Article at a Glance: –

Xanax can be found in urine for up to four days, saliva for up to two days, and hair for up to 90 days. Factors like age, liver health, weight and even race can impact how long Xanax stays in your system. Xanax can be found in breast milk for up to three days, and breastfeeding women should discuss alternatives to Xanax with their doctor. Xanax cannot be flushed from the system more quickly once you have taken the drug.

Xanax, or alprazolam, is prescribed to treat anxiety and panic disorders, among other mental health conditions. Xanax belongs to a class of sedative drugs called benzodiazepines. Depending on the part of the body being examined, whether it’s urine, blood or hair, Xanax can be detected in your system for up to 90 days.

1. Benzodiazepines like Xanax increase the activity of gamma-Aminobutyric acid (GABA) receptors in the brain,
2. This heightened GABA receptor activity inhibits nerve signals and chemicals in the brain that trigger anxiety or panic,
3. Xanax also releases chemicals in the brain that cause a pleasurable sensation and relaxation.

The high that Xanax creates can make it addictive, and the relaxation it causes can make working or driving dangerous. Because of Xanax’s addictive potential, employers or law enforcement officers may test for it, leading those who take Xanax often to wonder how long the drug will affect them and how long it will be detectable in the body.

What Benzos don’t show up in urine?

Although most benzodiazepines show up in standard urine tests, some don’t. Alprazolam, clonazepam, temazepam, and triazolam may not be found in many of the common tests. Many benzodiazepine tests can find whether the medicine is present, but they can’t give the amount.

How long does 2.5 Xanax stay in system?

On average, it takes approximately 2.5 to 4 days for Xanax to be completely cleared from the body. However, traces of the drug can be found in certain tests for a longer period of time, particularly in hair and urine samples.

What are the metabolites of alprazolam in urine?

Abstract – Alprazolam is a short-acting triazolobenzodiazepine with anxiolytic and antidepressant properties. It has a half-life of 10-15 hours after multiple oral doses. Approximately 20% of an oral dose is excreted unchanged in the urine. The major urinary metabolites are alpha-OH alprazolam glucuronide and 3-HMB benzophenone glucuronide.

The objective of this study was to characterize the reactivity of alprazolam and three metabolites in the Abbott ADx and TDx urinary benzodiazepine assays compared with the EMIT d.a.u. benzodiazepine assay. Alprazolam (at 300 ng/mL) gave an equivalent response as the 300 ng/mL low control (nordiazepam).

alpha-OH alprazolam gave an equivalent response to this control between 300-500 ng/mL and 4-OH alprazolam between 500-1000 ng/mL. The 3-HMB benzophenone was not positive even at 10,000 ng/mL. The ADx screening assay was positive in 26 of 31 urine specimens collected from alprazolam-treated patients.

All 31 of these specimens were confirmed positive for alpha-OH alprazolam by GC/MS after enzymatic hydrolysis and formation of a TMS derivative. For the TDx, 27 of 31 specimens were positive for benzodiazepines and all 31 were confirmed by GC/MS. All 5 of the negative ADx specimens and 4 of 5 TDx specimens contained 150-400 ng/mL of alpha-OH alprazolam.

In conclusion, both the ADx and TDx urine benzodiazepine assays are acceptable screening assays for alprazolam use when the alpha-OH alprazolam concentration is greater than 400 ng/mL.

What over the counter drugs will test positive for benzodiazepines?

OTC Cough Suppressants, such as Robitussin and Delsym: The main ingredient in many cough syrups is dextromethorphan, which could show positive for PCP in a urine test. Oxaprozin, also known as Daypro : Used to treat arthritis pain, oxaprozin may result in a positive result for benzodiazepines.

Why would I test negative for benzodiazepines?

6,7 This antibody has relatively low cross reactivity with clonazepam and lorazepam and is therefore less likely to be detected reliably. Another reason a benzodiazepine test may be falsely negative is that a dose may not be of a sufficient concentration to reach the detection threshold level in the urine.

What is a normal benzodiazepine level in urine?

Benzodiazepines Urine Level – Laboratory Test Catalog LCMS Exp Benzodiaz | Alpha-hydroxyalprazolam | Lorazepam | Oxazepam | Confirmation | Clonazepam | Diazepam | Temazepam | Oxazepam | 508

• Specimen Collection: Urine
• Container(s): Sterile Urine Cup / Plastic screw-top transport tube
• Uscreen and iSCREEN POC (Point of Care) urine drug testing cups are acceptable but not preferred
• Preferred Volume to Collect: 10.0 mL
• Minimum Volume to Collect: 1.0 mL
• Collection Instructions:

• Urine specimen must be collected on site at lab or office. Do not send collection container home with patient.
• Keep container upright at all times and check that lid is fastened evenly and securely.
• Detailed Instructions (link):

Processing Instructions (Laboratory, Outpatient or Off-site collection)

Transport Temperature: Refrigerate

1. Ambient: 72 hours
2. Refrigerate: 14 days
3. Frozen: 365 days
4. Laboratory Retention: 10 days

Available Monday through Friday, day shift. TAT 2 – 3 days A urine benzodiazepine (Oxazepam/Lorazepam/Alprazolam metabolite/Clonazepam metabolite/Nordiazepam/Temazepam) result of < 50 is a NEGATIVE result (50 ng/mL is the lower reporting limit for this LCMS confirmation assay). 　 Values reported ≥ to 50 should be interpreted as POSITIVE, Corewell Health Reference Laboratory, Grand Rapids, MI Liquid Chromatography-Mass Spectrometry This test was developed and its performance characteristics determined by Spectrum Health Toxicology Laboratory. It has not been cleared or approved by the FDA. The laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes. It should not be regarded as investigational or for research. Exp Benzodiaz Conf: 16195-0 : Benzodiazepines Urine Level - Laboratory Test Catalog

Is 0.5 Xanax okay?

– You may be curious about how Xanax compares with other medications that are prescribed for similar purposes, such as buspirone, Xanax and buspirone may be used to treat generalized anxiety disorder, These drugs also have other uses that differ. Both come as oral tablets.

How long is 1mg of Xanax detectable?

Article at a Glance: –

Xanax can be found in urine for up to four days, saliva for up to two days, and hair for up to 90 days. Factors like age, liver health, weight and even race can impact how long Xanax stays in your system. Xanax can be found in breast milk for up to three days, and breastfeeding women should discuss alternatives to Xanax with their doctor. Xanax cannot be flushed from the system more quickly once you have taken the drug.

Xanax, or alprazolam, is prescribed to treat anxiety and panic disorders, among other mental health conditions. Xanax belongs to a class of sedative drugs called benzodiazepines. Depending on the part of the body being examined, whether it’s urine, blood or hair, Xanax can be detected in your system for up to 90 days.

• Benzodiazepines like Xanax increase the activity of gamma-Aminobutyric acid (GABA) receptors in the brain,
• This heightened GABA receptor activity inhibits nerve signals and chemicals in the brain that trigger anxiety or panic,
• Xanax also releases chemicals in the brain that cause a pleasurable sensation and relaxation.

The high that Xanax creates can make it addictive, and the relaxation it causes can make working or driving dangerous. Because of Xanax’s addictive potential, employers or law enforcement officers may test for it, leading those who take Xanax often to wonder how long the drug will affect them and how long it will be detectable in the body.

Can you take 2 Xanax 0.5 mg?

Dosing – The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

For anxiety:

For oral dosage forms (solution, tablets, or orally disintegrating tablets):

Adults—At first, 0.25 to 0.5 milligram (mg) 3 times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 4 mg per day. Older adults—At first, 0.25 mg 2 or 3 times a day. Your doctor may increase your dose as needed. Children—Use and dose must be determined by your doctor.

For panic disorder:

For oral dosage form (extended-release tablets):

Adults—At first, 0.5 to 1 milligram (mg) taken in the morning once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day. Older adults—At first, 0.5 mg taken in the morning once a day. Your doctor may increase your dose as needed. Children—Use and dose must be determined by your doctor.

For oral dosage forms (solution, tablets, or orally disintegrating tablets):

Adults—At first, 0.5 milligram (mg) 3 times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day. Older adults—At first, 0.25 mg 2 or 3 times a day. Your doctor may increase your dose as needed. Children—Use and dose must be determined by your doctor.

Which benzo has an active metabolite?

Abstract – Anxiolytic drugs, namely benzodiazepines, are the most commonly used psychoactive substances since anxiety disorders are prevalent mental disorders particularly in the Western world. Oxazepam is a short-acting benzodiazepine and one of the most frequently prescribed anxiolytic drugs.

It is also the active metabolite of a wide range of other benzodiazepines, such as diazepam, ketazolam, temazepam, chlordiazepoxide, demoxazepam, halazepam, medazepam, prazepam, pinazepam, and chlorazepate. Therefore, relevant clinical and forensic outocomes may arise, namely those related to interference in driving performance.

It is clinically available as a racemic formulation, with S-enantiomer being more active than R-enantiomer. In humans, it is mainly polimorphically metabolized by glucuronide conjugation at the 3-carbon hydroxyl group, yielding stable diastereomeric glucuronides (R- and S-oxazepam glucuronide).

Relevant metabolic and stereoselective interspecies differences have been reported. In this work, the pharmacokinetics of oxazepam with particular focus on metabolic pathways is fully reviewed. Moreover, the metabolic profile of other prescribed benzodiazepines that produce oxazepam as a metabolite is also discussed.

It is aimed that knowing the metabolism of oxazepam and related benzodiazepines may lead to the development of new analytical strategies for its early detection and help in further toxicological and clinical interpretations. Keywords: Oxazepam; benzodiazepines; metabolism; pharmacokinetics; toxicological analysis.

What is the metabolite half-life of Xanax?

Using a specific assay methodology, the mean plasma elimination half-life of alprazolam has been found to be about 11.2 hours (range: 6.3-26.9 hours) in healthy adults. Distribution In vitro, alprazolam is bound (80 percent) to human serum protein.

Do all benzodiazepines have active metabolites?

Toxicokinetics – The benzodiazepines are generally well absorbed from the gastrointestinal tract. The time to peak concentration of the benzodiazepines ranges from 0.5 to 6 h after ingestion. The benzodiazepines are all extensively metabolized by microsomal enzyme systems in the liver.

1. The metabolites of many benzodiazepines are pharmacologically active and are biotransformed much more slowly than the parent compounds.
2. The benzodiazepines that are not biotransformed to active metabolites include clonazepam, estazolam, lorazepam, nitrazepam, oxazepam, temazepam, and triazolam.
3. The benzodiazepines and their active metabolites are widely distributed into body tissues and readily cross the blood–brain barrier and placenta.

All are highly bound to plasma proteins. The elimination half-lives of the benzodiazepines range from 1 to 70 h at therapeutic doses. The half-lives of active metabolites, however, may be as long as 120 h. These metabolites are ultimately conjugated, largely with glucuronic acid, to inactive compounds that are excreted primarily in the urine.

What is a therapeutic level of alprazolam?

Therapeutic range: 10 – 100 ng/mL. Potentially toxic at greater than 100 ng/mL. Alprazolam Metabolite Synonym(s): Alpha-Hydroxyalprazolam has approximately 66% of the pharmacological activity of Alprazolam.

What panel test shows benzodiazepines?

Specimen Type

Reviewed by Christopher Parker on January 11, 2022 Note: Reference ranges provided on this web site are for guidance only, and may not reflect the most recent changes. Refer to laboratory reports for current reference data. UNC Hospitals McLendon Clinical Laboratories 101 Manning Drive Chapel Hill, NC 27514

What causes benzodiazepine tolerance?

Benzodiazepine dependence defines a situation in which one has developed one or more of either tolerance, withdrawal symptoms, drug seeking behaviors, such as continued use despite harmful effects, and maladaptive pattern of substance use, according to the DSM-IV,

In the case of benzodiazepine dependence, however, the continued use seems to be associated with the avoidance of unpleasant withdrawal reaction rather than from the pleasurable effects of the drug. Benzodiazepine dependence develops with long-term use, even at low therapeutic doses, without the described dependence behavior.

Addiction consists of people misusing or craving the drug, not to relieve withdrawal symptoms, but to experience its euphoric or intoxicating effects. It is necessary to distinguish between addiction to and abuse of benzodiazepines, and physical dependence on them.

The increased GABA inhibition on the neural systems caused by benzodiazepines is counteracted by the body’s development of tolerance to the drug’s effects; the development of tolerance occurs as a result of neuroadaptations, which result in decreased GABA activity and increased excitability of the glutamate system; these adaptations occur as a result of the body trying to overcome the central nervous system depressant effects of the drug to restore homeostasis,

When benzodiazepines are stopped, these neuroadaptations are “unmasked” leading to hyper-excitability of the nervous system and the appearance of withdrawal symptoms. Therapeutic dose dependence is the largest category of people dependent on benzodiazepines.

1. These individuals typically do not escalate their doses to high levels and generally use their medication as intended by their prescriber.
2. Smaller groups include patients escalating their dosage to higher levels and drug misusers as well.
3. Tolerance develops within days or weeks to the anticonvulsant, hypnotic, muscle relaxant and after 4 months there is little evidence that benzodiazepines retain their anxiolytic properties.

Some authors, however, disagree and feel that benzodiazepines retain their anxiolytic properties. Long-term benzodiazepine treatment may remain necessary in certain clinical conditions. Numbers of benzodiazepine prescriptions have been declining, due primarily to concerns of dependence.

How do you reverse benzodiazepine tolerance?

How To Prevent Benzodiazepine Tolerance – The most effective way to prevent benzo tolerance is to take it infrequently and at the lowest effective dose. Prescribing guidelines for benzodiazepines indicate that they should be prescribed for intermittent, short-term use to avoid concerns associated with tolerance, dependence and addiction.

Benzodiazepine tolerance reversal remains an area of active research. Tolerance development is a complex molecular process, as are potential mechanisms associated with tolerance reversal. Benzos act on receptors in the brain that normally interact with the inhibitory neurotransmitter called GABA. Evidence suggests that specific components of the GABA-A subfamily of GABA receptors can influence tolerance and perhaps reversal.

Intravenous administration of the benzodiazepine antagonist flumazenil may also reverse tolerance. The majority of research done on flumazenil reversal is in the context of people who use benzos to manage epileptic seizures. It bears repeating that benzo potentiation can be very dangerous.

What is benzo tolerance?

People can experience benzodiazepine withdrawal even if they’re not decreasing their dose. This is known as “tolerance.” – Put simply, tolerance may develop, for most, in as little as 2-4 weeks after a person has taken benzodiazepine, as the body and brain attempt to overcome, or work around, the drug’s effects (also known as neuroadaptations).

The tolerance or “tolerance withdrawal” phenomenon is often how patients initially discover that their benzodiazepine is no working as well, as it did the first time they used it, and feel they need to up- dose their medication. Beyond anxiety, tolerance to the anticonvulsant effects of benzodiazepines making them generally unsuitable for long-term control of epilepsy.

The original dose of the drug will be progressively less effect, and a higher dose is required to obtain the original effect. This has often led doctors to increase the dosage in their prescriptions or to add another benzodiazepine so that some patients end up taking two benzodiazepines at once. Tolerance to the anxiolytic effects develops more slowly but there is little evidence that benzodiazepines retain their effectiveness after a few months. In fact, long-term benzodiazepine use may even aggravate anxiety disorders. Many people find that anxiety symptoms gradually increase over the years despite continuous benzodiazepine use, and panic attacks and agoraphobia may appear for the first time after year/s of chronic use.

Such worsening of symptoms during long-term benzodiazepine use is probably due to the development of tolerance to the anxiolytic effects, so that “withdrawal” symptoms emerge even in the continued presence of the drugs. Tolerance develops with many regularly used drugs including alcohol, heroin and morphine and cannabis.

The body responds to the continued presence of the drug with a series of adjustments that tend to overcome the drug effects. In the case of benzodiazepines, compensatory changes occur in the GABA and benzodiazepine receptors which become less responsive, so that the inhibitory actions of GABA and benzodiazepines are decreased.

1. At the same time there are changes in the secondary systems controlled by GABA so that the activity of excitatory neurotransmitters tends to be restored.
2. Tolerance to different effects of benzodiazepines may vary between individuals – probably because of differences in underlying neurological and chemical make-up which are reflected in personality characteristics and susceptibility to stress.

The development of tolerance is one of the reasons people become dependent on benzodiazepines and sets the scene for the withdrawal syndrome. There are a few theories on why tolerance develops – receptor down-regulation from repeated and long-term exposure to benzodiazepines.

Many people are surprised to learn that short-term use of benzodiazepines is only 2 to 4 weeks. Another is receptor uncoupling, also known as decoupling, which is the process of receptor-binding sites or domains becoming separated, moving alignments and/or becoming internalized, resulting in medication tolerance from prolonged exposure to benzodiazepines.

Compensatory changes occur in the GABA and benzodiazepine receptors which become less responsive so that the inhibitory actions of GABA and benzodiazepines are decreased. At the same time, there are changes in the secondary systems controlled by GABA so that the activity of excitatory neurotransmitters tends to be restored.

Tolerance is the reason why many medical prescribers often increase a patient’s prescribed dose over time. Sometimes they even add another benzodiazepine, and some patients have ended up taking two (or more) benzodiazepines at once. Of course, inevitably the body then becomes tolerant on the new, higher dose, and the cycle repeats.

Benzodiazepines are not intended to be taken long-term, continued use or abuse use can cause the brain to become both physically and psychologically dependent on them. Some people may only have a few withdrawal symptoms that may not impact their life, while others may have more symptoms.

• PostScript360 helps to reduce withdrawal symptoms with a personalised taper schedule, health eating plan, lifestyle changes and wellbeing exercises.
• If you have been taking benzodiazepines longer than 3 weeks, please do not abruptly stop taking benzodiazepines, this can cause serious withdrawal symptoms.

Withdrawal symptoms, ranging from a return of uncomfortable psychological symptoms to physical symptoms such as:

Increased sensitivity to light and noise Mild to moderate depression

Sore tongue and metallic taste Tingling in the hands and feet

Family history of drug dependency or previous issues with substance abuse and/or dependency can increase the likelihood of developing a dependency to benzodiazepine and may potentially add to the withdrawal timeline duration. People taking benzodiazepine for a long time, and higher doses are likely to experience more withdrawal symptoms that last longer than those taking smaller doses for a shorter length of time.

What are high doses of benzodiazepines?

4.1.2. A specific daily, weekly or yearly DDD fraction – According to the WHO, the DDD is a unit developed to measure ‘the average maintenance dose per day for a drug used for its main indication in adults’ (WHO, 2003 ). It does not necessarily correspond to the recommended or prescribed daily dose and is often a compromise between different doses in various countries.

• There may be insufficient clinical support and the equivalent dose of 10 mg of diazepam may represent 6.25%–200% of the DDD, depending on the specific BDZ.
• The DDD definitions may be arbitrary (e.g., due to the prescription habits in a specific country) and they are sometimes reconsidered, thus varying in time.

The DDD for clonazepam, for example, may be inappropriate (Islam et al., 2014 ), since DDD of 8 mg is listed for that drug, where the usual clinical dose is 0.5 mg. To define high‐dose use, the authors rely on a specific daily, weekly or yearly DDD fraction in their studies, as described in Table 3,

• To reflect the mean BDZ dose of all the different BDZs by one parameter, Kan et al.
• 1997 ) divided the mean daily BDZ dose (MDD) by the defined daily BDZ dose (DDD).
• While the basic definition idea is similar (an index over one), prevalence may differ according to selection length (6 months, 1 year) and the references used for the highest recommended dosages.

Fredheim et al. ( 2019, 2020 ) define high dose use of benzodiazepines and benzodiazepine‐related hypnotics, in an adolescent population, as receiving more than 100 DDDs in 1 year. Specific attention should be given to the ageing population (≥65 years) in which a 50% reduction of the recommended adult dose is generally recommended (Etchepare et al., 2016 ; Nakra & Grossberg, 1986 ; Teboul & Chouinard, 1991 ) or a dose selection at the low end of the adult dosage range (Hanlon et al., 2009 ).

Does zopiclone show up in urine drug test?

Abstract – Data from previous experimental studies on the detection time of oxazepam and zopiclone in biological matrices are limited. The aim of this study was to examine the detection time in urine and oral fluid after single oral doses of oxazepam and zopiclone.

Ten healthy volunteers received 25 mg of oxazepam in the evening of Day 1 and 7.5 mg of zopiclone in the evening of Day 3. Urine and oral fluid samples were collected twice daily for 9 days, with an additional sampling the day after ingestion of zopiclone. A total of 19 samples of both urine and oral fluid from each participant were analyzed using fully validated chromatographic methods.

The median detection time for oxazepam was 91 h (range 73-108) in urine and 67 h (range 50-98) in oral fluid. The median detection time for zopiclone in urine was 49 h (range 25-98) and 59 h (range 48-146) in oral fluid. The metabolite zopiclone N-oxide showed a detection time of 36 h (range 25-84) in urine.

1. The area under the concentration-time curve (AUCTotal) in urine corrected for creatinine was 150 μmol/L/mmol/L*h (range 105-216) for oxazepam and 1.60 μmol/L/mmol/L*h (range 0.79-4.53) for zopiclone.
2. In oral fluid, the AUCtotal was 673 nmol/L*h (range 339-1,316) for oxazepam and 2,150 nmol/L*h (range 493-4,240) for zopiclone.

In conclusion, oxazepam can be detected longer in urine than in oral fluid, while zopiclone can be detected longer in oral fluid than in urine. The high AUCTotal for zopiclone in oral fluid shows that the transfer into oral fluid is significant. In certain individuals the detection time of zopiclone in oral fluid is long.

Can ibuprofen show up as benzodiazepines?

Abstract – Anecdotal and uncontrolled studies have suggested that nonsteroidal anti-inflammatory drugs produce false-positive results in immunoassay urine tests for some drugs of abuse. This study was performed in 60 volunteers who took ibuprofen as either a single 400-mg dose, or 200 mg three times a day, or 400 mg three times a day, and in 42 patients taking ibuprofen, naproxyn, or fenoprofen in therapeutic regimens for more than 30 days.

Of the 510 urines collected from 102 individuals during these dosage regimens, two gave false-positive tests for cannabinoid by enzyme-mediated immunoassay (EMIA), one after 1200 mg of ibuprofen in three divided doses for one day and one in a patient taking naproxyn on a chronic basis; none was falsely positive for benzodiazepines.

Two urines were false-positive for barbiturates by fluorescence polarization immunoassay (FPIA), one in a patient taking ibuprofen and one in a patient taking naproxyn. These data, collected prospectively, demonstrate the small likelihood of a false-positive immunoassay test result for cannabinoids, benzodiazepines, or barbiturates after the acute or chronic ingestion of ibuprofen, or after the chronic ingestion of naproxyn or fenoprofen.

Is hydroxyzine a benzo?

Is Hydroxyzine the Same as Xanax? – No, these drugs are not the same, but sometimes people confuse them. Both are available by prescription only, but hydroxyzine is an antihistamine medication used to treat allergic reactions and anxiety. Xanax is also used to treat anxiety, but it is classified as a benzodiazepine drug. It works by enhancing the effects of GABA in the brain.

Why does Klonopin not show up in my urine?

The Basic Urine Drug Screen – It’s important to understand the drug assay your ED uses and its limitations. For a basic UDS, let’s go over a few broad limitations one might encounter: Amphetamines

A basic amphetamine screen is unlikely to detect MDMA, designer drugs, or LSD. Many common nasal inhalers, decongestants (i.e. pseudoephedrine), antipsychotics, stimulant ADD/ADHD medications (i.e, methylphenidate), and antidepressants (i.e. trazodone and buproprion) may also give you a false positive.

Benzodiazepines

Many basic urine drug screens only test for the breakdown metabolites, oxazepam and noroxazepam.Alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), midazolam (Versed), and triazolam (Halcyon) do not undergo metabolism to oxazepam and can be missed in detection. Sertraline can also commonly cause false positives.One helpful mnemonic for some of the benzos picked up by the UDS: The benzo screen TOLD me about my patient’s benzo use:

T – temazepam O – oxazepam L – Librium (chlordiazepoxide) D – diazepam Opiates ‘Opiate’ is the broad term used to define the natural opioids, as opposed to the umbrella term ‘opioid’, which is generally used to describe the ‘natural’, semi-synthetic, and synthetic xenobiotics that act at the mu receptor.

1. When you see the ‘t,’ think of morphine, codeine, which both are naturally isolated from the opium poppy (Papaver somniferum), and heroin (metabolizes into morphine).
2. This does not include the semisynthetic and synthetic types of opioids our patients have access to.
3. The UDS is unlikely to detect semisynthetics, like oxycodone, hydrocodone as the molecular structures are too altered from the natural opiate.

It will not detect synthetics like fentanyl or methadone, as the structures are too dissimilar, unless your hospital’s UDS specifically tests for these xenobiotics.

It is possible to obtain a false positive from poppy seeds if eaten in large amounts.Ofloxacin and levofloxacin may also create false positive results.

Chemical Structure of Morphine. By NEUROtiker (Own work), via Wikimedia Commons Chemical Structure of Fentanyl. By Ben Mills (Own work), via Wikimedia Commons THC

The synthetic cannabinoids (Spice, K2, ‘fake weed’), which have become increasingly more frequent, will not be picked up on a THC screen.

PCP

One can see false positives from a number of commonly used substances includingdiphenhydramine, ibuprofen, dextromethorphan, venlafaxine, and lamotrigine.