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Will the UA be negative when heroin-positive menses blood is mixed with clear urine?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

My daughter is currently in recovery from heroin and my husband and I believe she is using it again. We check her UA's at home and mail the findings to a lab. We suspect that she is giving us her friend’s urine. However, I know that today she began her menses and the urine she gave us is blood tinged slightly. Our question is if the urine is clean for heroin and if the blood is not, will the urine drug screen come back negative?

Answered by Dr. Patil Pratik Pramod

Hello,

Welcome to icliniq.com.

  • Ideally, both the urine and blood screens come positive.

For more information consult an internal medicine physician online.

Patient's Query

Thank you doctor,

I would like to know if the urine drug test shows positive if there is heroin-positive menses blood mixed in a clear urine. Does heroin produce the same metabolite in urine and blood and can urinalysis detect it?

Answered by Dr. Patil Pratik Pramod

Hello,

Welcome back to icliniq.com.

  • The menses blood in urine is detailed as the number of RBCs (red blood cells) in urine which does not carry any metabolites of heroin in blood. Hence ideally urine and blood both show positive results for heroin metabolites.
  • The quantity of heroin consumed would be very very low favoring a positive result in blood and not in the urine.

Thank you.

For more information consult an internal medicine physician online.

Patient's Query

Thank you doctor,

So, does that mean you are saying when her friend’s heroin-negative urine is mixed with a drop or two of my daughter’s heroin-positive menses blood, the UA will not detect it as the RBCs do not carry heroin? Will the test come back negative? Please help as I am extremely concerned about this.

Answered by Dr. Patil Pratik Pramod

Hello,

Welcome back to icliniq.com.

  • Yes, exactly. This is what I mean.
  • Also, the halftime for eliminating heroin out of the body is as low as 30 minutes. So if you take blood and urine samples after this time, the tests shall come negative too.

Regards.

For more information consult an internal medicine physician online.

Patient's Query

Thank you doctor,

I know it is possible to test positive for heroin on a blood tox screen. So then why would not blood from a heroin user’s menses test positive in a UA? If there is no heroin in the RBC of blood, where and why is it detectable on a blood tox screen? I read something about both blood and urine drug tests testing for the 6-MAM metabolite, which they both carry even if it is for a short time. Is this true? If it is located in the blood, I would think we would be able to prove my daughter is still using heroin. Kindly provide your opinion.

Answered by Dr. Patil Pratik Pramod

Hello,

Welcome back to icliniq.com.

  • Please note that the absence of 6-AM (6-monoacetylmorphine) which is a direct metabolite of heroin does not rule out heroin use because trace amounts of 6-AM are only excreted for approximately two to eight hours following the heroin use or slightly longer for heavy or chronic usage.
  • This requires a urine specimen to be collected soon after the last heroin use in order for it to be detected.
  • Thus, it is a best practice to continue to use the standard five-panel urine-based drug test which includes the screening for opiate use along with the 6-AM metabolite test to more specifically screen for heroin.

For more information consult an internal medicine physician online.

Patient's Query

Thank you doctor,

So, then is it possible that my daughter's heroin-contaminated menses blood will yield a dirty or a positive result on the urinalysis despite the urine not having heroin in it? Also, I do believe she used heroin just an hour or two before we gave her the test.

Answered by Dr. Patil Pratik Pramod

Hello,

Welcome back to icliniq.com.

  • Yes, it will be positive.

For more information consult an internal medicine physician online.

Answered byDr. Patil Pratik Pramod

Medically reviewed byiCliniq medical review team

Published At November 2, 2017
Reviewed AtApril 25, 2025

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Dr. Patil Pratik Pramod
Dr. Patil Pratik Pramod

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