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Q: Health ( Answered 4 out of 5 stars,   1 Comment )
Question  
Subject: Health
Category: Health
Asked by: love42-ga
List Price: $5.00
Posted: 31 Jul 2005 22:06 PDT
Expires: 30 Aug 2005 22:06 PDT
Question ID: 550289
I have tested positive for methamphetamine which I am not taking. 
Retest 10 weeks later still show a positive reading.  I am on other
medication but none are known to produce this problem.  Can you help?

Request for Question Clarification by justaskscott-ga on 31 Jul 2005 22:20 PDT
What other medication or supplements are you taking?  Perhaps if we
know this, we'll better be able to research your question.
Answer  
Subject: Re: Health
Answered By: angy-ga on 01 Aug 2005 05:21 PDT
Rated:4 out of 5 stars
 
Hi, Love42 !

As Justaskscott pointed out, it?s difficult to narrow this down for
you without knowing what medication you are taking.

And, as he suggests, many  people take vitamin supplements and natural
herbal remedies without realising  these are essentially medications -
so they don?t mention them to their health professional. Ma Huang, for
example, is a natural source of ephedrine.

That said, there are many reasons for a false positive result to show
up, though the marketers of tests - particularly those
?try-it-at-home? tests - have every reason not to draw your attention
to them.

I?ve put what seem to me to be the more credible sources first.


NOTE especially that kidney and liver problems and diabetes can cause
false positives, so PLEASE see your doctor to rule out these problems.


The best site I found was:

http://www.erowid.org/chemicals/meth/meth_testing.shtml

Note: I have reformatted slightly for clarity.

?Substances or Conditions which can cause false positives

Ephedrine, pseudoephedrine, propylephedrine, phenylephrine, or desoxyephedrine
(Nyquil, Contact, Sudafed, Allerest, Tavist-D, Dimetapp, etc)
Phenegan-D, Robitussin Cold and Flu, Vicks Nyquil

Over-the-counter diet aids with phenylpropanolamine (Dexatrim, Accutrim)

Over-the-counter nasal sprays (Vicks inhaler, Afrin)

Asthma medications (Marax, Bronkaid tablets, Primatine Tablets)

Prescription medications (Amfepramone, Cathne, Etafediabe, Morazone,
...phendimetrazine, phenmetrazine, benzphetamine, fenfluramine, dexfenfluramine,
...dexdenfluramine,Redux, mephentermine, Mesocarb, methoxyphenamine, phentermine,
... amineptine, Pholedrine, hydroymethamphetamine, Dexedrine,
amifepramone, clobenzorex,
...fenproyorex, mefenorex, fenelylline, Didrex, dextroamphetamine,
methphenidate, Ritalin,
...pemoline, Cylert, selegiline, Deprenyl, Eldepryl, Famprofazone)

Kidney infection, kidney disease

Liver disease, diabetes?



A similar list can be found at:

http://www.ipassedmydrugtest.com/_methamphetamine_drug_test_kits.asp

?Over-the-counter cold and allergy remedies that contain ephedrine,
pseudoephedrine, propylephedrine, phenylephrine or desoxyephedrine:
Nyquil, Contactd, Sudafed, Allerest 12-Hour, A.R.M., Triaminic 12,
Ornade, Tavist-D, Dimetapp, Sinex, Neosynephrine, Actifed, Bayer
Selectd Maximum Strength Sinus Pain Relief Caplets, Contact Non-Drowsy
Formula Sinus Caplets, Dristan Cold Caplets, Maximum Strength Sine-Aid
Tablets, Maximum Strengeth Sudafed Sinus Caplets, Maximum Strength
Tylenol Sinus Gelcaps, No Drowsiness Sinarest Tabs, Sinus Excedrin
Extra Sterength Caplets, Characol Sinus, Drixoral Cold and Flu,
Efidac/24, Phenegan-D, Robitussin Cold and Flu.

Over-the-counter diet aids containing phenylpropanolamine: Dexatrim, Accutrim.

Over-the-counter nasal sprays: Vicks inhaler, Afrin. Asthma
medication: Marax, Bronkaid tablets, Primatine Tablets.

Prescription medication: Amfeprainone, Cathne, Etafediabe, Morazone,
phendimetrazine, phenmetrazine, benzphetamine, fenfluramine,
dexfenfluramine, dexdenflurarnine, Redux, mephentermine, Mesocarb,
methoxyphenamine, phentermine, amineptine, Pholedrine,
hydroymethamphetamine, Dexedrine, amifepramone, clobenzorex,
fenproyorex, mefenorex, fenelylline, Didrex, dextroamphetamine,
methphenidate, Ritalin, pemoline, Cylert, selegiline, Deprenyl,
Eldepryl, Famprofazone?

I would add Demazin to that list.


Now let?s look at the tests themselves.


http://www.myhealthcare21.com/TM483/Methemphetamine-Drug-Screen.html

TestMedica kit.

?TestMedica Methamphetamine Drug Screen diagnostics are a quick and
easy way to check for specific parameters in the urine. The detection
of these parameters and their levels may be indicative of an
abnormality or an infection.?

This confirms the possibility of a disease process as noted above, as
well as a positive result for drug use.


http://www.testsymptomsathome.com/aco13.asp

?the drug has a half-life of 9-24 hours in the body. Methamphetamine
is excreted in the urine primarily as amphetamine and oxidized and
deaminated derivatives. However, 10-20% of Methamphetamine is excreted
unchanged. Thus, the presence of the parent compound in the urine
indicates Methamphetamine use. Methamphetamine is generally detectable
in the urine for 3-5 days, depending on urine pH level.?

   ? 2. There is a possibility that technical or procedural errors, as
well as other interfering substances in the urine specimen may cause
erroneous results.

    3. Adulterants, such as bleach and/or alum, in urine specimens may
produce erroneous results regardless of the analytical method used. If
adulteration is suspected, the test should be repeated with another
urine specimen.

    4. A Positive result does not indicate level or intoxication,
administration route or concentration in urine.

....

    6. Test does not distinguish between drugs of abuse and certain medications.?




http://www.syntron.net/inserts/11330A.pdf

OneStep test - this site emphasises that sterile glass or plastic
containers must be used for sample collection and that the stability
of the kit is affected if it is kept beyond the Expiry date.



http://www.testsymptomsathome.com/MSI01_directions_methamphetamine.asp

DetectNow home test kit instructions.

?Methamphetamine Test is a two part field test reagent for the
detection and identification of methamphetamine and other secondary
amines. Methamphetamine Test utilizes a modified Simon reagent.
Product modifications have been incorporated to reduce the number of
false positives, stabilize the traditional Simon reagent and eliminate
sensitivity to temperature extremes.?

Note  positive results for ?other secondary amines.?

Their caps: 

?DETECT NOW IS AN AID IN ATTEMPTING TO IDENTIFY THE PRESENCE OF
....(drugs). A POSITIVE TEST INDICATES THE PROBABILITY OF THE PRESENCE
OF AN ILLEGAL DRUG. HOWEVER, THERE ARE OCCASIONS WHEN THE TEST WILL
SHOW A FALSE POSITIVE READING FOR UNCONTROLLED SUBSTANCES. FOR
EXAMPLE, THE FOLLOWING SUBSTANCES WILL SHOW A FALSE READING WHEN THE
DETECT NOW IS APPLIED: FOR COCAINE OR CRACK TEST KIT; DIBUTACAINE,
BUTACAINE, METHAPYRILENE. FOR MARIJUANA TEST KIT; NUTMEG OR HENNA...

...A POSITIVE RESULT DOES NOT MEAN THAT AN INDIVIDUAL IS USING
.....(drugs).... BUT COULD REFLECT THAT SUCH AN INDIVIDUAL MERELY HAS
COME IN CONTACT WITH SUCH DRUGS OR OTHER REASONS FOR A FALSE POSITIVE
READING.?

Usage instructions for the kit give specific details for avoiding
cross-contamination - so cross-contamination remains a possibility.


Amines - 

http://en.wikipedia.org/wiki/Amine

?Amines are organic compounds containing nitrogen as the key atom in
the amine functional group. Amines have structures resembling ammonia,
where one or more hydrogen atoms are replaced by alkyl groups or other
groups where the nitrogen is bonded to a carbon atom in the group.....

.... if only one the hydrogens in ammonia is replaced by a carbon
based group, then it is a primary amine. If two of the hydrogens are
replaced by two carbon based groups, then it is a secondary amine.?

Note: amines are chemically related to alum, mentioned above as an
adulterant that can produce a false positive result.


You are probably aware that natural ephedra is related to
methamphetamine. Here is a good summary of why testing may confuse the
two:

http://www.supplementquality.com/z_askexpert/ephedra_testing.html

?False positive for methamphetamine on drug tests of people using ephedra:

Q: Can taking ephedra (also called ma huang) cause a "false positive"
for methamphetamine on a drug test?

 A:   A variety of different tests are used for drug testing. However,
many of them can give a false positive  result, in the sense that
ephedra use will show up as drug use. (In particular, ephedra use may
generate a positive finding for methamphetamine.)

    One active component in ephedra is ephedrine?which has
pharmaceutical properties and is in the same class of compounds as
many other drugs and natural stimulants. As such, it will be
metabolized similarly to these other substances.

    Much drug testing checks for the presence of drug metabolites as a
measure or indicator of ingested drug. By the time one tests blood or
urine for the drug, the body has metabolized most of it, so many tests
are directed towards testing for metabolites.

    There may also be other components in ephedra with metabolites or
parent structures that are similar to drugs taken for pleasure or
sports and would therefore test positive. Like other botanical
products, ephedra contains scores, perhaps even hundreds of different
chemical compounds.

    Drug tests are usually designed for ease of use and are
broad-based, so that a single test would detect many different drugs.
Thus, it can be difficult to differentiate between an actual
drug/pharmaceutical or a natural product/supplement like ephedra.

    Such differentiation can usually be done by further, intensive
testing that is targeted for a particular unique metabolite or
residual drug itself.?


On the same subject, look at


http://groups-beta.google.com/group/sci.chem.analytical/browse_thread/thread/12157213b9249196/90f4f7e2014b52f1?lnk=st&q=methamphetamine+test&rnum=2&hl=en#90f4f7e2014b52f1

?I have been retained to investigate the possible causes of a positive
test for amphetamine in the urine of a person taking Ma Huang (Formula
One) a natural source of ephedrine.

The conversion of ephedrine to methamphetamine requires a simple
reduction of the alpha-hydroxyl.  The drug-testing companies rule out
the possibility that ephedrine may be converted in small amounts to
methamphetamine in the body.   It seems plausible that either the
individual metabolic makeup or bacterial fermentation ...could
accomplish this conversion.
Anyone ever heard of this? 
 
PS they eliminate a-hydroxyls with periodate and say it is impossible to
generate the MA as artifact after treatment
.....
Robert Read, DVM, PhD

This has been reported before: see Autry, J.H.; Notice to all DHHS/NIDA
certified laboratories, Division of Applied Research, NIDA, Rockville,
MD, 1992......

The periodate oxidation is a usual precaution to eliminate ephedrine in the
urine specimen.  I understand that methamphetamine is metabolized to
amphetamine, so one should test for both methamphetamine and amphetamine
to make a positive confirmation of methamphetamine ingestion.  If no
amphetamine was detected, then the methamphetamine may be an artifact.

....

                                        Robert B. Cody, Ph.D
          Applications Manager
                                       Mass Spectrometry
                 JEOL USA, Inc.?



And finally, some forum comments, not necessarily particularly accurate:


http://groups-beta.google.com/group/free.uk.btinternet.chatter.refugees/browse_thread/thread/ea3884dc5ebbd19b/1c54030a28f92482?lnk=st&q=methamphetamine+test&rnum=6&hl=en#1c54030a28f92482

?The VICK inhaler sold in the UK is fine, but the VICK inhaler sold in the US
contains methamphetamine - the banned substance.

Methamphetamine is present in two different forms; "d" and "l". Street
methamphetamine is predominantly d -Methamphetamine. The over-the-counter
medication, Vick's Inhaler (and the Walgreen equivalent), contains
exclusively the "l" form of methamphetamine (the listed active ingredient
is l-Desoxyephedrine, another name for l -Methamphetamine). Although it
is uncommon, the heavy use of Vick's Inhaler can cause a positive urine
test for methamphetamine. The claim that Vick's Inhaler is the source of
a positive methamphetamine test can be checked by testing for "d" versus
"l" methamphetamine. This test is performed by GC/MS.?

And:

http://groups-beta.google.com/group/alt.drugs/browse_thread/thread/c1c619dea6c90efa/4ff0b6d75e92f12b?lnk=st&q=methamphetamine+test&rnum=3&hl=en#4ff0b6d75e92f12b

?I walked in to the place one morning, after doing a
nice assortment the day/night before. about 7g (2 balls) cocaine, three
pills, half bottle of vodka, 3.5 or so grams of weed, 1-1.5g K. There
might have been something else in there somewhere, but it remains hazy. 


( My comment - he?s lucky to be alive.)


Anyways, I get dropped the following day ...

Results came back.
High nanogram level of THC.
Barely over threshold level of cocaine.

Nothing else. I was still breathing off booze, the MDMA was finally
becoming completely inactive on my brain, leaving me cracked, and I was
still lockjawed and firey-eyed but hurting from the coke. Yet, that's
all that came up.

Other times, Various things didn't come up. The one that always got me,
and did, as (sic) weed though.?


Good luck. Please get those medical checks for diabetes or kidney or
liver problems.



Search strategies: 

?Methamphetamine test? false positive
secondary amines

Request for Answer Clarification by love42-ga on 05 Aug 2005 15:58 PDT
As requested here is the list of med's being taken, also those left
off in the past 6 weeks.   Many thanks.

Prescription:

1. Alprazolam 0.5mg (1 tab daily)
2. Hydrocodeine 5mg (2 tabs each 6 hours for planter fascitis pain as
required. Max 5 tabs per day)
3. Metoprolol 50mg (5 tabs daily) 

(I test positive for #1 and #2 above in my urine test and they claim
there is no way either of them could cause a false positive in the
methamphetmine category. Trust me, I've asked!).

Non- Prescription:

1. DHEA 25mg (1 tab daily)
2. Acidopholis (1 tab daily)
3. Prilosec OTC (omeprazole delayed release tab) 20mg (1 tab daily)
4. Centrum Advanced Formula Multi-Vitamin
5. If head or foot pain is excessive I may take an
asprin 100mg (1 tab) when taking foot pain medicine.

All tablets taken first thing in the morning on an empty stomach. 

Drugs I have stopped in the last 6 weeks: 

Fluoxatine (Prozac) 80mg daily
Hydrochlorathorazide 50mg daily (this drug that was sucking potassium
out of my system...but was probably also helping to keep my BP down?)
Allapurinol for gout 50mg daily.
Antihistamine for the redness in my eye.



____________________________________________________

Clarification of Answer by angy-ga on 05 Aug 2005 22:30 PDT
Hi, Love42 ?

Did you intend to respond to justaskscott's clarification request
after I had posted my answer? I didn't actually request a list of your
current meds.

That said, does the allergy medication you take contain
pseudo-ephedrine as well as an anti-histamine - many do?

Clarification of Answer by angy-ga on 05 Aug 2005 22:47 PDT
Sorry - I've just realised my first sentence could be understood as
request for more information - I'll do a quick check on inetactions
etc. of the meds. you are taking.

Clarification of Answer by angy-ga on 06 Aug 2005 01:44 PDT
Hi !

I've checked the various medications you list, and apart from the
possibility of pseudo-epehedrine in the allergy medication you have
now discontinued, there is nothing that would overtly cause the test
results that concern you.

I'm therefore sticking with the basis for my original answer: False
positives can be caused by EITHER
 test failure or cross-contamination 
OR
liver, kidney or diabetic problems - note that hypertension can lead
to kidney problems
OR
an over-the-counter cold or allergy medication.

So the first thing to check is the allergy medication you were taking previously.


Add to that the fact that you are taking a number of unprescribed
supplements and alternative medication. Unfortunately the quality
control on these is not as high as it is for prescription medications.
You may recall the massive recall of products manufactured by Pan
Pharmaceuticals in Australia in April 2003:

http://www.tga.health.gov.au/recalls/pan.htm

They were the largest contract manufacturer of health supplements in
the world, and are now in liquidation. Basically, they failed to
properly clean their equipment between manufacturing runs, leading to
contamination of one product with another.

So if these test results are of real concern to you, maybe you should
try eliminating the over-the-counter supplements one at a time, and
see if that makes a difference.


Your prescribed medications, I note are for hypertension, depression
or anxiety and gout or gouty pain.

With the old regime I am surprised that you were prescribed
Allopurinol (Lopurin) in combination with Hydrochlorothiazide since
this is strongly counter-indicated, although again your dosage of
Lopurin was exceptionally low and seems to have been well monitored.
Nevertheless:

http://www.rxlist.com/cgi/generic/allopur_ad.htm

"Thiazide Diuretics: The reports that the concomitant use of
allopurinol and thiazide diuretics may contribute to the enhancement
of allopurinol toxicity in some patients have been reviewed in an
attempt to establish a cause-and-effect relationship and a mechanism
of causation. Review of these case reports indicates that the patients
were mainly receiving thiazide diuretics for hypertension and that
tests to rule out decreased renal function secondary to hypertensive
nephropathy were not often performed. In those patients in whom renal
insufficiency was documented, however, the recommendation to lower the
dose of allopurinol was not followed. Although a causal mechanism and
a cause-and-effect relationship have not been established, current
evidence suggests that renal function should be monitored in patients
on thiazide diuretics and allopurinol even in the absence of renal
failure, and dosage levels should be even more conservatively adjusted
in those patients on such combined therapy if diminished renal
function is detected. (See WARNINGS)."


Please note the comments about diminished renal function, and the
possible link between kidney problems and false positives for
methamphetamines mentioned above.


I can't find any adverse interactions with the Prozac (fluoxatine).


With your current prescriptions I am sure you have been warned that
both Alprazolam (Xanax) and Hydrocodone are consider potentially
addictive, and that Hydrocodone is know to exaggerate the effects of
anti-anxiety drugs such as Xanax.:

http://www.rxlist.com/cgi/generic4/hydrocodone_ad.htm

Xanax should also not be combined with Allopurinol - see below.



There are also one or two concerns with the mix of meds as a whole,
and the way you are taking them.

One immediate point:

Meteprolol - Lopresor - should be taken with or following meals, NOT
on an empty stomach. This also apples to aspirin unless it is enteric
coated.

The one that requires an empty stomach is the omeprazole (Prilosec
OTC). The rest don't seem to matter either way.



Dealing with the non-prescription medications, neither the
multi-vitamin nor the occasional aspirin should be causing any
problems. Acidopholis also seems to have no known problems except some
people get allergic reactions.


Omeprazole (Prilosec OTC) is another matter. See:

http://www.rxlist.com/cgi/pharmclips2.cgi?keyword=%20Omeprazole

"    * Talk to your doctor and pharmacist if you are taking any of the following:
.....
          o benzodiazepines (e.g. diazepam; flurazepam; triazolam)"

Therefore it is not a good idea to combine it with Xanax (Alprazolam).

Also it should not be taken for long periods. See:

http://www.drugs.com/omeprazole.html

Over-the-counter omeprazole (Prilosec OTC) should be taken once every
24 hours for 14 days. Treatment may be repeated every 4 months if
needed. Do not take more than one tablet per day or repeat treatment
more often than every 4 months. "


I notice that both Acidopholus and Prilosec OTC are used to treat
stomach problems. Had you realised that stomach problems are side
effects of both Metoprolol (Lopresor) and Hydrochlorothiazide - your
current and your previous high blood pressure medications ?

Metoprolol - selective beta1-adrenoreceptor blocking agent  - can
cause gastro-intestinal discomfort (as I know myself, to my cost !!)
See:

http://www.rxlist.com/cgi/generic/metopro_ids.htm

 " ... Nausea, dry mouth, gastric  pain, constipation, flatulence, and
heartburn  have been reported in about 1 of 100 patients." That was
me!

Hydrochlorothiazide can cause " cramping, constipation, gastric
irritation, nausea..." (as well as the potassium loss you noted,
though not usually at your dosage level. See:

http://www.rxlist.com/cgi/generic/hctz_ids.htm

"Doses above 50 mg are often associated with marked reductions in serum potassium")


Taking stomach medication to soothe symptoms is one thing, but it is
not going to cure the problem if it is a side effect of medication.


The remaining non-prescription supplement, DHEA,
Dehydroepiandrosterone is  an unapproved medication developed for the
treatment of Lupus:

http://www.rxlist.com/cgi/generic/dhea.htm

Taber's says that 
"It is promoted as an antiaging, anticancer, and antiatherosclerosis
agent by alternative medicine practitioners.

"Taber's Cyclopedic Medical Dictionary," Copyright  2005 by F. A.
Davis Co., Phil., PA"

However there are serious doubts about its use, although the dose you
are taking is a small one:

http://www.quackwatch.org/01QuackeryRelatedTopics/dhea.html

Since it is unapproved and uncontrolled - can you be sure what you are
buying is what you think you are buying ??


Please see your doctor - especially to check on your non-prescribed
supplements, and to rule out any underlying pathology.



Good luck.





Search strategies:

Alprazolam
Hyrdocodone
Alprzolam Hydrocodone interaction

Followed by searches on the other drugs and supplements by name.
love42-ga rated this answer:4 out of 5 stars
Thank for your thoroughness.  I will need further time to digest contents

Comments  
Subject: Re: Health
From: dale08-ga on 03 Sep 2005 02:55 PDT
 
Gppd luck I am going through the same thing except i know that they
are required to do a spilt sample of collected urine.  I am also of
all charges.  Just don' battle the state of utah.  There all connected
together even though i went out of state and had a hair drug test
which came back negative of all amphetamines and meth.  But will any
of those employers of excuse their representatives and judges listen
to your case.  I receive legal advise and i am up in to the 10,000. 
All states need to addopt the hair drug test and be used over urine. 
Read urine in trouble book.  MRO also despite what they say they are
neutral.  Find me one that is.  My future as well as is a stake. 
Fight  for what you beleieve in and advocate that the only true test
is a hair.

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