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# A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
6-Monoacetylmorphine (Heroin Metabolite), Urine
Test Code: HEROIN
Synonyms/Keywords
6-MAM, 6-AM, Heroin​
Useful For
Detecting heroin abuse.​
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Urine​ Sage urine collection container​ Sterile plastic container with no preservatives​ 6 mL​ 6 mL​ 3 mL​
Specimen Stability Information
Specimen Type Temperature Time
Urine​ Ambient​ 72 hours​
Urine​ Refrigerate (Preferred)​ 30 days​
Urine​ Frozen​ 30 days​
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 2 days​ Gas chromatography-mass spectrometry (GCMS) using selected ion monitoring​
Test Information
This test was developed and its performance characteristics determined by Marshfield Labs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity testing.

6-monoacetylmorphine (6-MAM) is a metabolite of heroin (3,6-diacetylmorphine).  When a person uses heroin, the drug is rapidly deacetylated to form 6-MAM.  6-MAM is then deactylated at a slower rate for form morphine.  6-monoacetylmorphine (6-MAM) arises only from metabolism of heroin. It is not found in poppy seeds and is not a metabolic product of morphine, codeine, or any other opiate. Therefore, the presence of 6-MAM in urine is firm evidence of heroin use. Although 6-MAM is present in urine of a majority of heroin users, failure to detect 6-MAM does not rule out heroin, because 6-MAM is only present in low concentrations and for a relatively short time after use of the drug. ​
Reference Range Information
Performing Location Reference Range
Marshfield​

Negative.  Positives are reported with a quantitative GCMS result.

Interpretation

Current Cutoff Levels for Toxicology

Presence of the heroin metabolite 6-MAM is definitive evidence of recent heroin use.  However, the failure to detect heroin does not rule out heroin use due to its short half-life.  6-MAM is generally only present in urine up to 24 hours after heroin use.  6-MAM metabolizes to morphine, which can be detected up to a maximum of 3 days after heroin use.​

Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
80356 1​ 6-Monoacetylmorphine (Heroin Metabolite) Confirmation
G6058​ 1​ 6-Monoacetylmorphine (Heroin Metabolite) Confirmation For Medicare/Medicaid​
Classification
This test was developed and its performance characteristics determined by Marshfield Labs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity testing.
Synonyms/Keywords
6-MAM, 6-AM, Heroin​
Ordering Applications
Ordering Application Description
​Centricity ​6-MAM (Heroin Metab), Urine
​Cerner None​
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
No​ Urine​ Sage urine collection container​ Sterile plastic container with no preservatives​ 6 mL​ 6 mL​ 3 mL​
Specimen Stability Information
Specimen Type Temperature Time
Urine​ Ambient​ 72 hours​
Urine​ Refrigerate (Preferred)​ 30 days​
Urine​ Frozen​ 30 days​
Useful For
Detecting heroin abuse.​
Test Information
This test was developed and its performance characteristics determined by Marshfield Labs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity testing.

6-monoacetylmorphine (6-MAM) is a metabolite of heroin (3,6-diacetylmorphine).  When a person uses heroin, the drug is rapidly deacetylated to form 6-MAM.  6-MAM is then deactylated at a slower rate for form morphine.  6-monoacetylmorphine (6-MAM) arises only from metabolism of heroin. It is not found in poppy seeds and is not a metabolic product of morphine, codeine, or any other opiate. Therefore, the presence of 6-MAM in urine is firm evidence of heroin use. Although 6-MAM is present in urine of a majority of heroin users, failure to detect 6-MAM does not rule out heroin, because 6-MAM is only present in low concentrations and for a relatively short time after use of the drug. ​
Reference Range Information
Performing Location Reference Range
Marshfield​

Negative.  Positives are reported with a quantitative GCMS result.

Interpretation

Current Cutoff Levels for Toxicology

Presence of the heroin metabolite 6-MAM is definitive evidence of recent heroin use.  However, the failure to detect heroin does not rule out heroin use due to its short half-life.  6-MAM is generally only present in urine up to 24 hours after heroin use.  6-MAM metabolizes to morphine, which can be detected up to a maximum of 3 days after heroin use.​

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 2 days​ Gas chromatography-mass spectrometry (GCMS) using selected ion monitoring​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
80356 1​ 6-Monoacetylmorphine (Heroin Metabolite) Confirmation
G6058​ 1​ 6-Monoacetylmorphine (Heroin Metabolite) Confirmation For Medicare/Medicaid​
Classification
This test was developed and its performance characteristics determined by Marshfield Labs. This laboratory is certified under the Clinical Laboratory Improvement Amendments (CLIA) to perform high complexity testing.
For most current information refer to the Marshfield Laboratory online reference manual.