Background image

USDTL Research

Poppy Seed Consumption May Be Associated With Codeine – Only Urine Drug Test Results

Gary M Reisfield, MD;  Scott A Teitelbaum, MD, DFSAM-UF; Joseph T Jones, PhD., NRCC-TC
First published: 01 October 2022 https://doi.org/10.1111/1556-4029.13874

Abstract

Eatible poppy seeds

Poppy seeds with poppy flower | Sourced by Freepik© Stock

Background: Consumption of poppy seed–containing food products can result in opiate-positive urine drug test results and may pose challenges in distinguishing poppy seed consumption from opiate administration. Guidance has suggested that codeine concentrations exceeding a specific amount coupled with morphine-to-codeine rations indicate codeine consumption and, therefore, exclude poppy seed consumption as a legitimate explanation for the test result. 

Specific aim: In recent years, we performed independent medical examinations of three individuals who produced codeine-positive/morphine-negative (300 ng/mL) forensic urine drug test results but denied codeine administration, attributing their test results to the consumption of specific poppy seed–containing food products.

Methods:  In the present study, 11 participants consumed one of the 10 unique poppy seed–containing food products, including the three implicated food products.

Results: Six of 33 non-baseline urine samples (18%)—representing three food products—were positive for codeine and negative for morphine at 300 ng/mL cut-offs (and therefore featured morphine-to-codeine ratios <2). This study adds to a small literature indicating that consumption of poppy seed–containing food products cannot reliably be distinguished from codeine administration based on previously published urinary opiate concentrations and ratios. 

Conclusions:  An important caveat is that in none of these cases did maximum urinary codeine concentrations exceed 1,300 ng/mL.

Abstract Summary: Consumption of poppy seed–containing food products can result in opiate-positive urine drug test results and may pose challenges in distinguishing poppy seed consumption from opiate administration. In this context, guidance has suggested that codeine concentrations exceeding 300 ng/mL coupled with morphine-to-codeine ratios <2 are indicative of codeine consumption and, therefore, exclude poppy seed consumption as a legitimate explanation for the test result. In recent years, we performed independent medical examinations of three individuals who produced codeine-positive/morphine-negative (300 ng/mL) forensic urine drug test results but denied codeine administration, attributing their test results to the consumption of specific poppy seed–containing food products.

In the present study, 11 participants consumed one of the 10 unique poppy seed–containing food products, including the three implicated food products. Six of 33 non-baseline urine samples (18%)—representing three food products—were positive for codeine and negative for morphine at 300 ng/mL cut-offs (and therefore featured morphine-to-codeine ratios <2). This study adds to a small literature indicating that consumption of poppy seed–containing food products cannot reliably be distinguished from codeine administration based on previously published urinary opiate concentrations and ratios. An important caveat is that in none of these cases did maximum urinary codeine concentrations exceed 1,300 ng/mL.

 

Read the Full Article      Learn More on Urine Testing



Published by: United States Drug Testing Laboratories on

Contact USDTL

1.800.235.2367

Newsletters, Posters, and Catalogs

Our print materials will keep you up to date on the latest news in drug and alcohol testing.

Request Literature

Request Your Collection Supplies

For your convenience, USDTL provides test collection supplies at no additional charge.

Order Supplies