Drug Testing Myths Busted

 

Myth 1: Antibiotics will not cause a false positive drug test.

Myth 2: A screen followed by a second screen provides a confirmed result.

Myth 3: SAMHSA certification ensures you will get a more accurate drug testing result.

Myth 4: New marijuana use can be detected by comparing THC levels in consecutive samples.

Myth 5: Water is the only fluid that will cause a dilute specimen when consumed in large quantities.

Myth 6: Poppy seeds do not cause a false positive opiate result.

Myth 7: College of American Pathologists – Forensic Drug Testing certification is the same as CAP proficiency testing.

Myth 8: Urine and Saliva testing provide equivalent results.

Myth 9: Urine and Oral Fluid specimens taken from a donor at the same time will give the same result.

Myth 10: Knowing a donor is a diabetic means a positive alcohol test is invalid due to possible fermentation.

Myth 11: The levels provided by a screen test give the same information as those provided by a confirmation by LC/MS/MS or GC/MS/MS.

Myth 12: The level of drug in a specimen stays constant over time.

Myth 13: Some synthetic Opiates such as fentanyl and meperidine, are detected by an Opiate screening test.

Myth 14: Food and beauty products that contain hemp seed will not cause a positive THC test.

Myth 15: Dextromethorphan will cause a positive for PCP.

Myth 16: EtG testing is of minimal value due to “passive contact” positives.

Myth 17: A confirmed positive for both hydrocodone and hydromorphone indicates the donor has been using both.

Myth 18: New marijuana use can be detected by comparing THC levels in consecutive samples.

Myth 19: When test kit results and laboratory results do not agree this means that one or the other is not working correctly.

Myth 20: THC levels in immunoassay screens and those detected during confirmation testing should be the same.

Myth 21: Bleaching and other cosmetic hair treatments alter the results of a hair drug test.

Myth 22: The nanogram level per milliliter (ng/ml) reported in drug test confirmation results is an accurate way to determine the quantity of a drug consumed by the donor.

Myth 23: Any type of alcohol, such as stearyl alcohol, cetyl alcohol, or dodecanol (lauryl alcohol), which are used in many personal care products, will cause a positive result on an ethyl glucuronide, or EtG, test.

Myth 24: It possible to test positive for cocaine use by “making out” with someone who just snorted a line of cocaine

Myth 25: It is possible to distinguish the THC from a prescription drug like Marinol, from the THC present in marijuana.

Myth 26: Exposure to second hand marijuana (THC) smoke can yield a positive test result.

Myth 27: It is possible to drink or eat something that will “cleanse” your body, resulting in a negative drug test.

Myth 28: Methadone use will cause an individual to test positive for opiates.

Myth 29: Salvia Divinorum use can be detected by testing for Marijuana (THC).

Myth 30: Having a penny in your mouth will allow you to beat an oral fluid drug test.

Myth 31: Heroin is the most abused Opiate.

Myth 32: Witchcraft, wizardry and wickedness were most likely the causes for the Salem witch trials.

Myth 33: Hair testing can be used to determine recent drug abuse.

 

 

Myth 1: Antibiotics will not cause a false positive drug test.

Truth:

There is a class of antibiotics that may cross react with the opiate screen. The class of antibiotics quinolones (these include levofloxacin, ciprofloxcin, ofloxacin and others) can cause a positive screen, however, confirmation by methods such as GC/MS or LC/MS/MS will be negative. (JAMA. 2001;286:3115-3119.)
Levaquin product insert, Ortho-Mcneil, Inc. (revised *January 2006) TOP

 

Myth 2: A screen followed by a second screen provides a confirmed result.

Truth:

A second screen just provides the same answer twice, but does not eliminate substances that could have caused a false positive, i.e. over the counter medications. Only through the use of a definitive testing methodology, such as GC/MS or LC/MS/MS, (methods such as RIA and TLC are considered screening methods) can you truly confirm a test result. This is why CAP-FDT certification requires the use of two different techniques for a confirmed result.

 

Myth 3: SAMHSA certification ensures you will get a more accurate drug testing result.

Truth:

The regulatory scope of SAMHSA is strictly limited to Mandatory Federal Workplace Drug Testing and pertains to only five drugs (amphetamines, cocaine, opiates, PCP and THC). While SAMHSA requirements will improve the quality of testing over CLIA requirements (10% of all samples run in a batch must be quality control samples), the College of American Pathologists-Forensic Drug Testing (CAP-FDT) certification is equally rigorous in its quality control requirements and offers greater flexibility in types of drugs tested and positive cut-off levels. TOP

 

Myth 4: New marijuana use can be detected by comparing THC levels in consecutive samples.

Truth:

New marijuana use cannot be detected using only the THC level, as the drug concentration relative to the amount of water in consecutive samples may be very different. The only way to determine new use in consecutive samples is to compare THC/Creatinine ratios. If the ratio has gone up in the second specimen then new use has likely occurred. TOP

 

Myth 5: Water is the only fluid that will cause a dilute specimen when consumed in large quantities.

Truth:

Consuming large quantities, about 1 liter, of any liquid will significantly dilute the specimen within 30 minutes to 1 hour of consumption. This is the reason that all specimens tested should have a Creatinine level determined to evaluate whether the sample is too dilute to provide a valid test result. TOP

 

Myth 6: Poppy seeds do not cause a false positive opiate result.

Truth:

Poppy seeds can cause a positive result depending on the cutoff used for a positive test. At the 2000-ng/ml cut-off level it would be extremely unlikely, given the amount of seeds that would need to be consumed, to get a positive result from consuming poppy seeds. In addition, the poppy seeds would need to be un-washed. Most commercial bakeries use washed poppy seeds. However, as many agencies use a lower 300-ng/ml cut-off, a positive opiate test due to poppy seeds is a possibility. TOP

 

Myth 7: College of American Pathologists – Forensic Drug Testing certification is the same as CAP proficiency testing.

Truth:

College of American Pathologists – Forensic Drug Testing (CAP-FDT) accreditation requires an annual inspection process and dictates laboratory quality practices which must be utilized for all testing to ensure a forensic and legally defensible result. Laboratories that participate in the CAP proficiency-testing program are not necessarily complying with any of the requirements of accreditation. Participants in the CAP proficiency-testing program receive unknown specimens for testing 3 times per year. The participants analyze the specimens and return the results to the CAP for evaluation. The proficiency program does not dictate how specimens are to be tested, or the quality control measures that are required to ensure the day-to-day quality of testing, and the legal defensibility of results. TOP

 

Myth 8: Urine and Saliva testing provide equivalent results.

Truth:

While Urine and Oral Fluid drug testing are both scientifically valid test methodologies, they have some biologic differences that can provide different results. Drugs remain in oral fluid for a shorter period of time and at lower concentrations than in urine, particularly THC. Consequently, if you take a urine and oral fluid specimen at the same time from the same donor they may not correlate, which means one could be positive and one negative. TOP

 

Myth 9: Urine and Oral Fluid specimens taken from a donor at the same time will give the same result.

Truth:

Drugs become detectable, and remain detectable for different time for urine and oral fluid. Drugs show up more quickly, and are gone more quickly in oral fluid than in urine, with the most significant difference being with THC. Consequently, depending on the time elapsed since use; one test could be positive and the other negative. Both methodologies are very effective but may have different preferred applications based on this and specimen collection issues. TOP

 

Myth 10: Knowing a donor is a diabetic means a positive alcohol test is invalid due to possible fermentation.

Truth:

The fact that an individual reports being diabetic may or may not be significant. What is most important is whether there is glucose in the specimen together with a yeast infection, which can externally ferment glucose into alcohol. Some controlled diabetics may not show glucose present, and many diabetics, up to 25%, are not aware they are diabetic. Consequently, Norchem provides a glucose test on all positive alcohol tests. The presence of glucose would indicate the possibility that the alcohol was the result of glucose fermentation. TOP

 

Myth 11: The levels provided by a screen test give the same information as those provided by a confirmation by LC/MS/MS or GC/MS/MS.

Truth:

The level provided by a screening test typically indicates the level of color change that is caused by the interaction between the antibodies and the drug, however, this level does not correlate directly to a level of drug in the specimen. In contrast, the level provided by a confirmation by LC/MS/MS or GC/MS/MS directly correlates to the level of drug in the specimen. TOP

 

Myth 12: The level of drug in a specimen stays constant over time.

Truth:

Some drugs and their metabolites degrade over time, some quicker than others, such as THC and morphine. Some drugs are also sensitive to light, such as THC, LSD and mushroom-based drugs. When testing for these drugs, it is important to wrap the specimen in foil so that light exposure is minimized or prevented. Freezing positive specimens for storage minimizes drug degradation. TOP

 

Myth 13: Some synthetic Opiates such as fentanyl and meperidine, are detected by an Opiate screening test.

Truth:

Many synthetic opiates are not detected by an opiate screen and must be tested for as a separate drug. TOP

 

Myth 14: Food and beauty products that contain hemp seed will not cause a positive THC test.

Truth:

Products containing hemp seed contain trace amounts of non-psycho-active THC. Consequently, depending on the amount of usage some positive screens could occur in donors that use these products. Donors should be instructed not to use these products while they are involved in a drug testing program. TOP

 

Myth 15: Dextromethorphan will cause a positive for PCP.

Truth:

Dextromethorphan can cause a positive PCP screen result, but the confirmation test will be negative for PCP. To avoid performing a confirmation on every PCP positive screen that may have been caused by dextromethorphan, Norchem runs a CEDIA test on all positive PCP screens. CEDIA is only sensitive to PCP, not dextromethorphan, so if it comes up positive we do the LCMSMS confirmation, if it comes up negative we report a negative result. Dextromethorphan is found in over the counter cough medicine like Robotussin DM and is the primary active ingredient listed on the box. TOP

 

Myth 16: EtG testing is of minimal value due to “passive contact” positives.

Truth:

EtG can detect alcohol consumption in juveniles or individuals on a alcohol monitoring program. Laboratories must use a testing method like LC/MS/MS and a cutoff level that is able to distinguish between consumption of alcohol and passive contact with products containing alcohol. Commonly used cutoff levels range from 100 ng/ml to 1,000 ng/ml. There is mounting evidence that 100 is picking up passive alcohol exposure from frequent use of mouthwash or hand sanitizers, and the 1000 cutoff may be to high, missing real positives. Norchem uses a 500 ng/ml cutoff in both the LC/MS/MS screen and confirmation tests. This robust method will detect alcohol consumption while minimizing “passive contact” positives. TOP

 

Myth 17: A confirmed positive for both hydrocodone and hydromorphone indicates the donor has been using both.

Truth:

Hydromorphone is a direct metabolite of hydrocodone. Consequently a confirmed positive for both does not necessarily mean the donor has used hydromorphone as it could be positive due to the metabolizing of the hydrocodone. TOP

 

Myth 18: New marijuana use can be detected by comparing THC levels in consecutive samples.

Truth:

New marijuana use cannot be detected using only the THC level, as the drug concentration relative to the amount of water in consecutive samples may be very different. The only way to determine new use in consecutive samples is to compare THC/Creatinine ratios. If the ratio has gone up in the second specimen then new use has likely occurred. TOP

 

Myth 19: When test kit results and laboratory results do not agree this means that one or the other is not working correctly.

Truth:

While both laboratory testing and instant testing devices are designed to identify drugs in a specimen, they each have their advantages and disadvantages that could lead to a different result. While instant test kits have the advantage of providing a result on the spot, the testing tends to be more limited in terms of identifying adulterants/substitution or cross-reacting substances. Also test kits usually provide a subjective result (as read by the collector or officer). Subjective results may differ depending on who interprets the results. Laboratory testing provides an unbiased result, read by unbiased laboratory instrumentation.

A laboratory has the option to perform additional testing on a specimen should a specimen be suspected of adulteration or when there is a suspicious instrument reading. In the case of PCP, a laboratory can perform an additional test to rule out a positive caused by dextromethorphan, a component of numerous cough medicines. Only laboratory testing provides the caseworker or probation officer with Creatinine and THC levels, the THC Creatinine ratio, or glucose testing on positive alcohol specimens. Each of the above could lead to a differing result, or interpretation of the result, which is driven by the technical characteristics of each methodology. While both methodologies have their place, a specimen that is tested in a CAP-FUDT or SAMHSA certified laboratory, provides the highest level of testing and information. TOP

 

Myth 20: THC levels in immunoassay screens and those detected during confirmation testing should be the same.

Truth:

The THC level reported in an immunoassay screen reflects the sum of many THC metabolites in the specimen. Confirmation by LC/MS/MS (for more information on our LC/MS/MS confirmation procedures and technology please visit our website) detects only one specific metabolite. This physiologically active metabolite, known as THCC, accounts for approximately 1/3 of the marijuana metabolites excreted in the urine and is the most universally accepted chemical marker for marijuana usage. This is why the reported results differ between the two methods. TOP

 

Myth 21: Bleaching and other cosmetic hair treatments alter the results of a hair drug test.

Truth:

This is no myth. While studies disagree with the extent to which the outcomes can be altered, there is no doubt that the results obtained through the testing of treated hair are inaccurate. Initial studies would indicate that, at first, these treatments do lower the level of drug detectable in the hair, but subsequently leave the hair more porous allowing the hair to accumulate higher than normal levels of the drug through continued use. TOP

 

Myth 22: The nanogram level per milliliter (ng/ml) reported in drug test confirmation results is an accurate way to determine the quantity of a drug consumed by the donor.

Truth:

The nanogram/mL (part per billion) level corresponds to the amount of the specific metabolite detected. While detection of this metabolite above the cutoff level generally indicates usage, the amount of the metabolite detected cannot be definitively correlated to the amount of the drug used. This is due to a variety of factors such as when and how much drug was consumed, its half life, a person’s history of drug use, age, sex, weight, health, or even the properties of the specific drug itself, with respect to one’s individual metabolism. In other words, two people with the same ng/ml level may have consumed vastly different quantities of the drug detected. TOP

 

Myth 23: Any type of alcohol, such as stearyl alcohol, cetyl alcohol, or dodecanol (lauryl alcohol), which are used in many personal care products, will cause a positive result on an ethyl glucuronide, or EtG, test.

Truth:

No alcohol except for ethyl alcohol (ethanol) will cause a positive result on an EtG test. These other alcohols are, chemically, very different from ethyl alcohol and break down into metabolites that will not be detected during this test.

In addition, Norchem’s cut-off level for EtG testing is set at 500 ng/ml to virtually eliminate the chance of a positive result from passive contact. See Myth 16 for more details on EtG cutoff levels. TOP

 

Myth 24: It is possible to test positive for cocaine use by “making out” with someone who just snorted a line of cocaine.

Truth:

The simple answer is no. Although some cocaine will undoubtedly be absorbed via fluid transfer by the non-user, this amount would be very small (very little cocaine would make it past the nasal cavity into the saliva and even less would be transferred to another individual). And while a drug test may detect cocaine in the non-user’s system, the amount would be well below the “positive” cut-off level. TOP

 

Myth 25: It is possible to distinguish the THC from a prescription drug like Marinol, from the THC present in marijuana.

Truth:

No, they are the same chemical compounds derived from the same plant. TOP

 

Myth 26: Exposure to second hand marijuana (THC) smoke can yield a positive test result.

Truth:

Passive exposure to a drug can make it appear in your urine, but actual consumption of the drug makes it appear at a much higher concentration. To avoid the argument that a positive result is due to passive contact, cut-off levels have been established. These cut-off levels are set to make it virtually impossible for a specimen to screen positive from passive contact. In the case of THC, it has been shown that subjects can be exposed to extreme, uncomfortable levels of second-hand smoke for long periods of time without registering a positive urine test at the 50 ng/ml screening cutoff level.

For more information and references on this subject, please visit: href=”http://www.norchemlab.com/passive-inhalation-of-marijuana-smoke-and-urine-drug-test-results/”>this linkTOP.

 

Myth 27: It is possible to drink or eat something that will “cleanse” your body, resulting in a negative drug test.

Truth:

While there are many commercial products available that claim to do this and just as many, if not more, urban myths about household products that will, the truth is that none of them works. Here are a number of products that we have been asked about and what they actually do. TOP

Chemical Cleaners – Drinking chemicals such as bleach and Draino will do nothing to eliminate drugs from your system. Instead, they may cause esophageal burning, vomiting, all sorts of digestive problems and maybe even death! Online instructions available for this method indicate that these compounds should be consumed with lots of water. Any “clean” drug produced utilizing this method was most likely due to the specimen being dilute, which is a result of consuming excessive amounts of water, not from the chemical cleaner.

Pectin – Eating pectin does not help you pass a drug test. What pectin DOES do is act as a preservative and gelling agent in jams, jellies, pie fillings and some milk drinks. In addition, it is used to add dietary fiber to many of the foods we eat.

Herbal Teas – Herbal teas may have various beneficial effects, but passing your drug test is not one of them. Consumed in sufficient quantity, tea may make urine dilute as it is a diuretic, but there has been no evidence to show that tea has any drug metabolite reducing or negating abilities.

B Vitamins and Niacin – These products turn urine yellow. Before creatinine testing became standard, basic specimen validity testing was based, in part, on the color of the specimen. Since clear specimens were not accepted, this was a useful method of avoiding detection when submitting a diluted specimen. Creatinine testing is a much better indicator of urine concentration and authenticity than color alone.

Vinegar – Enough vinegar will cause a pretty good case of heartburn, but will not clean your urine.

Herbs and Herbal Supplements – The ever-popular Golden Seal falls under this category, but much like herbal teas, there is no evidence what so ever to support claims that ANY herb can cleanse urine of drugs or their metabolites.

Energy Drinks – No amount of energy drink consumption will cause a false negative (or positive) test result due to the ingredients in the drink. Drinking several of them, of course, can cause urine to be dilute.

“Pass Your Drug Test” Drinks – Some people pay $50+ for these drinks that claim to clean urine. In reality, these drinks don’t do much on their own. Instructions generally require the testee to avoid drugs for three days prior to the test. Abstaining for three days will already rid your system of cocaine, methamphetamine, and ecstasy. Additionally, the drink is supposed to be consumed with large amounts of water, resulting in a dilute specimen.

To reiterate, a donor may be able to dilute their specimen, but there is nothing that can be consumed that will “fool” a drug test or “cleanse” the urine. TOP

 

Myth 28: Methadone use will cause an individual to test positive for opiates.

Truth:

The properties that make Methadone an effective treatment for opiate addiction are the same properties that prevent it from testing positive for opiates. Methadone acts on the opioid receptors, just like morphine, heroin or any other opiate, to alleviate withdrawal symptoms, but is actually a synthetic opioid with a different chemical structure than traditional opiates. Methadone must be tested for separately because of this structural difference. TOP

 

Myth 29: Salvia Divinorum use can be detected by testing for Marijuana (THC).

Truth:

Salvia will not be detected by testing for Marijuana, because it does not contain THC. The ingredient responsible for Salvia’s psychoactive properties is salvinorin A.

 

Myth 30: Having a penny in your mouth will allow you to beat an oral fluid drug test.

Truth:

While the penny itself has no chemical effect on the test, it does have a secondary effect of causing an individual to salivate more. This extra saliva can dilute the specimen, possibly resulting in a false negative result. This isn’t just for pennies either, almost anything you can fit in your mouth from Legos to chewing gum to paper clips can induce salivation. If your agency conducts oral fluid testing, be sure to check those mouths for foreign objects! TOP

 

Myth 31: Heroin is the most abused Opiate.

Truth:

According to the DEA, abuse of prescription drugs such as OxyCotin and Vicodin far outstrips that of “street” drugs like heroin and opium. To ensure that these abuses don’t go undetected, Norchem has developed an expanded opiate confirmation panel which includes Morphine, Codeine, Hydrocodone, Hydromorphone, Oxycodone, Oxymorphone, and Dihydrocodeine. Call us today at 800-348-4422 to enhance your opiate testing capabilities. TOP

 

Myth 32: Witchcraft, wizardry and wickedness were most likely the causes for the Salem witch trials.

Truth:

While one would be wise to approach the subject of a witch’s power with trepidation, the evidence points to a less supernatural cause for these events. It is now believed that the initial cases of “possession” may have been caused by ergotism. Ergotism can be caused by eating grain product contaminated with Claviceps Purpurea, a fungus which produces an alkaloid with a similar chemical structure to LSD. Symptoms of ergotism include seizures, spasms, diarrhea, itching, headaches, nausea, vomiting, hallucinations, mania and psychosis. There is little wonder that victims of ergotism could be thought of as bewitched. TOP

 

Myth 33: Hair testing can be used to determine recent drug abuse.

Truth:

Even if the hair specimen is shaved off at the scalp (standard collection procedure requires the collector to cut the hair close to the scalp), any use that occurred over the previous week will not be detectable. To detect drug use during that week, a urine specimen would be your best option. TOP