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 Suboxone in order to ensure that you are taking your medication. In addition, employers sometimes require drug testing for certain jobs. These drug tests do not routinely include testing for Suboxone, which is considered a legal medication that most people take with a prescription from a doctor. 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?
These days, the tests for 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 morphine, methadone, codeine, and dihydrocodeine. However, most drug tests these days are able to differentiate between Buprenorphine and other opioids, so false positives are pretty 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. Buprenorphine is metabolized out of your body after one to three days. For people who are fast metabolizers, their drug test may be negative for Suboxone as quickly as one to two days after taking the drug.
Advice if You Are Impacted by a False Positive or Negative
While many employers don’t test for Suboxone use and similar medications, it’s becoming more common. 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.
If you are taking Suboxone legally with a doctor’s prescription and your employer tests your urine for Suboxone, the best thing to do is get a doctor’s note confirming that you are taking the medication legally and with a prescription. You have a right to take Suboxone legally 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 drug treatment medications as part of a prescribed addiction treatment. Exceptions do exist, such as in positions where Suboxone may impact your ability to safely perform your duties, but these are relatively 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.
- False-Positive Interferences of Common Urine Drug Screen Immunoassays: A Review. Journal of Analytical Toxicology. https://academic.oup.com/jat/article/38/7/387/2798054. September 2014. Accessed September 2022.
- Comments Proposed Rules, Industrial Commission, Pain Management. North Carolina Psychiatric Association. https://www.ic.nc.gov/RHuffmanNCPA.pdf. March 2018. Accessed September 2022.
- False-Positive Buprenorphine EIA Urine Toxicology Results Due to High Dose Morphine: A Case Report. Journal of Addictive Diseases. https://pubmed.ncbi.nlm.nih.gov/23244551/. 2012. Accessed September 2022.
- Does Buprenorphine Show Up in an Employer Drug Screening? The National Alliance of Advocates for Buprenorphine Treatment. http://www.naabt.org/faq_answers.cfm?ID=78. Accessed September 2022.
- The Americans With Disabilities Act, Addiction, and Recovery for State and Local Governments. ADA National Network. https://adata.org/factsheet/ada-addiction-and-recovery-and-government. Accessed September 2022.
Medically Reviewed By Elena Hill, MD, MPH
Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More