False Positives

False Positives – Changes in 2021

False positives – Many are feeling optimistic as the world moves close to a post-pandemic time.  In the first quarter of 2021, storefronts are reopening, and businesses are launching vacancies for new hires. As the tail end of the pandemic continues, the truth of how many have handled this traumatic world event is coming to light. The issue of stress management has weighed heavily on the masses.

As stressful times may continue, those who are unable to cope have sadly found other ways of dealing with personal difficulties. In an article published by apa.org, Mandy Owens, Ph.D., a clinical psychologist and researcher at the University of Washington Alcohol and Drug Abuse Institute, says she’s observed a spike in substance use that includes an increase in both quantity and frequency of drug use during the pandemic.

What this means for the Workforce

As businesses continue to open their doors, the need for qualified staff continues to grow.  If you are re-entering the workforce in 2021 you may be surprised to hear that more businesses are implementing pre-employment drug screening processes, now more than ever. For many reentering the workforce in 2021, this may be a surprise.  However, stringent policies on pre-employment drug screening are not a new practice.  New businesses today are being more cautious when hiring new employees and rightly so. Workplace drug testing is to be expected.

Pre-employment Screening

For those who are taking prescription drugs regularly, it is important to be aware of the type of medication they are consuming and how this may affect their drug test results. In fact, some have tested positive for drugs on the employment screening that they have never taken.  How is this possible?  The consumption of certain over-the-counter medications, prescription medication, or specific food items may cause someone to test positive for drugs not taken. This is known as a False Positive.

False Positives

A False Positive is a test result that incorrectly indicates a particular condition or an attribute. One of the most popular examples of this is the effect poppy seeds from bagels have.  The consumption of a Poppy Bagel before a Urine test may lead to an incorrect positive result for an opioid like heroin. Poppy Seeds (See Opioids) are obtained from the opioid poppy.

The extract is used in the creation of many drugs like morphine and heroin.  For this reason, those who consume pastries or food products like this may incorrectly test positive for drugs they have not consumed.

What Can Cause a False Positive Result on a Urine Drug Test?

Alcohol

• Heavy use of the alcohol in hand sanitizer or certain liquid medications, and mouthwash, or other breath cleaning products could cause you to test positive for alcohol consumption.

Amphetamines

• Adipex-P is the most prescribed medication for weight loss in the United States. It increases the release of neurotransmitters that stimulate metabolism and suppress appetite. Taking phentermine can result in a false-positive urine test for amphetamines.

• Pseudoephedrine and Phenylephrine are two popular decongestants that share similar structural characteristics with amphetamines.

• Oxyelite Pro – DMAA, an ingredient in some dietary and weight-loss supplements including Oxyelite Pro. A case report linked a false positive amphetamine screening to the use of the weight-loss supplement.

• Bupropion –  This is used as an antidepressant and smoking cessation aid, also is structurally similar to amphetamine and has been associated with false-positive screenings.

Barbiturates

• Ibuprofen (Motrin, Advil) and naproxen (Aleve) are two very common over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs). If you’ve taken either of these, your urine screen may test positive for barbiturates or THC (marijuana). Ibuprofen may also show a false positive for PCP.

Benzodiazepine

• The medication Daypro (oxaprozin), which is prescribed for types of arthritis, may result in a false positive test for benzodiazepines.

Buprenorphine

• Medical practitioners should be aware that high-dose morphine (with morphine urine levels turning positive within the 15,000 to 28,000 mg/mL range) may produce false-positive buprenorphine EIAs with standard urine EIA toxicology testing.

Cocaine

What Can Cause a False Positive for Cocaine? The following can lead to false-positive results for cocaine tests:

• The use of cocaine in a medical context, such as in ENT procedures. Cocaine is still in use for its anesthetic properties.
• The consumption of coca tea. Coca tea is made from the leaves of the coca plant, also the source of cocaine.
• The subject works in a job that gives him or her exposure to cocaine, such as being a crime lab technician. The use of personal protective equipment can prevent this.
• Being exposed to someone actively using cocaine or disposing of someone else’s cocaine.

Methadone

• Antihistamines and some sleep aids containing diphenhydramine (like Benadryl) could cause a false positive result for PCP or methadone. Doxylamine (the active ingredient in Unisom) can also trigger a positive drug result for methadone, opiates, and PCP.

• Consuming poppy seeds before a drug test (such as in a muffin or on a bagel) could cause a false positive drug result for opioids. Poppy seeds come from the seedpod of the opium poppy and while the seeds are cleaned before consumption, they may still contain trace amounts of opium residue. In 1998, the federal government raised the threshold on opiates from 0.3 micrograms to 2 micrograms per milliliter, but some testing facilities still go by the old standard.

• Tonic water contains quinine, and when consumed in large amounts could lead to false positive results for opiates.

THC

• CBD is the non-psychoactive portion of the marijuana plant that has become a very popular remedy for everything from pain control, to promoting sleep, to helping relieve anxiety.

Urine drug tests screen for the presence of THC, the psychoactive component of marijuana, but a problem could arise because these products are not very well-regulated and cross-contamination can occur. “With CBD available in everything from drink powders, to weight loss formulations, to tinctures of all types, false positive urine tests for THC will become more and more common,” warns Dr. McFadden.

Marijuana

Does passive smoke inhalation cause a false positive for marijuana? It is possible to receive positive test results for marijuana due to passive smoke inhalation.  Consider a few scenarios: 

• Residing in a small, poorly ventilated room or an enclosed vehicle with other active marijuana users.  
• The marijuana being smoked has very high levels of THC (the active ingredient in marijuana) – one stays for at least an hour in proximity with the marijuana users – one is tested immediately or up to a few hours after.
• It is important to remember that urine tests have cut off levels high enough to limit false-positive results. In other words, the cut off levels would have to be very low to test positive from secondhand marijuana smoke exposure.

Methamphetamine

• A key ingredient in Sudafed (pseudoephedrine) is also the main ingredient in the making of methamphetamine.

PCP

• The pain medication tramadol could trigger a false positive result for PCP. Common over-the-counter anti-inflammatory pain medications such as Advil (ibuprofen) and Aleve (naproxen) could make you test positive for barbiturates, THC (cannabinoids), or PCP. –  singlecare.com

Poppy Seeds

Do poppy seeds cause a false positive drug test? Consuming any food item with poppy seeds before submitting a drug test can give a false-positive result. Poppy seeds come from the plant opium poppy. When the seeds are gathered, they may get coated with opium extract.  Opium extract, incidentally, is used in making drugs like morphine and heroin. Poppy seeds generally go through cleaning before being used in food. However, the seeds still contain small amounts of opium extract, which can lead to false-positive results.  It is best to avoid any products containing poppy at least three days before undergoing any urine drug testing.