From the Guidelines
Yes, Suboxone (buprenorphine/naloxone) can cause a positive result on an opioid drug test, but it may not be detected by standard opioid screens due to its unique chemical structure. Buprenorphine is a partial opioid agonist that binds to opioid receptors in the brain, and while standard drug tests may not detect it, specialized tests that specifically look for buprenorphine will detect it 1.
When considering opioid drug testing, it's essential to understand that standard immunoassay panels may not detect all types of opioids, including buprenorphine. As noted in the guidelines, a positive "opiates" immunoassay detects morphine, which might reflect patient use of morphine, codeine, or heroin, but this immunoassay does not detect synthetic opioids (e.g., fentanyl or methadone) and might not detect semisynthetic opioids (e.g., oxycodone) 1.
If you are taking Suboxone as prescribed for opioid use disorder or pain management, it's crucial to inform the testing facility or your employer beforehand and provide documentation of your prescription. The detection window for buprenorphine varies, typically ranging from 7-10 days in urine tests, 1-3 days in blood tests, and up to 90 days in hair tests.
Clinicians should be aware of the limitations of standard opioid screens and consider using specialized tests when necessary. As recommended, clinicians should use urine drug testing to assess for prescribed opioids as well as other controlled substances and illicit drugs that increase risk for overdose when combined with opioids 1.
Key points to consider:
- Suboxone can cause a positive result on an opioid drug test, but may not be detected by standard screens
- Specialized tests are necessary to detect buprenorphine
- Inform testing facilities or employers of Suboxone prescription and provide documentation
- Detection window for buprenorphine varies depending on test type
- Clinicians should be aware of the limitations of standard opioid screens and use specialized tests when necessary 1.
From the Research
Suboxone and Drug Tests
- Suboxone, which contains buprenorphine, is a medication used to treat opioid dependence and can be detected in urine drug tests 2, 3.
- Buprenorphine is a partial mu-opioid receptor agonist that can produce a positive result on an opioid drug test, especially if the test is not specific to the medication 4.
- However, it's essential to note that a false-positive result can occur due to instrumental carry-over or sample adulteration 2.
Factors Affecting Test Results
- The presence of other substances, such as sedatives, hypnotics, and anxiolytics, can affect the accuracy of urine drug tests 3.
- Definitive urine drug testing is recommended to accurately identify the use of specific prescription medications and illicit substances, including buprenorphine 3.
- The use of buprenorphine/naloxone (Suboxone) can be detected in urine tests, and its presence can be confirmed through definitive testing 4.
Clinical Considerations
- Buprenorphine/naloxone is an effective maintenance therapy for opioid dependence and has a lower risk of abuse compared to other opioid medications 4.
- However, buprenorphine can interact with other medications, such as tricyclic antidepressants, and increase the risk of serotonin syndrome 5.
- Emergency department-initiated buprenorphine treatment, facilitated by peer support specialists, can be an effective pathway to treatment for patients with opioid use disorder 6.