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Q: Drug testing ( Answered 5 out of 5 stars,   2 Comments )
Question  
Subject: Drug testing
Category: Miscellaneous
Asked by: durangoskier-ga
List Price: $10.00
Posted: 08 Mar 2005 06:59 PST
Expires: 07 Apr 2005 07:59 PDT
Question ID: 486676
My son recently received a positive opiate urine test that was
confirmed by a gas chromatograph method.  He swears that he didn't
take any opiates and I would like to believe him but the counselor
says the test is 100% accurate.  I find it hard to believe that
anything is 100% accurate.  Please help
Answer  
Subject: Re: Drug testing
Answered By: cynthia-ga on 08 Mar 2005 08:01 PST
Rated:5 out of 5 stars
 
Hi durangoskier,

The simple answer to your question is that false positives happen, yet
no one is listening. People are losing their jobs over false
positives. There's an excellent example in the links below.

Opiates is a broad category and includes MANY over the counter
medications, as well as heroin.

The opiate category includes: Codeine, Morphine, and Heroin

Some Brands and Generic Names
http://www.sayno.com/opiates.html
Raw Opium, Opium, Codeine, Morphine, Heroin, Hydromorphone (Dilaudid),
Oxycodone (Percodan), Oxymorphone (Numorphan), Hydrocodone (Vicodin),
Meperidine (Demerol), Fentanyl, Methadone (Dolophine), Darvon, Talwin.

 
If your son is on opiates, it would be obvious. 

First, inspect his arms, legs, hands, and ankles, as heroin is usually
injected. No needle marks does not mean he is clean, but it is
excellent news. Heroin can also be snorted and smoked, but those types
of ingestions are usually indicitive of someone experimenting, not yet
addicted.

If your son is doing well in school, interacting normally with the
family, getting the same grades he was getting a year ago and they are
passing and above average, his hygiene is good, is not lying and
stealing, I would bet he is not using opiates.

Common signs of opiate addiction 
http://www.ecnnews.com/cgi-bin/04/s/specialstory.pl?fn-hsigns
List of signs comes from the Mayo Clinic

I personally have received a false positive for amphetimines when I
was on a prescribed drug, Cylert (pemoline). No one listened to me.


First, look here:

OTHER "FALSE POSITIVE" QUESTIONS AT GOOGLE ANSWERS
http://answers.google.com/answers/threadview?id=205477
http://answers.google.com/answers/threadview?id=477142
http://answers.google.com/answers/threadview?id=479489
http://answers.google.com/answers/threadview?id=484284
http://answers.google.com/answers/threadview?id=483887
http://answers.google.com/answers/threadview?id=478497
http://answers.google.com/answers/threadview?id=449057
http://answers.google.com/answers/threadview?id=377322
http://answers.google.com/answers/threadview?id=378206
http://answers.google.com/answers/threadview?id=361737
http://answers.google.com/answers/threadview?id=360038


HAVE FALSE POSITIVE DRUG TEST?
http://www.alwaystestclean.com/false_positive_causes.htm
..." According to a report by the Los Angeles Times New Service, a
study of 161 prescription and over the counter medications showed that
65 of them produced false positive drug test results in the most
widely administered urine test..."


Look at THIS list:

False Positive Drug Test Information
http://www.asmartsourceadditive.com/afalse.htm

OPIATES  [morphine, codeine, heroin]

Prescription medications that contain Morphine:

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

Prescription 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 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.
 

************************************************************************************

Drug Testing - False Positives
http://www.ultimatedetox.co.uk/drug-testing-advice-information/drug-testing-false-positives.htm

..."
Decongestants and Cold Remedies

Phenylpropanolamine and ephedrine are both substances found in many
over-the-counter cold remedies. They can result in a drug test false
positive for amphetamines on the EMIT test. Antitussives, to suppress
coughs, such as dextromethorphan and perylamine may cause a drug test
false positive for opiates.
Anti-depressants

Aside from when this class of drugs is specifically tested for, some
of them including amitriptyline can test positive for opiates for up
to three days after use. Even quinine in tonic water can also cause a
positive result for opiates.
Poppy Seeds

Poppy seeds which are usually found on bread contain traces of
morphine and can lead to positives for opiates. Codeine, which is
found in many pain relievers, may cause a false positive for morphine
or heroin because of its similar chemical structure. ..."


Check out this search string:

"false positive for opiates"
://www.google.com/search?sourceid=mozclient&ie=utf-8&oe=utf-8&q=%22false+positive+for+opiates%22


And this document was prepared by a DRUG TESTING FACILITY!!

TOXICOLOGY DRUG TESTING TID BITS
http://www.ncsconline.org/wc/publications/Res_JudEdu_SubstanceAbuseMaterial19Pub.pdf


Until I had absolute irrefutable proof that my son was using ILLEGAL
opiates (heroin), I would support him and try to determine the source
of his false positive.  Maybe he got a pill from a friend and it felt
good but he had no idea it was an opiate.  As you can tell from the
lists above, it is entirely possible to test positive for opiates and
have took something that is straight off the drug store shelf.

If I can assist further in this topic, please don't hesitate to ask
via the "Request FOr Clarification" feature.


~~Cynthia


Search strategy:
"false positives" opiates
other similar questions here at Google Answers

Request for Answer Clarification by durangoskier-ga on 08 Mar 2005 08:44 PST
Cynthia,
That is excellent.  However, I have been told that there are no false
positives with the gas chromatograph method - that it is completely
reliable.  I still find this hard to believe since human beings have
to operate the gas chromatograph (I think).  Would you please check on
this.  I will certainly pay you for everything you have so far. Thanks
for your quick response.
Steve

Clarification of Answer by cynthia-ga on 08 Mar 2005 09:58 PST
I assume this is a matter of trust.  You want to trust your son.

The category of Opiates is too broad.  Did they say WHAT opiate your
son was positive for?  It could be a number of things, not necesarily
something illegal.

If your son is not an addict, I think it's likely he took something,
knowingly or unknowingly, that gave him a true positive.  It doesn't
mean it was heroin, or an illegal drug.  It was most likely codeine. 
Codeine is in many prescription drugs, OTC medications, and even some
cough syrups.

Why don't you take your son in to get a hair test?  If he has not died
his hair,  this is as near to 100% as it gets.  It's expensive, and
highly accurate.  If the hair test shows no drug use, then I would
feel comfortable supporting my son.

REFERENCE:

CODEINE FAQ
http://www.erowid.org/pharms/codeine/codeine_faq.shtml
..."The amount of codeine allowable by law in OTC products is 8mg per
unit dose of a drug. A example is 325mg of acetaminophen (a unit dose
of acetaminophen) and 8mg codeine per tablet. This law is used to
prevent the excessive use of codeine as one would have to take doses
reaching toxicity of acetaminophen before any real problems with the
codeine administration would occur. It's the same situation with
aspirin. With OTC cough medications, the highest amount of codeine
allowed is 3.3mg/ml. This concentration is _so_ low that this FAQ will
not be discussing cough syrups as a source of recreational codeine.
The tablet form of OTC codeine products usually also includes 15mg of
caffeine in each standard dose..."


There are measureable false positives with GS/MS testing, but the
chance is unlikely:

Drug Testing Method Information
http://66.102.7.104/search?q=cache:xw2KuPGDxOwJ:www.radford.edu/~nreilly/drug%2520tests.doc+%22Gas+chromatography%22+accuracy+%22false+positive%22&hl=en

GAS CHROMATOGRAPHY/MASS SPECTROMETRY
..."Purpose: This method is used to confirm positive results obtained
from Thin Layer Chromatography or Enzyme Multiplied Immunoassay tests,
thereby drastically reducing the likelihood of a false positive
result..."

"Drastically reduce" does not mean eliminate.  Reputable sources
cannot conclusively say it is 100% accurate, only NEAR 100%.  I will
admit, it is virtually impossible that the test is wrong, but the
possibility DOES exist.  The problem is that this is the best test,
the most accurate test available.   Even though there is a statistical
possibility (and I'm sure real life examples that resulted in these
statistics) ...that the test could be wrong, the drug testing industry
has labeled it as 100% accurate.  In reality it is 99.xxx reliable.

There's even a "false negative" listed for Cocaine in the TidBits link
I gave you. That's not 100% accurate.


A Big Question:  Is the lab that did the testing NIDA Certified?

Drug testing accuracy and standards
http://www.neonjoint.com/passing_a_drug_test/test_standards_and_accuracy.html
..."Many human errors occur in labs and cause inaccurate results. Some
are careless or irresponsible errors, and some errors are accidents.
Human error can ruin the results of ANY test, screening or
confirmation GC/MS..."

3.2 False positives:  (same link)
No laboratory process is completely free from error. The GC/MS test is
virtually error free, but the EMIT is far from accurate.

3.3 True positives (legitimate):  (same link)
Some legal products actually contain small amounts of illegal
chemicals. All tests, including the GC/MS, will test you positive
because the metabolites derived from the true positive are identical
to the metabolites of the illegal drugs. One exception: poppy seeds
will not cause a positive GC/MS (explained below).


Drug Testing Toxicology
http://www.varianinc.com/nav/products/dat/toxicology&cid=IHLMKHPQFIH
..."Confirmation testing is the second step of testing following the
detection of a positive result on the preliminary or screening test.

The purpose of confirmation is to eliminate any false positive results
that may have originated from an initial screening process. To
eliminate false positive test results, a confirmation test that is
highly specific and possibly more sensitive should be used. It is
important to note that confirmation testing is not the same as repeat
testing in that running the same test a second time does not eliminate
systematic errors. More specific confirmation tests used to identify
drugs of abuse are generally thought to be of three types:

    - Gas liquid chromatography (GC)
    - High performance liquid chromatography (HPLC)
    - Gas chromatography with mass spectrometry (GC/MS)

All three of these methods are both highly specific and sensitive to
small quantities of the particular drug being tested. GC/MS is the
most specific and sensitive of the three methods. Consistent with FDA
position, Varian, Inc. strongly recommends confirmation testing using
GC/MS in situations requiring a confirmed analytical result..."


Indeed, the GC/MS method can be fooled.

Here's an example - SCROLL DOWN TO:

Drug Test Interaction With Medicines And Foods - THEN:   Ibuprofen,
contained in Advil, Nuprin, and Mortin,
http://www.deltabravo.net/custody/drugtest.htm
..."Ibuprofen in very high doses will still interfere with both the
EMIT and the GC/MS (Gas Chromatograph/Mass Spectrometer) test.
Ibuprofen: Ibuprofen is a common pain reliever that (even in low
dosages) used to cause a false THC positive on the EMIT test. The EMIT
has been changed to use a different enzyme to eliminate false
positives due to Ibuprofen. Ibuprofen in very high doses will still
interfere with both the EMIT and the GC/MS. There is some conflicting
data here because some sources say that the GC/MS tests can
distinguish between Ibuprofen and THC (as well as other
over-the-counter drugs)..."


HOW ACCURATE ARE THE DRUG TESTS?
http://www.1drugscreening.com/page6.htm

An interesting discussion:
http://brain.hastypastry.net/forums/showthread.php?t=40882
..."Despite the numerous techniques, only gas or liquid chromatography
coupled with mass spectrometry is the acceptable confirmation
technique for quantification of opiates - morphine and codeine..."


In closing, I again say that the category of opiates is too broad.
Here's what I would say ...."Opiates?  So what.  My son is not an
addict.  Be more specific and/or provide proof of his illegal drug
use.  Codeine is not illegal and can be purchased at the corner drug
store.  I will discuss with him what OTC medications have Codeine in
them so he can avoid them in the future.  If you have a clean hair
test as well, I'd stand by him.


Does this help?

~~Cynthia

Clarification of Answer by cynthia-ga on 08 Mar 2005 10:10 PST
LOL...  Died his hair?  :-)  DYED.  sorry, my bad...
durangoskier-ga rated this answer:5 out of 5 stars and gave an additional tip of: $5.00
Excellent.  Thanks very much Cynthia you did a great job.
Steve

Comments  
Subject: Re: Drug testing
From: cynthia-ga on 08 Mar 2005 15:22 PST
 
Steve,

Thank you very much for the 5 stars, the kind words and the generous
tip!  Good luck with your son.  I hope everything turns out well for
you.  If you get the hair test, and it is negative, I would appreciate
if you would come back and comment to that effect.  We need to
document false positives.

~~Cynthia
Subject: Re: Drug testing
From: cliffschaffer-ga on 16 Apr 2005 09:02 PDT
 
The gas chromatograph may be 100% accurate for the existence of a
particular substance in the urine, but that doesn't tell you where the
substance came from. A hair test isn't going to help you much on that,
either. Suppose someone has been eating poppy seed buns for the last
several months. A hair test could likely show them as an addict.

There are lots and lots of problems with drug testing that should make
anyone skeptical of its results. Any positive test (where it really
matters) should be followed up by further investigation.

Good luck.

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