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If I Use Opioids for Pain, Will I Fail a Drug Test?

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Updated July 16, 2014

Passing a drup test on Opiods
Images Etc Ltd Collection/Photographer's Choice RF/Getty Images
Question: If I Use Opioids for Pain, Will I Fail a Drug Test?
Answer: I’m sure we have all heard some variation of this story: a woman fired from her job after testing positive for opium is not an addict at all. She just happened to have a bagel with poppy seeds that morning for breakfast. Honest mistake, right?

It is nerve-wracking enough to take a drug test without having to worry about your pain medication showing up. You may not want your employer to know about your condition, especially if it doesn’t affect your performance at work. If you test positive for an opiate, however, it might be time to come clean. No pun intended.

The answer is complicated. Most routine drug screens do flag opiates, but not all opioids that are used as pain medicine are opiates. Put simply, they don’t all bind to receptors in the body in the same way. This means that some may show more routinely than others, depending on the type of test you take. Whether your drug screen turns up positive for opiates depends on what medications you take, and how much is in your system at the time of the test.

Morphine and codeine regularly show on most urine drug tests, but they are usually distinguished from harder substances such as heroin or opium. Other types of opioids may or may not screen positively – research shows that urine tests are not as reliable for detecting these medications. Unfortunately, there is no clear answer to this question.

What does this mean for you? Well, if you work in a drug-free workplace and are subject to random drug screens, it might be best to inform your supervisor of your pain management protocol before the situation comes up. Arming yourself with a note from your doctor can’t hurt either.

Mapa M, Arnold R. Fast Fact and Concept #110: Urine drug testing. End of Life Palliative Education Resource Center. Accessed March 30, 2009.

Nafziger, AN and Bertino, JS Jr. Utility and application of urine drug testing in chronic pain management with opioids. The Clinical Journal of Pain. January 2009. 25(1), pp73-9

Regional Laboratory for Toxicology. Drugs of Abuse Guidelines. 2002. Accessed March 30, 2009.

Schaffer Library of Drug Policy. Definitions and certain Properties of Ligands on Opioid Receptors Accessed March 30, 2009.

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