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What Can Cause a False Positive or Negative Drug Test for Suboxone?

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Feb 9, 2024 • 5 cited sources

Quick Answer

In rare cases, other opioids can cause a false positive for buprenorphine, and false negatives can occur if someone is a fast metabolizer and the Suboxone is out of their system.

These days drug tests are pretty accurate, but false negatives and positives do occur.

When you are on Suboxone, your provider may test your urine for buprenorphine in order to ensure that you are taking your medication. In addition, employers sometimes require drug testing for certain jobs; however, they are unlikely to order the specific buprenorphine test. 

These drug tests do not routinely include testing for buprenorphine, which is a legal medication prescribed to treat opioid use disorder (OUD). However, it is possible that some employers may test for Suboxone in addition to a routine drug screen.

A “false positive” means that a drug test shows buprenorphine in your urine even though you did not take buprenorphine.

A “false negative” means that a drug test shows no buprenorphine in your urine even though you did take buprenorphine. 

Why Would a False Positive for Suboxone Occur?

The specific drug tests that test for the presence of Suboxone in the bloodstream are very accurate and reliable. 

However, there are sometimes false positives, albeit rare. 

A number of opioids can result in a false positive for buprenorphine, the primary active ingredient in Suboxone, including:[1]

  • Morphine
  • Methadone
  • Codeine
  • Dihydrocodeine
  • Tramadol

However, most drug tests these days are able to differentiate between buprenorphine and other opioids, so false positives are rare. 

Why Would a False Negative For Suboxone Occur?

False negatives are probably much more common than false positives for Suboxone. 

A false negative means that your test shows no buprenorphine in your body even though you have been taking it. 

This can happen for several reasons. Oral buprenorphine is only detectable in urine for up to 6 days, often fewer, and in saliva for up to 3 days.

For people who are fast metabolizers, their drug test may be negative for Suboxone within a few days after taking the drug. However, even a false negative isn’t likely if you are taking your Suboxone every day for OUD treatment.

Advice if You Are Affected by a False Positive or Negative 

While many employers don’t test for Suboxone use and similar medications, it’s becoming more common.[4] Most routine drug tests do NOT include buprenorphine testing. 

However, different states have different rules/laws and your employer may order a routine drug test and an additional urine test for Suboxone.

For Those Taking Suboxone for OUD

If you are taking Suboxone with a doctor’s prescription and your employer tests your urine for Suboxone, the best thing to do is get a doctor’s note.

You have a right to take Suboxone and continue to work. The ADA (The American Disabilities Act) prevents employers and other entities from discriminating against a person who is taking Suboxone or other medications as part of a prescribed addiction treatment.[5] 

Exceptions do exist, such as in positions where Suboxone may impact your ability to safely perform your duties, but these are rare.

If you take Suboxone and your drug test is falsely negative, talk to your doctor about why this might be. In contrast, if you are not taking Suboxone and you have a false positive, talk to your employer or doctor.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. False-Positive Interferences of Common Urine Drug Screen Immunoassays: A Review. Journal of Analytical Toxicology. September 2014. Accessed September 2022.
  2. Comments Proposed Rules, Industrial Commission, Pain Management. North Carolina Psychiatric Association. March 2018. Accessed September 2022.
  3. False-Positive Buprenorphine EIA Urine Toxicology Results Due to High Dose Morphine: A Case Report. Journal of Addictive Diseases. 2012. Accessed September 2022.
  4. Does Buprenorphine Show Up in an Employer Drug Screening? The National Alliance of Advocates for Buprenorphine Treatment. Accessed September 2022.
  5. The Americans With Disabilities Act, Addiction, and Recovery for State and Local Governments. ADA National Network. Accessed September 2022.

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