MythsWhy Client’s “Invent” Excuses
■ denial of the disease
■ “learned” behavior of chronicdishonesty
■ risk taking/manipulative behavior
■ threat of court sanctionsThe
■ Passive inhalation of marijuana smoke cancause a“positive” drug test result.
■ NO – not if standard cutoffs are used
■ THC (cannabinoid) assay uses variablecutoffs (20/25 or 50 ng/mL)
■ passive inhalation research indicates lessthan 10 ng/mL in volunteer urines
■ urine versus hairThe Excuse:“I’m still positive forTHC because of excessbody fat.”The Excuse:“I’m positive for THCbecause I’m on a dietand breaking down fatcells containing THC.”The Excuse:“I’m positive for THCbecause I exercise a lotand I’m burning up fatcells containing THC.”The Excuse:“I’m positive for THCbecause I had a deeptissue massage.”The Excuse:“I’m positive for THCbecause I was in a hot tuband the THC was sweatout of my fat cells.”
■ body fat and/or obesity significantlyinfluences the results of drug tests formarijuana
■ body fat excuses by clients widespread
■ marijuana does bind to fat cells
■ there are case studies indicating prolong eliminationpatterns
■ BUT, marijuana’s elimination from the body islargely driven by concentration
■ while small amounts of marijuana may be retainedin the body – generally these amounts do not have aneffect on a urine drug testTHC and Fat:
■ Consuming poppy seeds (i.e.,eating poppy seed bagels) cancause a positive urine drug test foropiates.Place a poppy prohibition in youragreement and don’t allow clientsto use this excuse to “explain away”a positive urine opiate test result!
■ Drinking vinegar or cranberry juice willproduce a “negative” urine drug test.
■ theory is to cause a “pH shift”, makingthe urine sample acidic – altering thechemistry of immunoassay tests
■ in reality – the body detoxifies the acid &dilutes to physiological pH
■ consuming large does of vitamins(niacin – B3) purges marijuana from thesystem and/or speeds up itselimination from the body byincreasing a person’s rate ofmetabolism
■ niacin – vitamin that affects more than 50 metabolicfunctions, releasing energy from carbohydrates
■ does not increase metabolism rate
■ absolutely NO scientific or medical data indicatingniacin has ANY effect on a urine drug test
■ adds a more intense “yellow” color to the urine
■ niacin used to disguise diluted samples
■ niacin overdose is often accompanied byskin“flushing”All about niacin:
■ blood is a good alternative specimen for drugsof abuse testing
■ FALSE!◆ sample of limited volume◆“dirty”sample (protein, blood cells, lipids)◆ drugs in low concentrations◆ parent drugs with short half-life◆ many testing methods not sufficientlysensitive
■ beer-battered fish can cause a positiveurine test for alcohol
■ The presence of urine sediment (materialthat settles to the bottom of thecollection cup) is a good indicator ofsample tampering.
■FALSE!Urine sediment occurs naturally & is comprised of:cells – (epithelial, kidney, blood)casts – (cylindralical particles formed by WBC, RBC,granular material, fat, etc.crystals -organisms (bacteria, yeast, fungi)Urine is a complex matrix:
■ Sure-Jell or Certo is an effectivetechnique clients can use to adulterateurine samples and produce negative testresults.
■ FALSE!Sure Jell/Certo – Pectin
■ pectin – complex carbohydrate found inplant cells (skins & seeds of fruit)
■ pectin used to “set” jams & jellies
■“activation” of pectin requires boiling
■ pectin (ingested/added directly) maycause urine to be more viscous
■ Don’t believe in the Certo or Sure Jel method. I triedit…failed all the drug tests I took every time I usedit…I was being tested for marijuana for ArkansasDrug Court. Tested me every week…failed all threedrug screens…they use a new on site screeningmachine that spins the sample around…supposedlyit can even detect meth for up to 10 days…and candetect adulterants too…I cleaned up rather than tryto cover up.Sure Jell/Certo – Pectin
■ having sex with someone who usesdrugs will cause a positive urine drugscreen in an abstinent client
■ A urine creatinine level of 475 mg/dL isreasonable evidence to indicatespecimen tampering.
■ TRUE!Normal Urine Creatinine
■ 2005 study “Urinary Creatinine Concentrations inthe U.S.
Population” determine the mean (basedupon 22,245 participants) was 130 mg/dL◆ less than 1% below 20 mg/dL◆ less than 1% greater than 400 mg/dL
■ it’s all about patterns
■ significant fluctuations in urine creatinine levelsare not normal
■ Urine drug testing is an excellent strategy formonitoring clients using prescription drugsand determining potential abuse of prescribedmedications
■ Not so much!Drug testing is an excellent tool for theabstinence monitoring of court clients,however it provides limited informationfor the differentiation between theappropriate therapeutic use of prescribedmedications and the misuse/abuse ofthose same drugs – regardless of thespecimen tested.Other Control Strategies
■ search & seizure (client contract)
■ healthcare contact forms
■ pill counts
■ no out-of-state prescriptions
■ use of specified pharmacies
■ loss of completion credits/timewhile on certain prescription meds
■ Having a novacaine shot from a dentistwill cause a positive urine drug testresult for cocaine.
■FALSE!The Excuse:“I tested positive forcocaine because I usedOrajel/Anbesol for a toothache.” (benzocaine)The Excuse:“I tested positive forcocaine because I got abad sunburn andapplied Solarcaine®.”The Excuse:“I live near a farm thatgrows sugar cane.”The Excuse:“I tested positive forcocaine because I wentto a movie starringMichael Caine.”
■ A client with diabetes is likely toproduce dilute specimens (with urinecreatinine levels of less tha 20 mg/mL)because of his/her disease.
■False!Diabetes & Creatinine
■ what does the research say
■ question is whether diabetes causes diluteurine samples – the answer is NO!
■ average urine creatinine level for a nonHispanic black participant, 20-49 years of ageis 180 mg/dL – subtract 30 mg/dL ofcreatinine for a diabetic condition, startingwith an average urine creatinine level of 150mg/dLUrine Creatinine Patterns
■ don’t get hung up on 20 mg/dL
■ look for creatinine patterns
■ “normal” vs. dilute
■ honesty is a proximal goal
■ client who always produces “low”creatiniine urine sample
■ Does the act of cooking/heating foodsthat contain alcohol liberates the alcoholin the process, thus producing alcoholfree food.
■False!Alcohol in Food – Cook’s Illustrated Study(2005) “A Few Sobering Thoughts”
■ beef burgundy – three hours in oven,lid on, 40% alcohol retained
■ flambé recipes – igniting brandy overhigh heat 29% alcohol retained -igniting brandy in cold pan 57%alcohol retained
■ The presence of designer drugs (such asSpice & K2 or “bath salts” can bedetected by using routine urinescreening methods.
■ “Holding” drugs “for a friend” producespositive drug test results.
■ Really!!!! Pleading to a felony in order tobeat a drug test?
■ Washing hair with “special” shampooswill remove drugs of abuse from hair
■ False! This stuff doesn’t work!
■ Consuming baking soda willproduce a negative drug test for meth
■ sodium bicarbonate
■ No research to support this theory
■ “Over 500 Fabulous, Fun, and FrugalUses You’ve Probably Never ThoughtOf” by Vicki Lansky she mentionsnothing about using Baking Soda to passa drug test
■ Ur-ine Trouble, 200 pages – nomention of baking soda
■ Arm & Hammer – largest miningcompany of sodium bicarbonate doesdrug testing a gets positive results
■ sodium bicarbonate is a natruallyoccurring body chemical
■ strenuous exercise will cleanse yourbody of drugs
■ a quick trip to the gym the morning of asurprise test will do nothing to help yourchances of passing