Research Progress on the Metabolites in Detecting the Abuse of Opiates

OBJECTIVE To review the metabolites in detecting the abuse of opiates in recent years, and to provide evidence for the management of opiates abuse and the confirmation of death by illicit opiates abuse, and also to distinguish between illicit abuse and normal intake. METHODS Through a large number of materials on the metabolites in detecting the abuse of opiates, the metabolic process in vivo of opiates, the advantages and disadvantages of commonly used metabolites in detecting the opiates abuse and their application were reviewed to summarize. RESULTS Heroin, drugs containing codeine, poppy substances and so on were metabolized to morphine, resulting in false positive results. There was currently no clear and uniform gold standard that can be used to accurately determine the abuse of opioids. In addition to the commonly used metabolites 6-monoacetylmorphine and morphine, acetylcodeine, codeine, concentration ratios of morphine to codeine, metabolites of thebaine, papaverine and narcotine could also be tested in the confirmation. CONCLUSION When confirming illicit opiates abuse, it is necessary to carefully judge the reliability of the test results of metabolites, and ask the testee about his recent medication history in detail.