6-Monoacetylmorphine (6-MAM), Confirmation, Meconium
Use
This test is used for the detection of in utero heroin exposure up to 5 months before birth. Heroin, which is not clinically used in the United States, is metabolized into 6-monoacetylmorphine (6-MAM), a unique metabolite that indicates heroin use. Detection of 6-MAM in meconium indicates heroin use by the mother. Opiates, including heroin, readily cross the placenta, potentially causing harm to the developing fetus.
Special Instructions
For chain-of-custody testing, order MAMMX / 6 - Monoacetylmorphine (6-MAM) Confirmation, Chain of Custody, Meconium. If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
Limitations
The detection of 6-MAM may be prevented by its short half-life and stability. Detection relies on the presence of 6-MAM in meconium, which may degrade or convert to morphine if not properly handled. Positive results provide a definitive indication of heroin use, as 6-MAM is the only unique marker of heroin, but negative results do not rule out use.
New York Approved
Methodology
Mass Spectrometry (LC-MS/MS)
Biomarkers
LOINC Codes
- 29345-6
- 29345-6
- 69050-3
Result Turnaround Time
2 days
Related Documents
For more information, please review the documents below
Specimen
Stool
Volume
1 g (approximately 1 teaspoon)
Minimum Volume
0.3 g (approximately 1/4 teaspoon)
Container
Stool container
Collection Instructions
Collect entire random meconium (newborn's first bowel movements) specimen. Send specimen frozen.
Storage Instructions
When refrigerated, a significant percentage of 6-monoacetylmorphine will convert to morphine in less than 24 hours.
Causes for Rejection
Grossly bloody; Reject; Pink OK. Stool; diapers.
Stability Requirements
| Temperature | Period |
|---|---|
| Frozen | 14 days |