Urine and hair drug test results associated with daily consumption of codeine-predominant poppy seed food products.

This study investigated the urinary and hair opiate profiles resulting from daily consumption of presumptive codeine-predominant poppy seed-containing food products in ten adult participants. Results showed that two specific products—a cake made with Walmart Great Value poppy seeds and a Buttermaid poppy seed kolach—consistently produced urine samples positive for codeine at clinical (300 ng/mL), U.S. Department of Defense (2,000 ng/mL), and Federal Workplace Drug Testing Program (15,000 ng/mL) cut-offs, with codeine concentrations exceeding morphine levels and positivity persisting for over 24 hours. No increasing trend in urinary opiate concentrations was observed over the 10-day consumption period. Hair analysis revealed quantifiable but subthreshold codeine levels in two participants, suggesting current hair testing cut-offs effectively exclude poppy seed consumption as a cause of positive results in Caucasians, though further research is needed for populations with higher hair melanin content. The findings challenge longstanding guidelines that morphine-to-codeine ratios below 2 with codeine concentrations above 300 ng/mL indicate codeine use rather than poppy seed ingestion.