What medications test positive for Methamphetamemes

Objective: Two widely available legal products, Vicks VapoInhaler (lmethamphetamine with trace amounts of d-methamphetamine) and poppy seeds (morphine and codeine) contain small amounts of psychoactive substances that may generate positive tests for regulated drugs conducted in forensic, workplace and drug abuse treatment settings. This study evaluates the prevalence and duration of positive amphetamines and opiates drug tests in blood, oral fluid (OF) and urine.

Study population: Up to 30 healthy adults without a history of clinically significant adverse reactions to nasal or oral decongestants or stimulants, to oral opiates, or to poppy seeds, buckwheat, hazelnuts, or sesame.

Design: This is an open-label, non-treatment study in which each participant spends two days at NIDA IRP and the intervening night on the Behavioral Pharmacology Research Unit (BPRU). Vicks VapoInhaler (0.16-0.60 milligrams of l-methamphetamine and trace amounts of d-methamphetamine) is administered intranasally every two hours for six doses from 9 am to 7 pm on the first day and a seventh dose at 6 am the second day. Food grade uncooked poppy seeds (45 grams suspended in 500 milliliter of liquid) are administered orally at 9 am and 5 pm on the first day only.

Outcome measures: The primary outcome measures are prevalence of positive tests and windows of drug detection (based on concentrations in the biological matrix) of methamphetamine, l-amphetamine, morphine, and codeine in blood, OF, and urine. Secondary outcome measures are 1) performance of 2 OF collection devices (Quantisal and Oral-Eze) and an on-site OF screening test (Draeger Drug Test 5000) in comparison to liquid chromatography-tandem mass spectrometry (LCMSMS), and performance of urine screening test in comparison to gas chromatography-mass spectrometry (GC-MS). Performance parameters are prevalence of positive tests at each time point, windows of drug detection, sensitivity, and specificity for l-methamphetamine, l-amphetamine, morphine, and codeine in OF and urine. Cutoff concentrations for each matrix are those specified in the Mandatory Guidelines for Federal Workplace Drug Testing Programs; 2) detection of d-methamphetamine in any blood, OF and urine specimen; and 3) time course of these analytes in blood for comparison to other matrices, especially oral fluid/blood ratios.

Significance: These data are essential for establishing evidence-based drug policy and legislation, for establishing oral fluid drug testing by the Substance Abuse and Mental Health Services Administration, and for answering current questions about whether use of these legal products could produce positive tests in federally mandated drug testing programs.

These prescriptions—and other substances—can skew the results of a screen for illicit substances

There are several instances where you may be asked to complete a drug test—employers may require one when you’re applying for a new job, or if you are a student or an athlete. Urine drug screens are the most common test (although other body fluids may be analyzed). The test itself is simple and painless, and only requires a urine sample. It can feel a little unnerving to be asked to take a drug test, and it is important to know that there are some medications and other substances that could cause a false positive drug test result. 

What is a false positive drug test?

A “false positive” result occurs when the analytical drug detection method recognizes some of the molecules in the body as illegal drugs when you haven’t ingested any illegal substances. Drugs that are typically screened for include amphetamines/methamphetamines, benzodiazepines, barbiturates, marijuana, cocaine, PCP, methadone, and opioids (narcotics).

Research conducted at Boston Medical Center shows that drug tests produce false positives in 5% to 10% of cases. Although this is not a high percentage, the consequences for failing a drug test could jeopardize your career, education, or job prospects. Several common prescriptions, over-the-counter medications, herbs, vitamins, and even some foods could trigger a false positive drug test. According to one study, false positive drug tests are most commonly reported for amphetamine and methamphetamine. That’s because common over-the-counter medications can result in false positives for these substances.

When it comes to prescriptions, “warnings are available, but usually only if you look for them,” says Brent McFadden, Pharm.D., the owner of Brent’s Pharmacy & Diabetes Care in St. George, Utah. “It is usually in the fine print and most people, in my experience, don’t read the material given to them by the pharmacist.” 

Research suggests that 10% to 15% of drug tests yield false negative results. While urine drug tests are most commonly used, their accuracy depends on a number of factors, including the frequency of drug use and the how fast the drug is metabolized by the body. It’s important to note that no drug test is 100% accurate.

13 medications that cause false positive drug tests

So, if you are like most people who don’t take the time to study the fine print, here is a list of prescriptions and over-the-counter medications that could cause a false positive drug test.

1. Analgesics/ NSAIDS

The medication Daypro (oxaprozin), which is prescribed for types of arthritis, may result in a false positive test for benzodiazepines. The pain medication tramadol could trigger a false positive result for PCP. Common over-the-counter anti-inflammatory pain medications such as Advil (ibuprofen) and Aleve (naproxen) could make you test positive for barbiturates and THC (marijuana/cannabinoids); and ibuprofen can also make you test positive for PCP.

2. Antibiotics 

Quinolone antibiotics, such as Levaquin (levofloxacin) or Cipro (ciprofloxacin) are commonly prescribed for certain infections (urinary tract, sinus, etc.). They have been shown to trigger a false positive urine result for opiates. Rifampin, an antibiotic used to treat tuberculosis, can also lead to a false positive result for opiates.

3. Antidepressants

Antidepressants—such as Wellbutrin (bupropion), Prozac (fluoxetine), Seroquel (quetiapine), Effexor (venlafaxine), trazodone, and amitriptyline—could cause a false positive result for amphetamines or LSD. 

4. Antihistamines 

Antihistamines and some sleep aids containing diphenhydramine (like Benadryl) could cause a false positive result for PCP or methadone. Doxylamine (the active ingredient in Unisom) can also trigger a positive drug result for methadone, opiates, and PCP.

RELATED: Benadryl details | Doxylamine details

5. Central nervous system (CNS) stimulants 

Ritalin (methylphenidate) and Adderall are used to treat ADHD, and are well known to cause a false positive for amphetamines and methamphetamines.

RELATED: Ritalin details | Adderall details

6. Cough suppressant 

Dextromethorphan, the active ingredient in Robitussin-DM, Delsym, and other over-the-counter cough suppressants, may cause a drug screen to be positive for opiates and/or PCP.

RELATED: Learn the dangers of a cough syrup addiction

7. Decongestants

A key ingredient in Sudafed (pseudoephedrine) is also the main ingredient to the making of methamphetamine. Taking Sudafed can result in a false positive for amphetamine or methamphetamine.

RELATED: Sudafed details

8. Proton pump inhibitors

Prilosec (omeprazole), Nexium (esomeprazole), and Prevacid (lansoprazole) are used to treat gastroesophageal reflux disease (GERD) or peptic ulcer disease (PUD) and can cause a false positive for THC. 

9. Weight loss pills

The weight loss drug phentermine, may produce a false positive drug test. That’s because the chemical structure of phentermine is similar to that of an amphetamine, so if you’re taking the drug, it is likely to appear as a positive result on a 5-panel urinalysis. 

10. HIV medication

People taking the HIV medication Sustiva (efavirenz) may obtain false positive drug test results. In one study, 49 out of 50 patients taking the drug tested positive for benzodiazepines. As well, false positive urine tests for cannabinoids have been reported among those taking Sustiva.

11. Blood pressure medications

Common medications like Trandate (labetalol), a beta blocker used to treat hypertension, and Cardizem (diltiazem), a calcium channel blocker used to treat hypertension and chest pain, may result in false positive drug test results for LSD. Labetalol can also cause a false positive for amphetamine or methamphetamine because a labetalol metabolite is structurally similar to amphetamine.

12. Metformin

Metformin is a drug commonly used to reduce the blood sugar of diabetic patients. The drug has been linked to false-positive drug test results for amphetamine.

13. Prednisone

Prednisone is a corticosteroid that is detectable in your urine, so if you are taking the drug, it is possible that you will test positive for steroids.

“My recommendation to anyone taking these medicines who might be drug tested is first and foremost to be honest with the tester,” says Dr. McFadden. “Know if the meds you are taking might cause a false positive and notify the administrator of the test. If it is prescribed, make sure you have the label from the pharmacy, which will show that the medication was prescribed to you. If it is an OTC product, have some kind of documentation (the container it was in, a note from your physician, etc.) that you have taken it.”

What substances can cause a false positive?

In addition to prescription medications, these other common substances can lead to a false positive drug test. 

1. Vitamin B supplements

Riboflavin, also known as B2, is found in hemp seed oil and may return a false THC (marijuana) reading. 

2. CBD (cannabidiol)

CBD is the non-psychoactive portion of the marijuana plant that has become a very popular remedy for everything from pain control, to promoting sleep, to helping relieve anxiety. Urine drug testing screens for the presence of THC, the psychoactive component of marijuana, but a problem could arise due to the fact that these products are not very well-regulated and cross contamination can occur. “With CBD available in everything from drink powders, to weight loss formulations, to tinctures of all types, false positive urine screenings for THC will become more and more common,” warns Dr. McFadden.

3. Secondhand marijuana smoke

According to research, it’s highly unlikely that secondhand smoke will cause a false positive test for marijuana. In rare cases, a false positive might occur, but it will be most likely within several hours of exposure. 

4. Poppy seeds

Can poppy seeds make you fail a drug test? When consumed in large quantities (such as in a poppy seed bagel or muffin), the tiny black seeds might cause a false positive drug result for opioids. Poppy seeds come from the seedpod of the opium poppy and while the seeds are cleaned before consumption, they may still contain trace amounts of opium residue. In 1998, the federal government raised the threshold on opiates from 0.3 micrograms to 2 micrograms per milliliter, but some drug testing facilities still go by the old standard. 

5. Mouthwash

Alcohol in hand sanitizer (from heavy use), certain liquid medications, and mouthwash or other breath cleaning products could cause you to test positive for drinking alcohol. 

6. Tonic water

Tonic water contains quinine, and when consumed in large amounts could lead to false positive results for opiates. 

7. Coca tea

Coca tea is made from coca leaves, which are part of the coca plant from which cocaine is derived. Coca leaves are illegal in the United States, but if you consumed the tea in another country like Bolivia or Peru, you receive a positive test result for cocaine. 

Can you fight a false positive drug test?

If you believe you have a failed drug test due to taking a prescription drug or consuming one of these products, you do have options. 

“I would counsel [anyone who received a false-positive test to ask] the administrator to do a more specific test,” says Dr. McFadden, who recommends samples be sent away to labs to have a more specific mass spectroscopy assay done. “Furthermore, if they can prove they are taking a medicine that can produce a false positive (by producing a legitimate prescription), the administrator may schedule another test 30 to 60 days later. If, under their physicians’ approval, the person can be off the medicine for that length of time, a negative test should result.”

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