A patient who had admitted to recent heroin use had a urine sample collected for urinalysis and drug screening. The drug screen was positive for opiates and ethanol. The results of a urinalysis were remarkable only for trace ketones and trace leukocytes. Confirmatory testing revealed codeine and morphine. A headspace GC-MS analysis revealed an ethanol concentration of 125 g/L. When notified of the strange ethanol result, the physician replied that the patient did not appear inebriated. A blood ethanol concentration was ordered on a sample that had already been drawn, and the result was negative (<0.1 g/L).
- Are the codeine and morphine results consistent with heroin use?
- What caused the high urine alcohol concentration with a negative blood alcohol result?
- Is ethanol ever intentionally added to urine samples?
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