Skip to main content

Analytical True Positives in Workplace Drugs Testings Due to Use of Prescription and OTC Medications

  • Chapter
  • First Online:
Beating Drug Tests and Defending Positive Results
  • 807 Accesses

Abstract

Analytical true positive workplace drug testing results due to use of prescription medication or OTC (over-the-counter) medication do occur. Amphetamine positive result due to prescription medication was discussed in Chap. 9. Prescription use of any benzodiazepine may cause positive test results although benzodiazepine is not one of the SAMHSA drugs. Topical use of cocaine may cause positive results in workplace drug testing. Many pain medications contain opiates and use of such medication leads to false positive opiate tests. Marinol is synthetic marijuana which is metabolized in the same way as marijuana and can cause positive marijuana results in workplace drug testing.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Manchikanti L. National drug control policy and prescription drug abuse: facts and fallacies. Pain Physician 2007; 10: 399–424.

    PubMed  Google Scholar 

  2. Manchikanti L, Singh A. Therapeutic opioids: a ten year perspective on the complexities and complications of the escalating use, abuse, and nonmedical use of opioids. Pain Physician 2008; 11(2 Suppl): S63–S88.

    PubMed  Google Scholar 

  3. Wunsch MJ, Nakamoto K, Behonick G, Massello W. Opioid deaths in rural Virginia: a description of the high prevalence of accidental fatalities involving prescribed medications. Am J Addict 2009; 18: 5–14.

    Article  PubMed  Google Scholar 

  4. DeRienz RT, Holler JM, Manos ME, Jemionek J et al. Evaluation of four immunoassays screening kits for the detection of benzodiazepines in urine. J Anal Toxicol 2008; 32: 433–437.

    CAS  PubMed  Google Scholar 

  5. Klette KL, Wiegand RF, Horn CK, Stout PR et al. Urine benzodiazepine screening using Roche Online KIMS immunoassay with beta-glucuronidase hydrolysis and confirmation by gas chromatography-mass spectrometry. J Anal Toxicol 2005; 19: 193–200.

    Google Scholar 

  6. Fraser AD, Jowell P. Oxaprozin cross-reactivity in three commercial immunoassays for benzodiazepines in urine. J Anal Toxicol 1998; 22: 50–54.

    CAS  PubMed  Google Scholar 

  7. Piergies AA, Sainati S, Roth-Schechter B. Lack of cross-reactivity of Ambien (zolpidem) with drugs in standard urine drug screens. Arch Pathol Lab med 1997; 121: 392–394.

    CAS  PubMed  Google Scholar 

  8. ElSohly MA, Gul W, Murphy TP, Avula B. LC-(TOF) MS analysis of benzodiazepines in urine from alleged victims of drug facilitated sexual assault. J Anal Toxicol 2007; 31: 505–514.

    CAS  PubMed  Google Scholar 

  9. ElSohly MA, Gul W, Avula B, Murphy TP et al. Simultaneous analysis of thirty five benzodiazepines using liquid chromatography-mass spectrometry time of flight. J Anal Toxicol 2008; 32: 547–561.

    CAS  PubMed  Google Scholar 

  10. Reisfield GM, Haddad J, Wilson GR, Johannsen LM et al. Failure of amoxicillin to produce false-positive urine screens for cocaine metabolite. J Anal Toxicol 2008; 32: 315–318.

    CAS  PubMed  Google Scholar 

  11. Bruns AD, Zeiske LA, Jacobs AJ. Analysis of the cocaine metabolite in the urine of patients and physicians during clinical use. Otolaryngol Head Neck Surg 1994; 111: 722–726.

    Article  CAS  PubMed  Google Scholar 

  12. Kavanagh KT, Maijub AG, Brown JR. Passive exposure to cocaine in medical personnel and its effect on urine drug screening test. Otolaryngol Head Neck Surg 1992; 107: 363–366.

    CAS  PubMed  Google Scholar 

  13. Jacobson DM, Berg R, Grinstead GF, Kruse JR. Duration of positive urine for cocaine metabolite after ophthalmic administration: implications for testing patients with suspected Horner syndrome using ophthalmic cocaine. Am J Ophthalmol 2001; 131: 742–747.

    Article  CAS  PubMed  Google Scholar 

  14. Patrinely JR, Cruz OA, Reyna GS, King JW. The use of cocaine as an anesthetic in lacrimal surgery. J Anal Toxicol 1994; 18: 54–56.

    CAS  PubMed  Google Scholar 

  15. Altieri M, Bogema S, Schwartz RH. TAC topical anesthesia produces positive urine test for cocaine. Ann Emerg Med 1990; 19: 577–579.

    Article  CAS  PubMed  Google Scholar 

  16. Smith ML, Hughes RO, Levine B, Dickerson S et al. Forensic drug testing for opiates. VI. Urine testing for hydromorphone, hydrocodone, oxymorphone and oxycodone with commercial opiate immunoassays and gas chromatography-mass spectrometry. J Anal Toxicol 1995; 19: 18–26.

    CAS  PubMed  Google Scholar 

  17. Dunn KE, Sigmon SC, McGee MR, Heil MR et al. Evaluation of ongoing oxycodone abuse among methadone maintained patients. J Subst Abuse Test 2008; 35: 451–456.

    Article  Google Scholar 

  18. Popa C, Beck O, Brodin K. Morphine formation from ethylmorphine: implications for drugs of abuse testing in urine. J Anal Toxicol 1998; 22: 142–147.

    CAS  PubMed  Google Scholar 

  19. Wasam AD, Michna E, Janfaza D, Greenfield S et al. Interpreting urine drug tests: prevalence of morphine metabolism to hydromorphone in chronic pain patients treated with morphine. Pain Med 2008; 9: 918–923.

    Article  Google Scholar 

  20. Cone EJ, Caplan YH, Moser F, Robert T et al. Evidence that morphine is metabolized to hydromorphone but not to oxymorphone. J Anal Toxicol 2008; 32(4): 319–323.

    CAS  PubMed  Google Scholar 

  21. Oyler JM, Cone EJ, Joseph RE Jr, Huestis MA. Identification of hydrocodone in human urine following controlled codeine administration. J Anal Toxicol 2000; 24: 530–535.

    CAS  PubMed  Google Scholar 

  22. Murao S, Manabe H, Yamashita T, Sekikawa T. Intoxication with over the counter antitussive medication containing dihydrocodeine and chlorpheniramine causes generalized convulsion and mixed acidosis. Intern Med 2008; 47: 1013–1015.

    Article  PubMed  Google Scholar 

  23. Coffman KL. The debate about marijuana usage in transplant candidates: recent medical evidence on marijuana health effects. Curr Opin Organ Transplant 2008; 13: 189–195.

    Article  PubMed  Google Scholar 

  24. Rossi S, Yash T, Bentley H, van der Brande G et al. Characterization of interference with six commercial d9-tetrahydrocannabinol immunoassays by efavirenz glucuronide in urine. Clin Chem 2006; 52: 896–897 [letter to the Editor].

    Article  CAS  PubMed  Google Scholar 

  25. ElSohly MA, deWit H, Wachtel SR, Feng S et al. Delta 9-tetrahydrocannabivarin as a marker for ingestion of marijuana versus Marinol: results of a clinical study. J Anal Toxicol 2001; 25: 565–571.

    CAS  PubMed  Google Scholar 

  26. di Tomaso E, Beltramo M, Piomelli D. Brain cannabinoids in chocolate. Nature 1996; 382(6593): 677–678.

    Article  CAS  PubMed  Google Scholar 

  27. James JS. Marijuana and chocolate. AIDS Treat News 1996; 18(2567): 3–4.

    Google Scholar 

  28. Tytgat J, Van Boven M, Daenens P. Cannabinoid mimics in chocolate utilized as an argument in court. Int J Legal Med 2000; 113: 137–139.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amitava Dasgupta .

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Dasgupta, A. (2010). Analytical True Positives in Workplace Drugs Testings Due to Use of Prescription and OTC Medications. In: Beating Drug Tests and Defending Positive Results. Humana Press. https://doi.org/10.1007/978-1-60761-527-9_10

Download citation

Publish with us

Policies and ethics