with high doses [
49]. The presence of codeine in the urine also does not always indicate the use of codeine-containing medications. A small quantity of codeine is present in poppy seeds along with morphine, and it may appear in the urine following consumption of poppy seeds [
41,
42]. It has also been observed in small quantities (∼0.03 % of the morphine concentration) in patients on chronic morphine therapy [
50]. Although difficult to confirm, the authors postulate that the source of codeine in these cases may derive from contamination of morphine with codeine sulfate derived during the manufacturing process as an impurity.“
It seems that unless you take morphine with enough frequency that there’s detectable levels of hydromorphone metabolites they can’t really tell the difference. I’m not sure on this but it sounds like a one time use isn’t going to produce enough to be detectable. To my understanding, as long as there’s a decent amount of codeine metabolites in your urine it’s going to appear that you’re only taking codeine. Although if you’re a fast metabolizer you may show similar concentration as taking morphine, and if you’re a slow metabolizer you’ll have almost no morphine metabolites.
I really doubt a one time use is going to effect the amounts enough that even under lab analysis they’re going to be able to say for sure you took illegitimate morphine. There’s quite a few common foods and drinks that speed up/slow the enzymes that metabolize codeine so there’s tons of plausible deniability as to why you may have slightly higher morphine metabolites than the average codeine user. But as far as I can tell any screening isn’t going to show anything out of the ordinary as there’s no perfect conversion levels to base it off of
