In a recent study of 136,605 urine samples, what findings norbuprenorphine:buprenorphine (N:B) ratio can help identify potential cases of tampered urine specimens?
According to the cited reference, a N:B ratio of <0.02 in concert with a high naloxone concentration (>1000 ng/mL) can help identify potential cases of tampered urine specimens
Warrington, Jill S. MD, PhD; Warrington, Gregory S. PhD; Francis-Fath, Samuel BA; Brooklyn, John MD Urinary Buprenorphine, Norbuprenorphine and Naloxone Concentrations and Ratios: Review and Potential Clinical Implications, Journal of Addiction Medicine: November/December 2020 – Volume 14 – Issue 6 – p e344-e349 doi: 10.1097/ADM.0000000000000676
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