From CDL drivers to flight attendants, a false positive drug test is more than a minor inconvenience.
🤔 If Robitussin DM and Benadryl can trigger a false positive, are you 100% certain you could pass a random drug test?
Do you know which common medications could mean the difference between keeping or losing your job?
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Even a product as common as Advil or Motrin (ibuprofen) can lead to a false positive for a controlled substance like THC or barbiturates.
Robitussin, which contains dextromethorphan, can be mistaken for PCP in a drug test and Benadryl (diphenhydramine) could trigger a false positive for opioids.National Library of Medicine
These are not just possibilities! 🙅♂️
There are peer-reviewed documented interactions in which a “pediatric patient with suspected diphenhydramine (Benadryl) ingestion had a positive methadone result on the rapid urine drug screen.”
🤔 So, what are the most common drug tests and which substances do each test detect?
5 Panel Drug Testing
The 5 Panel Drug Test is a standard screening tool used to detect five of the most commonly abused substances.
Its quick turnaround time and affordability make it a preferred choice for many employers, especially for pre-employment and random drug testing.
- Marijuana (THC): No legal brand names for THC, though medicinal forms include dronabinol (Marinol).
- Cocaine: No prescription brand names as it is not legally prescribed in the U.S.
- Amphetamines (including methamphetamine):
- Amphetamine/Dextroamphetamine (Adderall, Adderall XR)
- Lisdexamfetamine (Vyvanse)
- Methamphetamine (Desoxyn)
- Opiates (including heroin, codeine, and morphine):
- Codeine (various brand names include Tylenol with Codeine)
- Morphine (MS Contin, Kadian, Duramorph)
- Heroin is illegal with no prescription counterparts.
- Phencyclidine (PCP): Illegally manufactured, no legal brand names or prescriptions.
The 5 Panel Drug Test is primarily employed in workplace testing and is mandated by the Department of Transportation (DOT) for safety-sensitive employees.
The 5 Panel Drug Test is known for its cost-effectiveness and the rapidity of results – the a go-to drug test for large-scale testing needs.
10 Panel Drug Testing
Expanding on the 5 Panel, the 10 Panel Drug Test covers a broader spectrum of illicit drugs.
It’s particularly used in environments where a more comprehensive screening is essential.
Includes all substances detected in the 5 Panel Drug Test plus the following:
- Phenobarbital (Luminal)
- Pentobarbital (Nembutal)
- Butalbital (found in Fioricet, Fiorinal)
- Alprazolam (Xanax)
- Lorazepam (Ativan)
- Diazepam (Valium)
- Clonazepam (Klonopin)
- Methadone (Dolophine, Methadose)
- Methaqualone: No longer legally prescribed in the U.S.
- Propoxyphene: Discontinued in the U.S.; previously marketed as Darvon, Darvocet.
The 10 Panel Drug Test is used in law enforcement, rehabilitation, and occupational medicine settings, where a more extensive substance use assessment is required.
The 10 Panel Drug Test offers a more extensive analysis, making it suitable for high-risk industry sectors and sensitive job roles.
Urine Drug Testing
The Urine Drug Test is the most common drug screening method due to its non-invasive nature and the ability to detect recent substance use.
Varies by panel but can range from the 5 most common drugs to extended opiates and synthetics based on the specific panel selected.
The Urine Drug Test is a standard for pre-employment, post-accident, and random drug testing scenarios across various industries.
The Urine Drug Test is notable for its wide detection window and the ability to test a broad range of substances.
Saliva Drug Testing
The Saliva Drug Test (Oral Fluid Test) is known for its convenience and the difficulty in adulterating samples.
The test provides quick results and is ideal for detecting very recent drug use.
Often mirrors a 5 or 10 Panel Drug Test but can vary based on requirements.
The Saliva Drug Test is used immediately after accidents or for reasonable suspicion testing due to its ability to detect on-the-spot drug use.
The Saliva Drug Test offers ease of use and immediate results make it suitable for on-site testing.
Blood Drug Testing
Blood Drug Tests are the most accurate but are also the most invasive.
They are typically used when precision is crucial and can detect drug usage in a very short window after consumption.
Can detect a wide array of substances, from alcohol to more illicit substances, often tailored to specific testing needs.
Due to its invasive nature, the Blood Drug Test is used in circumstances requiring exact results, such as in legal cases or serious workplace incidents.
The Blood Drug Test offers the highest level of accuracy and can pinpoint the exact concentration of drugs in the bloodstream.
Hair Follicle Drug Testing
The Hair Follicle Drug Test stands out for its long detection period, tracing drug use up to 90 days. Its sensitivity to historical substance use makes it unique.
Covers a wide range, often similar to the 10 Panel Test, and can sometimes detect even more substances due to the extended detection period.
The Hair Follicle Drug Test is utilized in situations where an extensive history of drug use needs to be assessed, such as in court cases or high-security job clearances.
The Hair Follicle Drug Test is unparalleled in its ability to detect past drug use, offering a three-month overview of an individual’s substance use history.
10 Medications That May Cause a False Positive Drug Test 💊
Before scanning the medications that can potentially lead to false positive results on a urine drug test, it is important to remember these instances are not common but they are not entirely rare either.
Here are ten medications known to have the potential to cause false positive drug test results:
1. Dextromethorphan (Robitussin DM, Delsym)
- Description: Dextromethorphan is a primary ingredient in many over-the-counter cough suppressants.
- Potential Outcome: If you’ve taken dextromethorphan, a urine test may yield a positive result for PCP.
Is Robitussin DM bad for your heart?
Can I mix Robitussin and alcohol to sleep better?
No, it is not recommended to mix Robitussin and alcohol as it can have adverse effects on your health. Combining these substances can increase the risk of side effects such as dizziness, drowsiness, and impaired coordination.
Additionally, Robitussin and alcohol can cause respiratory depression, which can be dangerous, especially when combined.
2. Diphenhydramine (Benadryl, ZzzQuil)
- Description: Diphenhydramine is an antihistamine commonly used to treat allergies, itching, and cold symptoms.
- Potential Outcome: Diphenhydramine may lead to a false positive result for some opioids and opiates, although the specific dosage that triggers this result is unclear. In rare cases, it may also produce a positive test for PCP.
Which medications not to combine with Benadryl?
It is important to avoid consuming alcohol and other central nervous system depressants, such as tranquilizers or sedatives, while taking Benadryl, as they can increase the sedative effects of the medication.
Additionally, it is not recommended to take Benadryl with other antihistamines, as it may increase the risk of side effects.
Always consult with a healthcare professional or read the medication label for specific instructions.
Can Benadryl make you fail a drug test?
Yes, it is possible for Benadryl to cause a false positive result for certain substances in a drug test, particularly tricyclic antidepressants.
It would be best to inform the testing laboratory and specimen collector about any medications you are taking before the test.
3. Decongestants (Pseudoephedrine, Sudafed, Nexafed)
- Description: Decongestants like pseudoephedrine are utilized to alleviate sinus and nasal congestion.
- Potential Outcome: Pseudoephedrine may result in false positive test results for amphetamine or methamphetamine.
What does Sudafed do?
Sudafed is a brand name for a medication called pseudoephedrine, which is a decongestant. It helps relieve nasal congestion by narrowing the blood vessels in the nasal passages, reducing swelling and congestion.
Sudafed is commonly used to treat symptoms of the common cold, sinusitis, and allergies.
How to get Sudafed out of your system?
Generally, Sudafed has a half-life of about 5-9 hours, which means it takes that amount of time for half of the drug to be eliminated.
Sudafed typically takes around 5 half-lives for a drug to be completely eliminated, so Sudafed should be out of your system within 1-2 days.
Drinking plenty of water and staying hydrated can help facilitate the elimination process.
Is phenylephrine an effective replacement for pseudoephedrine?
No, a U.S. Food and Drug Administration (FDA) advisory committee unanimously concluded that phenylephrine, an ingredient found in popular decongestants sold under such brand names as Sudafed and Dayquil, is ineffective in treating cold and allergy symptoms.
Which cold medicines without phenylephrine are effective?
According to Dr. Maryann Amirshahi, a medical toxicologist and emergency medicine professor at Georgetown University School of Medicine, the active ingredient in Sudafed, known as pseudoephedrine, is quite effective at clearing up nasal congestion.
However, restrictions on its sale have been implemented, requiring pseudoephedrine to be sold from behind the pharmacy counter with a limit on purchase quantities, as a strategy to prevent its misuse in the production of methamphetamine.
4. Phentermine (Adipex-P, Lomaira)
- Description: Phentermine is an FDA-approved medication used to aid weight loss by reducing appetite.
- Potential Outcome: Taking phentermine can potentially lead to false positive urine test results for amphetamines.
How does Lomaira work?
Phentermine, available under brand names like Adipex-P and Lomaira, is prescribed to curb hunger. It assists in weight reduction by reducing your appetite or extending the sensation of fullness.
Additionally, phentermine is available in a combination with topiramate as Qsymia for enhanced weight loss effects.
How long does Lomaira stay in your system?
Phentermine can stay in your system for approximately 3 to 5 days. The drug’s half-life, which is the time it takes for half of the substance to be eliminated from your system, is around 20 hours.
What are the side effects of taking phentermine?
Common side effects of phentermine include:
1. Increased blood pressure
2. Increased heart rate
3. Dry mouth
It’s important to note that this is not an exhaustive list and there may be other side effects associated with phentermine. It is always recommended to consult with a healthcare professional for personalized advice and information.
5. NSAIDs (Ibuprofen, Naproxen, Advil, Motrin, Aleve)
- Description: NSAIDs like ibuprofen (Motrin, Advil) and naproxen (Aleve, Naprosyn) are used to treat fever, inflammation, and pain.
- Potential Outcome: If you consume these OTC NSAIDs, there’s a chance your urine test may return positive results for barbiturates (a sedative) or THC. Another NSAID, oxaprozin (Daypro), can result in a false positive test for benzodiazepines.
Can ibuprofen cause you to fail a drug test?
Yes, ibuprofen is still frequently reported in reputable resources as a possible cause for a false-positive drug test. This over-the-counter pain reliever can cause a drug test to show up as positive for barbiturates, benzodiazepines, and THC.
How long does ibuprofen stay in your system?
The half-life of ibuprofen is around 2 to 4 hours. It typically takes around 5 half-lives for a medication to be completely eliminated from the body.
Therefore, it can take approximately 10 to 20 hours for ibuprofen to be eliminated from your system.
Is ibuprofen a blood thinner?
No, ibuprofen is not a blood thinner. It is a nonsteroidal anti-inflammatory drug (NSAID) that helps relieve pain, reduce inflammation, and lower fever.
It does not have the same blood-thinning effects as medications like aspirin or anticoagulants.
Naproxen vs Ibuprofen?
Naproxen and Ibuprofen are both nonsteroidal anti-inflammatory drugs (NSAIDs) used to relieve pain and reduce inflammation. However, there are some differences to consider:
Naproxen tends to provide longer-lasting pain relief compared to Ibuprofen.
Ibuprofen is generally faster-acting than Naproxen.
Naproxen is typically taken less frequently throughout the day compared to Ibuprofen.
Ibuprofen may be more suitable for short-term pain relief, while Naproxen is often used for chronic conditions.
It is important to consult with a healthcare professional to determine which medication is most appropriate for your specific needs.
6. Antidepressants (Bupropion, Trazodone, Prozac, Zoloft)
- Description: Several antidepressants have been associated with false positive results on urine drug tests.
- Venlafaxine (Effexor XR) and desvenlafaxine (Pristiq), both serotonin-norepinephrine reuptake inhibitors (SNRIs), may yield false positives for PCP.
- Sertraline (Zoloft), a selective serotonin reuptake inhibitor (SSRI), can produce positive results for the hallucinogen LSD and benzodiazepines.
- Trazodone, an older antidepressant, may result in false positive test results for amphetamine or methamphetamine.
- Bupropion (Wellbutrin XL, Wellbutrin SR) may lead to false positive results for amphetamine or methamphetamine.
Can taking Zoloft cause you to fail a drug test?
Zoloft can produce a false positive drug test result for benzodiazepines due to the way the test works. False positives can occur because Zoloft may interfere with the urine screening test and produce a similar reaction to benzodiazepines.
However, it is important to note that confirmatory tests, like gas chromatography-mass spectrometry (GC-MS), can distinguish between Zoloft and benzodiazepines, providing accurate results.
Why is trazodone prescribed so often?
Although trazodone is not commonly utilized as a sole treatment for depression, it is often prescribed at lower dosages for insomnia.
This is partly because, unlike other sleep aids such as Ambien, trazodone is not deemed a controlled substance by the FDA, indicating a low risk of dependency and abuse.
What happens if you take trazodone and sertraline together?
It is common for sertraline and trazodone to be prescribed together with most patients handling the combination without issue. However, there is an elevated risk of developing serotonin syndrome when these two medications are taken together.
This serious medical condition can manifest with a range of symptoms, including disorientation, visual disturbances, seizures, significant fluctuations in blood pressure, rapid heartbeat, fever, profuse sweating, tremors, and hallucinations.
Is Wellbutrin prescribed for weight loss?
Yes, Wellbutrin, a medication primarily used to treat depression, may also be recommended for weight reduction due to its potential to decrease appetite as a secondary effect (utilized for off-label purposes).
Contrary to many other medications for depression, Wellbutrin is not typically associated with weight gain, although not all individuals may notice a reduction in weight while on this medication.
7. Quetiapine (Seroquel)
- Description: Quetiapine is an atypical antipsychotic used to treat certain mental health conditions like bipolar disorder and schizophrenia.
- Potential Outcome: Quetiapine could potentially lead to a positive result for opioids, specifically methadone.
What are the side effects of Seroquel?
The most common side effects of Seroquel (quetiapine) include drowsiness, dizziness, dry mouth, constipation, and weight gain.
Other potential side effects may include blurred vision, low blood pressure, increased heart rate, and changes in blood sugar levels.
How long does Seroquel stay in your system?
Seroquel has a half-life of approximately 6 to 7 hours. It takes about 5 half-lives for a medication to be mostly cleared from the system.
Seroquel can take around 24 to 45 hours to fully leave your system.
Can taking Seroquel make you fail a drug test?
Yes, Seroquel is an antipsychotic medication that treats schizophrenia and bipolar disorder and could potentially lead to a positive result for opioids, specifically methadone.
8. Proton Pump Inhibitors (Omeprazole, Esomeprazole, Prilosec, Nexium)
- Description: PPIs, such as pantoprazole (Protonix), are utilized to treat gastroesophageal reflux disease (GERD) and heartburn symptoms.
- Potential Outcome: Taking PPIs may result in false positive results for THC.
Pantoprazole vs Omeprazole?
Pantoprazole and omeprazole are both proton pump inhibitors (PPIs) commonly used to treat acid-related conditions such as gastroesophageal reflux disease (GERD) and stomach ulcers.
While both medications work in a similar way by reducing the production of stomach acid, there are some differences between them:
1. Potency: Pantoprazole is typically considered to be more potent than omeprazole, meaning it may provide stronger acid-suppressing effects.
2. Duration of action: Pantoprazole has a longer duration of action compared to omeprazole, which means it may provide relief from acid-related symptoms for a longer period of time.
3. Metabolism: Omeprazole is primarily metabolized by the liver, while pantoprazole undergoes minimal hepatic metabolism, making it a favorable choice for individuals with liver impairment.
4. Interactions: Omeprazole has a higher potential for drug interactions compared to pantoprazole due to its involvement in the metabolism of certain medications.
What happens if you take proton pump inhibitors too long?
Taking proton pump inhibitors (PPIs) for a prolonged period can have potential side effects and risks, which include:
1. Increased risk of infections: Prolonged use of PPIs can increase the risk of respiratory and gastrointestinal infections.
2. Nutritional deficiencies: PPIs can interfere with the absorption of certain nutrients, such as vitamin B12, calcium, magnesium, and iron, leading to potential deficiencies.
3. Increased risk of bone fractures: Long-term use of PPIs may increase the risk of bone fractures, particularly in older adults.
4. Rebound acid hypersecretion: Stopping PPIs abruptly after long-term use can result in a rebound effect, causing an overproduction of stomach acid.
5. Increased risk of kidney disease: Some studies suggest a potential association between long-term PPI use and an increased risk of kidney disease.
Can taking Prilosec make you fail a drug test?
Yes, Prilosec (omeprazole) is a proton pump inhibitor that treats severe stomach acid-related conditions like GERD and may result in false positive results for THC.
9. Quinolone Antibiotics (Ciprofloxacin, Levofloxacin, Cipro, Ofloxacin)
- Description: Quinolone antibiotics are employed to treat various bacterial infections.
- Potential Outcome: Levofloxacin and ofloxacin, two quinolone antibiotics, may trigger false positive urine tests for opiates. Ofloxacin may also cause a false positive result for amphetamine or methamphetamine.
What should I avoid while taking levofloxacin?
Avoid the following while taking levofloxacin:
1. Dairy products: Avoid consuming dairy products such as milk, yogurt, and cheese as they can interfere with the absorption of levofloxacin.
2. Antacids and supplements: Avoid taking antacids, iron supplements, multivitamins, or other products containing calcium, magnesium, aluminum, or zinc within 2 hours before or after taking levofloxacin, as they can reduce its effectiveness.
3. Caffeine and alcohol: Limit or avoid consuming caffeine (e.g., coffee, tea) and alcohol while using levofloxacin, as they can worsen side effects like nervousness or sleep disturbances.
Which antibiotics cause the most false positive for opiates?
Levofloxacin, ofloxacin, and pefloxacin have been the most consistent contributors to false-positive drug test outcomes.
10. Promethazine (Phenergan, Promethegan)
- Description: Promethazine is part of the phenothiazine group and is used to relieve nausea and vomiting.
- Potential Outcome: Promethazine can cause false positive results for amphetamine or methamphetamine.
Does promethazine have codeine in it?
Yes, promethazine and codeine combination is used to relieve cough, runny or stuffy nose, sneezing, or other symptoms caused by allergies or the common cold.
Is promethazine the same as phenergan?
Promethazine, known to alleviate nausea, motion sickness, and allergic reactions, is also employed as a sedative and for managing vertigo. It’s marketed under various brand names, including Phenergan, Promethegan, and Phenadoz.
What drugs should not be taken with promethazine?
Medications for colds or allergies, sedatives, opioids for pain, sleep aids, muscle relaxants, and treatments for seizures, depression, or anxiety may have interactions with promethazine, potentially leading to health complications or heightened side effects.
What Else Can Cause a False Positive Drug Test Result?
In addition to the medications listed above, there are a rare instances where medications may rarely cause false positives.
These include labetalol, doxylamine, and tramadol.
Can taking labetalol cause a false positive drug test?
Yes, labetalol, a beta-blocker, is used to lower blood pressure. In rare cases, it may lead to a false positive test for amphetamine or methamphetamine.
Can doxylamine show up on a pre-employment drug test?
Yes, doxylamine, an over-the-counter medication that aids sleep. Large doses of doxylamine can result in a false positive for opioids, particularly methadone.
Will tramadol make you fail a random drug test?
Yes, tramadol is an opioid medication used to manage pain. Large doses of tramadol can lead to positive results for methadone or PCP.
Is 666 cold medicine still available?
No, the classic formulation of 666 Cold Medicine is no longer on the market. Regulatory changes by the FDA have led to the prohibition of the former recipe, which consisted of a 40% alcohol base and included components such as codeine, quinine, a drug used to treat malaria, and a potent laxative.
Debunked: Does Methylphenidate Cause False Positives for Amphetamine?
Methylphenidate is a stimulant medication commonly prescribed to treat Attention Deficit Hyperactivity Disorder (ADHD).
While it is often claimed that methylphenidate can cause false positive results for amphetamines, research suggests otherwise.Journal of Analytical Toxicology
Individuals prescribed methylphenidate for ADHD should not be concerned about testing positive for amphetamines.
What to Do if You Receive a False Positive Drug Test Result
If you suspect that you have received a false positive result on a urine drug test, it is essential to take appropriate steps to address the situation.
- Stay Calm and Seek Clarification: If you’re a Department of Transportation (DOT) employee who receives a false positive drug test result, remain calm. Request detailed information about the test results and the substances for which you tested positive.
- Review Your Medications and Supplements: Compile a list of all prescription medications, over-the-counter drugs, and dietary supplements you have taken recently, as some substances can lead to false positives.
- Inform Your Employer: Communicate with your employer or the designated union or HR representative immediately. Disclose any medications or substances that could have affected the test results.
- Request a Re-Test: Ask for a second test to be administered, preferably with a fresh sample. Ensure the second test is conducted at a certified and reputable testing facility.
- Consult the Medical Review Officer (MRO): Speak with the Medical Review Officer assigned to your case. The MRO is a licensed physician responsible for analyzing drug test results and determining if there is a legitimate medical explanation for the positive result.
- Seek Legal Advice: If necessary, seek legal counsel, especially if the correct procedures for testing were not followed or if you believe there has been a violation of your rights.
- Follow DOT Protocols for Disputing Results: Familiarize yourself with and adhere to DOT’s procedures for contesting a drug test result. This process often includes formal written statements and could involve appeals.
- Gather Documentation: Collect any relevant documentation, such as medical records or prescriptions, that provide evidence supporting your case against the false positive result.
- Consider Substance Abuse Professional (SAP) Evaluation: If required by your employer, undergo an evaluation by a DOT-qualified Substance Abuse Professional, which is the first step in the Return-To-Duty process.
- Stay Informed About Your Rights: Understand your rights as a DOT employee, including the confidentiality of drug test results and your right to fair treatment throughout the process.
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