Drug and Alcohol Testing Q&A - 2008

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Can hydrocodone cause hydromorphone?

From: Michael Band DO, MS
Password: orange
Date: 30 Jan 2008
Time: 09:19:08 -0800
Remote Name: 24.227.66.222

Comments

Health care worker with possible diversion. Positive for: codeine, morphine, hydrocodone, hydromorphone, oxycodone. Levels: codeine: 2200 hydrocodone: 178 hydromorphone: 2200 oxycodone: 154.  Valid prescriptions for Tylenol #1, hydrocodone, oxycodone, propoxyphene, and methadone.

Question is, Can a low level of hydrocodone cause a high level of hydromorphone?  Is the correct call a positive test for hydromorphone due to the highly unlikely scenario of a high level due to hydrocodone or even morphine metabolism?