Module CC-28 · Version 1.0
Urine Drug and Opiate Testing
Interpret urine drug-testing patterns by assay target, metabolites, specimen validity, cutoff, and confirmation status.
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Who this module is for
Medical laboratory scientists and laboratory professionals who review or release clinical urine drug-testing results.
Learning objectives
- Differentiate opiate-class immunoassays from specific opioid testing.
- Use metabolite relationships to identify compatible and incompatible urine drug-testing patterns.
- Recognize specimen dilution, adulteration, cross-reactivity, cutoff, and detection-window limitations.
How completion works
Mark every required section done and answer every knowledge check in those sections correctly. The final save completes the module automatically.
Sources
19 sources
1. Substance Abuse and Mental Health Services Administration. Mandatory Guidelines for Federal Workplace Drug Testing Programs Using Urine. Federal Register 88 FR 70768, effective February 1, 2024.
Source note · federal regulation
2. SAMHSA. Medical Review Officer Guidance Manual for Federal Workplace Drug Testing Programs, 2024 edition.
Source note · federal guidance
3. SAMHSA. Frequently Asked Questions and Answers About Federal Workplace Drug Testing.
Source note · federal guidance
4. SAMHSA. Clinical Drug Testing in Primary Care, Technical Assistance Publication 32.
Source note · federal guidance
5. US Department of Transportation. 49 CFR Part 40 Section 40.87, cutoff concentrations for initial and confirmatory drug tests.
Source note · federal regulation
6. eCFR. 42 CFR Part 493.937, Standard: Toxicology.
Source note · federal regulation
7. eCFR. 42 CFR Part 493 Subpart I, proficiency testing programs for nonwaived testing.
Source note · federal regulation
8. CDC. Test Complexities: Clinical Laboratory Improvement Amendments test complexity information.
Source note · federal guidance
9. Clinical and Laboratory Standards Institute. C52, Toxicology and Drug Testing in the Medical Laboratory, 3rd edition.
Source note · consensus standard
10. Centers for Medicare and Medicaid Services. Local Coverage Determination L36393, Controlled Substance Monitoring and Drugs of Abuse Testing.
Source note · federal guidance
11. Centers for Medicare and Medicaid Services. MLN Matters SE18001, definitive drug testing coding and method description.
Source note · federal guidance
12. Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain, United States, 2022. MMWR Recomm Rep 2022;71(3):1-95.
Source note · peer-reviewed literature
13. American College of Medical Toxicology. ACMT Position Statement: Interpretation of Urine Opiate and Opioid Tests.
Source note · professional society guidance
14. Smith et al. Morphine and Codeine Concentrations in Human Urine following Controlled Poppy Seeds Administration of Known Opiate Content.
Source note · peer-reviewed literature
15. Struempler RE. Excretion of codeine and morphine following ingestion of poppy seeds. Journal of Analytical Toxicology 1987.
Source note · peer-reviewed literature
16. Urine Concentrations of Morphine and Codeine in Paired Oral Fluid and Urine Specimens Following Ingestion of a Poppy Seed Roll and Raw Poppy Seeds.
Source note · peer-reviewed literature
17. Poppy Seed Consumption May Be Associated with Codeine-Only Urine Drug Test Results. Journal of Analytical Toxicology 2023;47(2):107.
Source note · peer-reviewed literature
18. FDA. 510(k) Substantial Equivalence Determination Decision Summaries for urine fentanyl-norfentanyl immunoassay devices.
Source note · manufacturer labeling
19. Mayo Clinic Laboratories. Fentanyl Screen with Reflex, Random, Urine test catalog entry.
Source note · manufacturer labeling