Urine Buprenorphine Screen
A urine test that looks for buprenorphine, a medicine used to treat opioid use disorder and pain. A positive result is expected if you take it as prescribed.
AI-verified against cited sources. Awaiting expert reviewAlso called BUPLOINC 93494-3
What it is
Buprenorphine is a prescription medicine used to treat opioid use disorder and, in some forms such as skin patches, chronic pain. This test checks a urine sample for buprenorphine and sometimes its breakdown product, norbuprenorphine. It is usually an immunoassay screen that reports negative or positive against a cutoff, which is 5 ng/mL at Mayo Clinic Laboratories. A positive screen is often confirmed with a more specific mass spectrometry test that gives amounts. Common opiate drug screens usually don't pick up buprenorphine, so it is tested on its own.
Why it matters
Clinicians and treatment programs use this test to check that buprenorphine treatment is being taken as prescribed and to make sense of other drug tests. A positive result is normal and expected if buprenorphine is prescribed to you. A negative result doesn't always mean doses were missed, because screens can miss buprenorphine, for example when the urine is dilute or the last dose was several days ago. How programs use urine tests varies, and many people find them stressful, so it is reasonable to ask how your results will be used.
If it’s low
A negative screen means buprenorphine wasn't found at or above the cutoff. If you take buprenorphine, that doesn't always mean you missed doses. Screens can miss buprenorphine. A 2025 article reports one New South Wales analysis in which more than half of samples from people on supervised sublingual treatment screened negative for buprenorphine. Dilute urine, the time since your last dose and the screen's cutoff can all play a part.
Common causes
- Not taking buprenorphine, or the last dose was several days ago
- Very dilute urine
- A screen that is less sensitive than a confirmation (mass spectrometry) test
- A cutoff higher than the amount in the urine
What can help
- If you take buprenorphine and the negative result surprises you, tell your prescriber and ask whether a confirmation test would help
- Ask your clinician how the timing of your last dose affects the result
If it’s high
A positive screen means buprenorphine, or something the test reacts to, was found at or above the cutoff. If you take buprenorphine, such as Suboxone, Subutex or Sublocade, a positive result is expected. Many other things can also explain a positive result, and a confirmation test can sort out an unexpected one.
Common causes
- Taking buprenorphine as prescribed, for example as Suboxone, Subutex or Sublocade
- A buprenorphine skin patch used for chronic pain
- A prescription from another clinician, or a medicine you forgot to mention
- Taking buprenorphine that was not prescribed to you
- A screen that reacted to a different substance (a false positive), which a confirmation test can sort out
What can help
- Tell every clinician about all your medicines, including buprenorphine, before you have urine tests
- If a positive result is unexpected, ask whether a confirmation test has been done or can be done
- Ask how your treatment program uses urine test results
What can affect your result
- How long ago the last dose was (buprenorphine is reported detectable for up to about 7 days, norbuprenorphine up to about 14 days)
- Dose and how long you have been taking it
- How dilute the urine is
- The test's cutoff (5 ng/mL at Mayo Clinic Laboratories) and whether it is a screen or a confirmation test
- Some medicines can interfere with certain confirmation methods, such as quetiapine metabolites in some mass spectrometry tests
- Standard opiate screens are built to find natural opiates such as morphine and codeine and are less reliable for buprenorphine, so buprenorphine has its own test. A negative opiate screen says nothing about buprenorphine.
- Screens can miss buprenorphine or give false positives. A positive screen is usually confirmed by a mass spectrometry test (LC-MS/MS), which also reports the amount.
- Very dilute urine can bring buprenorphine under the screen's cutoff (5 ng/mL at Mayo Clinic Laboratories).
- In some labs' mass spectrometry confirmation, metabolites of the antipsychotic quetiapine have interfered with the norbuprenorphine measurement.
Any time. A random (spot) urine sample is used, and Mayo Clinic Laboratories asks for no preservative. Shows recent use. One paper summarizes buprenorphine as detectable in urine for up to about 7 days and its breakdown product norbuprenorphine for up to about 14 days, depending on the dose, how long it has been taken and the test's cutoff.
When to talk to a clinician
A urine drug screen is not an emergency test. Talk with the clinician who ordered it about any result you didn't expect. If you or someone else shows signs of an opioid overdose, such as extreme sleepiness, very slow or shallow breathing, or being unable to wake, call 911 or your local emergency number.
Questions you could ask
- How will my program use my urine test results?
- What is this test's cutoff, and what medicines does it pick up?
- Is a positive buprenorphine result expected given my current medicines?
- If this result is unexpected, would a confirmation test help?
- If I take buprenorphine, could dilute urine or timing explain a negative result?
- Would a confirmation test be useful here?
Questions people ask
I take buprenorphine as prescribed. Should I expect a positive result?
Usually yes. A positive buprenorphine screen is the expected result for people taking it. Tell the person reviewing the result about your prescription so it isn't misread.
Does a negative buprenorphine result mean I missed doses?
Not necessarily. Screens can miss buprenorphine, and dilute urine, a low amount or a longer time since your last dose can bring it under the cutoff. A confirmation test using mass spectrometry is more sensitive and can be requested.
Why isn't buprenorphine caught by my regular opiate drug test?
Standard opiate screens are built to find natural opiates like morphine and codeine. They are less reliable for semisynthetic medicines such as buprenorphine, so labs use a separate buprenorphine test.
Show the science and sources
For clinicians and researchers
An immunoassay screen (Mayo BUPR, LOINC 93494-3) with a 5 ng/mL buprenorphine cutoff and a reference result of Negative; positives reflex to LC-MS/MS (Mayo BUPM) with cutoffs of 5.0 ng/mL for buprenorphine and 2.5 ng/mL for norbuprenorphine. Mayo's targeted opioid screen (inside the clinical monitoring profile) lists 5 ng/mL for both buprenorphine and norbuprenorphine, so cutoffs differ between assays and labs. Opiate immunoassays detect natural alkaloids such as morphine and codeine better than semisynthetic opioids, including buprenorphine, and immunoassays are at best semiquantitative because of cross-reactivity (Pain Med 2018 consensus), and a 2025 Medical Journal of Australia article cites a New South Wales analysis in which 57% of qualitative urine screens from people on supervised sublingual buprenorphine were negative for buprenorphine. Quetiapine metabolites caused interferences in norbuprenorphine LC-MS/MS transitions at several labs, and the authors identified interference-free transitions (J Anal Toxicol 2022). Detection windows of up to about 7 days (buprenorphine) and 14 days (norbuprenorphine) are summarized in a 2024 paper that cites earlier work and vary with dose and duration of use. A buprenorphine-to-norbuprenorphine ratio above 50 has been proposed to flag adulterated samples (Subst Use 2024), which is outside this screen's scope.
LOINC 93494-3 (primary), 3414-0, 58359-1, 38373-7, 16208-1. Specimen: urine.
Sources
- Buprenorphine Screen with Reflex, Random, Urine (Mayo test BUPR), Mayo Clinic Laboratories
- Buprenorphine and Norbuprenorphine, Random, Urine (Mayo test BUPM), Mayo Clinic Laboratories
- Controlled Substance Monitoring Profile, Random, Urine (Mayo test CSMPU), Mayo Clinic Laboratories
- Rational Urine Drug Monitoring in Patients Receiving Opioids for Chronic Pain: Consensus Recommendations, Pain Medicine (2018)
- Buprenorphine, Norbuprenorphine, and Naloxone Levels in Adulterated Urine Samples: Can They be Detected When Buprenorphine/Naloxone Film is Dipped into Urine or Water?, Substance Use: Research and Treatment (2024)
- Norbuprenorphine Interferences in Urine Drug Testing LC-MS-MS Confirmation Methods from Quetiapine Metabolites, Journal of Analytical Toxicology (2022)
- Exploring the role of urine drug screening in opioid agonist therapy, Medical Journal of Australia (2025)
- Opioid Testing (MedlinePlus Medical Test), MedlinePlus, U.S. National Library of Medicine
- Drug Testing (MedlinePlus Medical Test), MedlinePlus, U.S. National Library of Medicine
AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.