What are the expected metabolites for codeine on confirmatory urine testing?

The expected metabolites for codeine on confirmatory urine testing include both codeine and morphine. When codeine is metabolized in the body, it is primarily converted into morphine due to the activity of the enzyme UGT2B7. This conversion process results in the presence of both substances in the urine after codeine consumption.

Detecting both codeine and morphine is significant in clinical and forensic settings, as it indicates codeine usage while helping to differentiate it from other opioids. The presence of morphine can sometimes raise questions regarding the source of the drug, but in the case of codeine, it is an expected finding.

Other choices do not correctly represent the metabolites that would be anticipated from codeine usage. For example, hydromorphone and oxycodone are not metabolites of codeine, and hydrocodone is a separate opioid that does not typically arise from codeine metabolism. Thus, the identification of codeine and morphine as metabolites aligns with the biochemical pathways associated with codeine and confirms its expected profile in urine testing.