A recent report by the United Nations has indicated that heroin use is on the rise again with a five-fold increase in the US since 2000, to an estimated 1 million users (1). There are clear indications that this trend is also occurring in Australia, with a report published by Odyssey House indicating a significant rise in heroin-related admissions (2).
Heroin is a highly addictive drug of abuse accounting for the highest number of drug of abuse deaths per annum. It is highly impairing - causing drowsiness, clouding mental function and slowing reaction times. These can be serious risks to safety in a workplace situation.
However, heroin can be very difficult to detect if urine drug testing is used in a workplace AOD programme. This is due to the unique heroin metabolite 6MAM disappearing in urine within minutes and the metabolite morphine, which is common to all other opiates including codeine, being the only detectable form.
This makes a conclusive decision as to whether a morphine positive urine drug test is caused by heroin or a high dose of codeine very difficult. However in oral fluids drug testing the unique 6-MAM metabolite can be readily detected and a definitive conclusion can be made regarding a positive opiate result being heroin or a medication. The increasing risk of a heroin user being in a workplace makes the decision as to which mode of drug testing, urine or oral fluids, even more important.
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