Ingestion of a poppy seed product with a sufficient number of poppy seeds can result in detectable levels of morphine and codeine in the urine. Certain findings can help distinguish opiate abuse from poppy seed ingestion.
Ingestion of large amounts of poppy seeds (50 to 150 grams) can result in urine morphine levels > 2,000 ng/mL at 12-24 hours after ingestion.
where:
• In describing the ingestion of poppy seeds, it is best to determine the actual amount of poppy seeds ingested. Some report the weight of a pastry or pastry filling (only fractionally poppy seeds).
• The country of origin for the poppy seeds can also affect the opiate concentration.
morphine-to-codeine ratio =
= (urine morphine concentration in ng/mL) / (urine codeine concentration in ng/mL)
In 1998 the threshold for a positive opiates in a urine drug screen was raised from >= 300 ng/mL to >= 2,000 ng/mL. The ratio of morphine-to-codeine after poppy seed ingestion ranges from 2 to 60.
Findings indicative of poppy seed ingestion:
(1) presence of narcotine, papaverine, or thebaine (absence does not exclude poppy seed ingestion, since there is variability in its excretion)
Findings excluding poppy seed ingestion:
(1) urine morphine concentration > 1,000 ng/mL and morphine-to-codeine ratio < 2
(2) urine codeine concentration > 300 ng/mL with morphine-to-codeine ratio < 2
Findings indicative of opiate abuse:
(1) total urine morphine concentration > 5,000 ng/mL (can be heroin, morphine or codeine)
(2) urine morphine concentration > 1,000 ng/mL with no detectable codeine (< 25 ng/mL) indicates morphine use
(3) urine codeine concentration > 300 ng/mL with morphine-to-codeine ratio < 2 indicates codeine use
(4) presence of 6-acetylmorphine in the urine indicates heroin abuse (cut-off >= 10 ng/mL)
