Drug Test Information

Items Known To Cause A False Positives On Drug Tests.

(1)  OPIATES  [morphine, codeine, heroin]

Pre-Toxscription medications that contain Morphine:

Astramorph PF®     Duramorph®       MSIR®      MS Contin Tablets® Infumorph         Oramorph         Rescudose         Roxanol

Pre-Toxscription medications that contain Codeine:

Actifed with Codeine Cough Syrup®   Ambenyl    Aspirin with Codeine     Broncholate CS    Capital and Codeine Oral Solution

  Cheracol  Codinal PH®    Deconsal    Dimetane-DC Cough Syrup®

Empirin with Codiene®    Fiorcet with Codeine®

 Fiorinal with Codeine®       Isoclor Expectorant        NovahistineDH®         Novahistine Expectorant®   Nucofed Expectorant      Par-Glycerol-C (CV)      Pediacof®    Phenaphen with Codeine®  Phenergan with Codeine®       Phenergan VC®    Poly-Histamine      Promethazine VC with Codeine Robitussin A-C®     Robitusision DAC®  Soma with Codeine

Triaminic Expectorant with Codeine ®  -Tussi-Organiden

 Tylenol with Codeine®    Tylenol with Codeine(#1,2,3, or 4)® Tussar-2®     Tussar SF

NOTE:  List is only a representative sample of the prescription medications that contain  Codeine or Morphine.

Nonprescription products that contain Opium:

Amogel PG®            Diabismul®            Donnagel PG®

Infantol Pink®       Kaodene with Paregoric ®     Paregoric

Nonprescription product that contains Codeine:

Kaoden with Codeine®

Note:  The listed nonprescription products are used as Antidiarrheals.  They are generally available over-the-counter, however, nonprescription sale is prohibited in some states. Paregoric alone is a Schedule III prescription drug, but in combination with other substances in a Schedule 5 over-the-counter product.

Substances that metabolizes to Morphine:    Heroin

Note:  There are a number of synthetic or semisynthetic Opiates available including, but not limited to:

hydromorphine    –    (Dilaudid®)    dihydrocodeine   –    (Paracodine®)

oxymorphone     –     (Numorphan®)  oxycodone    –    (Percodan®)

hyrocane      –      (Hycodan®)      propoxyphene   –   (Darvon®)  

methadone    –      ((Dolophine®)     buprenorphine   –    (Buprenex®)

These drugs do not metabolize to either codeine, morphine or 6-acetylmorphine.  When a doctor presents a prescription for a narcotic analgesic, the MRO should verify that it does not contain codeine, morphine, or 6-acetylmorphine.

Food items that contain morphine:        Poppy Seeds

Note:  Eating normal dietary amounts of poppy seeds can cause  urine specimen to test positive for morphine and ( possibly)  codeine.  The concentration of morphine can be substantial, and usually very low concentrations or no detectable codeine.

MARIJUANA, (THC)

Pre-Toxscription medication that contains delt-9-tetrahydrocannibol (THC)     Dronabinol (Marinol®)

Note:  Marinol may be used to stimulate appetite and preventing weight loss in patients with a confirmed diagnosis of AIDS and treating nausea  and vomiting associated with cancer chemotherapy. Additionally, some individuals have been permitted by a your order  to use THC for the management of Glaucoma.  There are no other prescription medica-tions  that contain cannabinoids or any other substance that might be  identified as or metabolized to THC…

Over-The Counter NSAIDS: Advil®, Nuprin®, Medipren®, Motrin®, Bayer Select Pain Relief Absolute Detox®, Excedrin IB Caplets®, Genpril®, Haltran®, Ibuprofen®, Midol 200, Pamprin®, Trendar Cramp Relief Absolute Detox®, Cramp End Tablets® Rufin®, Naprosyn®, Aleve®, Ketoprofen®, Orudis KT®

Pre-Toxscription NSAIDS, Anaprox®, Tolectin®, Ifenoprofen®, Fluriprofen®, oxaprozin®, Ansaid®, Clinoril®, Dolobid®, Feldene®, Indocin®, Lodine®, Meclomen®, Motrin®, Nalfon®, Naprosyn ®, Orudis®, Relafen ®, Voltaren®

Over-The-Counter allergy preparations, sleep-aids and anti-nausea medications that contain promethazine, Phenergan®, Promethagan®

Riboflavin (vitamin B2), Dronabad®, Edecrin ®

  AMPHETAMINES

Over-the-counter cold and allergy remedies that contain ephedrine, pseudoephedrine, propylephedrine, phenylephrine, or deoxyephedrine:  Nyquil, Contact, Sudafed, Allerest 12 Hour, A.R.M., Triaminic 12;Ornade, Tavist-D, Dimetapp, Neosynephrine, Actifed, Bayer Select Maximum Strenght Sinus Pain Relief Caplets, Contact Non-Drowsy Absolute Detox Sinus Caplets, Maximum Strength, Dristan Cold Caplets, Maximum Strength Sudafed Sinus Tablets, Dristan Cold Tablets, Maximum Strength Sine-Aid Tablets, Maximum Strength Sinus Gelcaps, No Drowsiness Sinarest Tablets, Sinus Excedrin Extra Strength Caplets, Cheracol Sinus, Drixoral Cold and Flu, Efidac/24, Phenergan -D, Robitussin Cold And Flu, Vicks Nyquil,

Over-the-counter diet aids containing Phenylpropanolamine:  Dexatrim®, Accutrim®

Over-the-counter Nasal Sprays that contains l-Methamphetamine 

Vicks Inhaler®, Afrin®

Note:  Although one would expect to see 100% l-methamphetamine following Vicks Inhaler use, there may be a trace amount of d-isomer present because a very slight amount d-methamphetamine may be present as a contaminant in the Vicks Inhaler.

Asthma Medication:  Marax®, Bronkaid Tablet®s, Primatene Tablets®

Amphetamines (Methamphetamine and Amphetamine)

  Pre-Toxscription medications that contain either d-amphetamine or racemic d, l – amphetamine (equal amounts of d- and l-amphetamines):

    Adderall®                  Benzedrine®                Biphetamine® Dexedrine®               Durophet®                   Obetrol®

Pre-Toxscription medications that contain D-Methamphetamine:

Desoyn® (Gradumet®)

Substances known to metabolize to Methamphetamine (and Amphetamine):

Benzphetamine (Didrex®)   Dimethylamphetamine     Famprofazone   Fencamine   Furfenorex   Selegiline (Deprenyl, Elderpryl®)

Substances known to metabolize to Amphetamine:

Amphetaminil    Clobenzorex (Dinintel®, Finedal®)                     Ethylamphetamine    Fenethyllne (Captagone ®)                                Fenoprofex (Tegisec®)     Mefenorex (Pondinil®)                                     Mesocarb          Pre-Toxnylamine

COCAINE 

 PRESCRIPTION MEDICATIONS THAT CONTAIN COCAINE:     
Amoxcillin, Tonic Water and Most Antibiotics

Note: The medical community uses TXC (tetracaine;epinephrine, cocaine) as a topical preparation prior to various surgical procedures and may use cocaine by itself as a topical vasoconstrictive anesthetic for various ear, nose, throat and bronchoscopy.

Note:  Cocaine is structurally unique and does not resemble any of the other topical analgesics such as Novocaine®, xylocaine®,  benzocaine, etc.. Although these compounds have analgesic properties, there is no structural similarity to cocaine or its metabolite (benzoylecdonine).

BARBITURATES

  Pre-Toxscription medications that contain barbiturates: 

Phenobarbital      Pentobarbital        Secobarbital

Acrolase Plus®      Nembutal Sodium     Seconal Sodium

 Bellergal-S ®     Donnatal®        Kenesed®      Luminal     Muldrane GC®

  Quadrinal Rexatal®        Solfoton

Fiorinal®, Donnatol®;some sleeping pills, antiasthmatic, preparations that contain phenobarbital, Dilantin®

BENZODIAZEPINES

 Pre-Toxscription medications that contain benzodiaepines:

Diazepam        Oxazepam       Clonazepam     Triazolam    Valium®        Serax®    Klonopin®     Halcion®     Valrelease®    Sernid®       Rivitril®

Flurazepam:                 Lorazepam                   Lorprazolam          Chlordiazpoxide         Dalmane®                  Ativan®                      Dormonocet®      Libritab®                Flurazepam                 Lorazepam                    Librium                 Limbitrol

LYSERIC ACID DIETHYLAND

Migraine medications:  ergotamine, Ergostat®, Cafergot®, Wigraine®, Imitrex Hydergine®, bromocriptone, methysergiside, lisuride, lysergol, Artane®, triprolidine, amitriptyline, (Elavil)®, dicyclomine (Bentyl)®; Antinausea medications that contain promethazine: Phenergan®, Promethagan®.

Reference

Department of Health & Human Services     From Drug Testing Service

Substance Abuse And Mental Health        Division Of Workplace Program

Services Administration     Revision 11/08/2002

Rockville, MD 20857      Revision   01/08/2004

Date:  11/0820/02

Reference:   San Diego reference Laboratory Technical Brief  6122 Nancy Ridge Driveway   San Diego, CA 92121 Phone: 1-800-677-7995 Fax:  1-656-677-7998     Toxicology Lab Technical Brief  From Dr.. Joseph Grass Ph.D

Additional (Some Duplicate) False Positive Information

Nasal decongestants such as Dristan, Neosynephren, Vicks Nasal Spray, and Sudafed, which cause false positives for amphetamines.

Poppy seeds like those on a dinner roll, which cause false positives for opiates. Even the highest-quality test currently available, the GCMS test, still confuses poppy seeds with heroin.

Pain relievers such as Advil, Nuprin, Midol, Trendar, or any medicine containing Ibuprofen cause false positives for marijuana.

Antibiotics such as amoxicillin or ampicillin cause false positives for cocaine.

***Pain relievers such as Advil, Nuprin, Motrin and menstrual cramp medications like Midol and Trendar .  All drugs containing the widely used pain reliever ibuprofen, are known to cause positive samples for Marijuana.  Non-steroidal anti-inflammatories like Naproxyn has cross-reacted in blind tests. These are often prescribed for runners, sports injuries to joints, and those suffering from Arthritis.

Syva labs has recently reworked its Cannabanoid test and claims to have eliminated this problem.  But a Science Magazine article (July 8, 1988) lists ibuprofen as cross-reactive. Under the new government guidelines THC testing levels will be reduced 50 nanograms. Many more THC false positives can be expected.

***Dristan Nasal Spray,  Neosynephrine, Vicks Nasal Spray, Sudafed and others containing ephedrine or phenylpropanolamine.  Over the counter appetite suppressants which contain propanol amine.  Most common nasal decongestants can cause a reading for amphetamines; amphetamine false positives are the most common.  Recent articles in the Journal of Clinical Chemistry, Vol.38, No. 12, 1992 and Vol 39, No.3, 1993 warn that medications containing chlorpromazine , fluspirilene and others may yield a positive result when tested for amphetamines.

***Vicks Absolute Detox 44M containing Dextromethorphan, and Primatene -M containing pyrilamine as well as the pain reliever Demerol, and prescription anti-depressant, Elavil® test positive for opiates up to three days.  Even Quinine water can also cause a positive reading for opiates.

***Poppy seeds such as on the Burger King roll, on a bagel from your favorite deli, etc.  The Journal of Clinical Chemistry, Vol.33, No.6, 1987 reports:  “The quantities of poppy seed ingested in this study represent this study (25 and 40g) may be expected to be contained in one or two servings of poppy seed cake.

***Therefore, poppy seeds represent a potentially serious source of falsely positive results in testing opiate abuse.  “Clinical Chemistry goes on to conclude:  Not only is it difficult to distinguish heroin or morphine abuse from codeine, but dietary  poppy seeds can give a strong positive result for urinary opiates for several days duration that is confirmed bybGC/MSb analysis.”

***Nyquil Nightime Cold Medicine will test positive for Methadone for up to two days.

***Antibiotics.  Certain newly developed antibiotics have caused positive sample urine tests.  Ampicillin is suspect.  Amoxicillin has caused positives  for cocaine.

***Diazepam (Valium®) positive for PCP  as well as the ingredient in some cough medicines, Dextromethorophan.

The above list is only a beginning. Most substances which people have in their blood have never been tested to see if they cause false positives. Indeed, even some natural body enzymes cause false positives. According to research validated by the Congressional Office of Technology Assessment, melanin, the natural pigment which makes skin dark, can cause false positives for marijuana.

*** Black Skin. ( This Is Not A Joke!) Those of African origin, certain orientals, or Pacific Islanders might test positive for MARIJUANA.  Dr. James Woodford, a toxicologist associated with Emory university labs hypothesized the pigment melanin which protects the skin from the sun approximates the molecular structure of the THC metabolite to cross react on the Marijuana urine test.  Dark-skinned Caucasians such as those from the sub-continent of India could also read positive on marijuana tests.  The body eliminates some melanin in a dark person’s urine sample.

***Passive marijuana inhalation.  If you attend a rock concert or ride in a car where marijuana is smoked nearby, even if you do not partake, the second hand marijuana that you might inhale can give your test a positive result for several days.

***Your own enzymes.  A small fraction of the population excrete large amounts of certain enzymes in their urine which can produce a positive drug test.  Dr. John Morgan of the Department of Pharmacology of a New York City University writes:  “A false positive test could occur in some individuals because they excrete unusually large amounts of endogenous lysozymes or malate dehydrogenase”.  Dr. Morgan judges that natural enzyme interference may run as high as 10% of positive samples.

Reference www.GeorgiaNAMA.com

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