Naltrexone and Its Noroxymorphone Minor Metabolite – A Case Report. Issue 2 (14th March 2020)

• Record Type: Journal Article
• Authors: Stanciu, Cornel N.; Gnanasegaram, Samantha
• Is Part Of: Journal of psychoactive drugs. Volume 52:Issue 2(2020)
• Page Start: 169
• Page End: 171
• Publication Date: 2020-03-14
• Subjects: Naltrexone -- noroxymorphone -- naltrexone metabolite -- false positive; Hallucinogenic drugs -- Periodicals; Drug abuse -- Periodicals; Hallucinogens -- Periodicals; Psychotropic Drugs -- Periodicals; Drogues -- Périodiques; Hallucinogènes -- Périodiques; Electronic journals; 616.86
• DOI: 10.1080/02791072.2019.1649507
• Languages: English
• ISSNs: 0279-1072

Abstract

ABSTRACT: As part of substance use maintenance programs, individuals are monitored for sobriety through urine drug screens. A positive screen, and its confirmation and interpretation, can have devastating consequences, sometimes even leading to termination from the program and relapse. Naltrexone metabolism involves several steps and metabolites – one minor metabolite with very little mention in medical literature being noroxymorphone. This is also the final intermediate in the metabolic pathway of oxycodone; hence, detection is naturally presumed by clinicians to be attributed to oxycodone use. Through this case report, we alert clinicians that, depending on individual pharmacogenomics, it is possible to obtain a positive confirmation of this component alone (without any oxycodone pathway intermediates) with naltrexone administration.