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From: Robert Swotinsky MD
Password: orange
Date: 13 Dec 2007
Time: 18:09:41 -0800
Remote Name: 71.233.246.147
There is no scientific literature that would support a conclusion that codeine at 628 ng/mL and morphine at less than 300 ng/mL is due to poppy see ingestion.
So, why do federal regulators advise MROs to declare such results as "negative"? Regulators advise MROs that all morphine- and/or codeine-positive results less than 15,000 ng/mL should be downgraded to negative unless there is clinical evidence of opiate abuse. Such results could be due to poppy seed ingestion. But, many and perhaps most are NOT due to poppy seed ingestion. MROs especially worry about codeine-positive, morphine-negative results, which seem hardly likely to be due to poppy seed ingestion. However, there is no consensus as to how to distinguish which low-level-opiate results are due to poppy seeds and which are due to codeine use. Also, the federal regulators never intended to target codeine in their testing programs. Thus, regulators have kept the opiate rule simple and have included both codeine and morphine in the guidelines