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My Drug Test Is Positive?! Now What?!

My Drug Test Is Positive?! Now What?!

My Drug Test Is Positive?! | Maryland Mom Finds Out the Hard Way

My drug test is positive?! How is that possible? I don’t take drugs of any kind!  A story out of Maryland reminds us of the cold, hard realities of urine drug testing – at best it gives you incomplete information; at worst it gives incorrect information.

http://www.foxnews.com/health/2018/08/07/maryland-mom-tests-positive-for-opiates-after-eating-poppy-seed-bagel.html

Take this new mom for example – according to her, she ate a poppy seed bagel in the morning, delivered her baby in the afternoon and then she tested positive for opioids on a (presumably) random urine drug test that is (probably) performed on all new mothers.  Given what we know about poppy seeds and drug tests, her explanation is entirely plausible. OR she gobbles oxycodone like they are gummy bears and the poppy seed bagel defense is her go-to excuse whenever she pops positive on a drug test. Poppy seeds don’t contain morphine, but they are coated by it. Unless they are extensively and vigorously washed to remove all the opium clinging to the surface of the seed, the opium will be ingested along with the seed and turn the urine opioid immunoassay positive.

This happens all the time and not just with opioid drug tests. Here is the exact same story from 2013:

And another one – this time caused by bagel chips – from 2017:

I’ve had a patient contact me because she popped positive for cocaine on a pre-employment urine test. She swore that she never took cocaine in any way, shape or form. The thing about urine testing for cocaine – its one of the few things that really doesn’t have any false positives because you aren’t testing for the parent compound, you are actually testing for benzoylecognine, the principle metabolite of cocaine. So if you take a urine test and it pops positive for cocaine – there is a very, very good chance you have been into the candy, so to speak. As our interview progressed I asked her about her diet and other habits, I learned that she drank a type of tea called “Mate de coco” that she bought at Trader Joe’s.Mate de coco tea Mate de coco tea

 

I thought “Hmmm…mate de coco…kinda sounds like cocaine.” We picked up a box of the tea at Trader Joe’s and brewed up a cup and tested it with a gas chromatography/mass spectroscopy (GC/MS) and sure enough learned that each cup of mate de coco tea had about 6 mg of cocaine in it. Now, 6 mg of cocaine isn’t really much – for instance, your ENT surgeon typically puts 100 mg of cocaine on your nasal mucous membranes to pull out your polyps, but that little amount of cocaine in a cup of tea was enough to turn my patient’s urine positive. OR she is the biggest crackhead in the city and the mate de coco defense has worked for her before. I have no way of telling.

 

On two occasions during my fellowship in Denver we had to physically get in-between an irate set of parents and representatives from Child Protective Services because the parents had brought the child to the ER after the child had a seizure at home. A well-intentioned but ill-informed doctor had performed a urine drug test on the child, which popped positive for phencyclidine (PCP), so the state was called in. What the doctor didn’t know was that the urine test at the hospital frequently misidentified diphenhydramine (Benadryl) for PCP and the parents had given the child a cough and cold preparation containing Benadryl a little while before the seizure. The seizure was a simple febrile (fever-related seizure) and had nothing to do with PCP or Benadryl, but on the basis of a bad test, the state was ready to take a child away from its parents.

In the Maryland case, it sounds like they performed a more exact test and determined that the mom wasn’t using opioids and her poppy seed bagel defense was legitimate. It’s easy to differentiate heroin from other opioids (and poppy seeds) with some slightly more sophisticated testing but its still impossible to differentiate poppy seeds from other opiates, like morphine.

One thing that makes no sense at all from the news report at the top of the blog is this statement: “The Federal Institute for Risk Assessment writes that until food manufacturers reduce morphine levels in poppy seeds, it advises against excessive consumption, particularly during pregnancy.” How in the world are food manufacturers supposed to reduce the morphine levels in poppy seeds? Wash them by hand?

Whenever you are asked to participate in a urine drug test, make absolutely sure whoever collects the sample, splits it into 2 separate samples, then seal and initial one and freeze it – that’s your insurance policy in the event the first one is positive for any reason.

Important life lesson courtesy of your friendly neighborhood Poison Boy.

Poison Boy

 

Written by Poison Boy

Gerry O'Malley (a.k.a Poison Boy) is a board certified ER doctor and toxicologist with a interest in the unusual, terrifying and occasionally hilarious world of poisonings and toxicology. This site is an exploration of poisons of historical interest as well as in current events and pop culture.

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