Metabolic Marker for Abuse of Heroin: 6-Monacetymorphine

News Brief from MEDTOX Journal, August, 2009 — The MEDTOX DARS Hotline receives frequent calls for information about the relevance of positive 6-monacetlymorphine (also known as 6-acetlymorphine and 6-MAM) drug tests as it relates to the use of heroin and other opioids.
6-MAM is a metabolite of heroin. When heroin enters the bloodstream, enzymes go into action to break the drug down and eliminate it from the circulatory system. Byproducts from this chemical process are called metabolites; they are the creations of a metabolic process.
The real chemical bottom line is that 6-MAM doesn’t exist anywhere other than in the blood and the urine (and in some other biological products too) of people who’ve ingested heroin. No other opiate has a metabolic pathway that leads to the creation of 6-MAM.
Most Hotline callers are doing so to verify that Vicodin use will prompt a final confirmed drug test result that has detected 6-MAM. Many heroin users who have positive 6-MAM drug tests explain the results away by producing or alluding to a prescription for Vicodin (hydrocodone) and/or sometimes a script for Tylenol with Codeine. Ingestion of these two narcotic pain relievers will not produce or lead to the detection of 6-MAM; there’s no alibi for the presence of 6-MAM in urine or in blood other than heroin use.

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