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Norbuprenorphine to Buprenorphine Ratio in a Urine Test for Buprenorphine Use

Description

Detection of a drug metabolite in urine, hair or blood indicates that the person has been exposed to the parent drug. The presence of a metabolite is useful in troubleshooting a positive or negative screening test for drug exposure. The authors are from the University of Colorado, Millennium Health San Diego and Johns Hopkins University.


Patient selection: patient being monitored for compliance to an opioid such as buprenorphine prescribed for opioid use disorder.

 

Norbuprenorphine is a metabolite of buprenorphine found in the urine.

 

Parameters:

(1) urine concentration of norbuprenorphine in mg/L

(2) urine concentration of buprenorphine in mg/L

 

ratio of norbuprenorphine to buprenorphine =

= (urine concentration of norbuprenorphine) / (urine concentration of buprenorphine)

 

Interpretation:

• A ratio < 0.02 is associated with addition of buprenorphine to the urine to hide diversion.

• Substitution of urine from a person using buprenorphine would not be detected.

 


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