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Medications & Substances Causing False Positives

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 results in the most widely administered urine test. Ronald Siegel, a psychopharmacologist at UCLA said 'The widespread testing and reliance on tell-tale traces of drugs in the urine is simply a panic reaction invoked because the normal techniques for controlling drug use haven't worked very well. The next epidemic will be testing abuse."

Substances that cause False Positive Drug Test Results

THC - Substances or Conditions which can cause false positives
Dronabinol (Marinol)
Ibuprofen; (Advil, Nuprin, Motrin, Excedrin IB etc)
Ketoprofen (Orudis KT)
Kidney infection (Kidney disease, diabetes) Liver Disease
Naproxen (Aleve)
Promethazine (Phenergan, Promethegan)
Riboflavin (B2, Hempseed Oil)

Amphetamines - Substances or Conditions which can cause false positives
Ephedrine, pseudoephedrine, propylephedrine, phenylephrine, or desoxyephedrine
(Nyquil, Contact, Sudafed, Allerest, Tavist-D, Dimetapp, etc)
Phenegan-D, Robitussin Cold and Flu, Vicks Nyquil
Over-the-counter diet aids with phenylpropanolamine (Dexatrim, Accutrim)
Over-the-counter nasal sprays (Vicks inhaler, Afrin)
Asthma medications (Marax, Bronkaid tablets, Primatine Tablets)
Prescription medications (Amfepramone, Cathne, Etafediabe, Morazone,
phendimetrazine, phenmetrazine, benzphetamine, fenfluramine, dexfenfluramine,dexdenfluramine,Redux, mephentermine, Mesocarb, methoxyphenamine, phentermine,amineptine, Pholedrine, hydroymethamphetamine, Dexedrine, amifepramone, clobenzorex,fenproyorex, mefenorex, fenelylline, Didrex, dextroamphetamine, methphenidate, Ritalin,pemoline, Cylert, selegiline, Deprenyl, Eldepryl, Famprofazone) Kidney infection, kidney disease, Liver disease, diabetes

Opiates - Substances or Conditions which can cause false positives
Poppy Seeds
Tylenol with codeine
Most prescription pain medications
Cough suppressants with Dextromethorphan (DXM)
Kidney infection, Kidney Disease
Diabetes, Liver Disease

Ecstacy - Substances or Conditions which can cause false positives
Ephedrine, pseudoephedrine, propylephedrine, phenylephrine, or desoxyephedrine
(Nyquil, Contact, Sudafed, Allerest, Tavist-D, Dimetapp, etc)
Phenegan-D, Robitussin Cold and Flu, Vicks Nyquil
Over-the-counter diet aids with phenylpropanolamine (Dexatrim, Accutrim)
Over-the-counter nasal sprays (Vicks inhaler, Afrin)
Asthma medications (Marax, Bronkaid tablets, Primatine Tablets)
Prescription medications (Amfepramone, Cathne, Etafediabe, Morazone,phendimetrazine, phenmetrazine, benzphetamine, fenfluramine, dexfenfluramine, dexdenfluramine,Redux, mephentermine, Mesocarb, methoxyphenamine, phentermine, amineptine, Pholedrine, hydroymethamphetamine, Dexedrine, amifepramone, clobenzorex, fenproyorex, mefenorex, fenelylline, Didrex, dextroamphetamine, methphenidate, Ritalin, pemoline, Cylert, selegiline, Deprenyl, Eldepryl, Famprofazone) Kidney infection, kidney disease
Liver disease, diabetes

Cocaine - Substances or Conditions which can cause false positives
Kidney infection (kidney disease)
Liver infection (liver disease)
Amoxicillin, tonic water

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UR-INE TROUBLE Dr. Holtorf demonstrates how common foods, prescription medications, and vitamin supplements are forcing many non-users to falsely test positive, and shows how drug users are able to easily pass these tests. Yes, even with the GC/MS, there are often false positives. Dr. Holtorf unveils the ugly truth about drug testing and explains how you can avoid the devastating pitfall of a false positive test.

Among the items reported as causing false positive test results are:

  • Pain relievers such as Advil, Nuprin, Motrin and menstrual cramp medications like Midol and Trendar. All drugs containing the widely used pain reliever Ibuprofen are known to cause positive samples for Marijuana. Non-steroidal anti inflammatories such as Naproxyn have cross reacted in blind tests. These are often prescribed for runners, sports injuries to joints, and those suffering from arthritis.
  • Syva labs has recently reworked its Cannabinoid test and claims to have eliminated this problem. But a Science magazine article (July 8, 1988) lists Ibuprofen as cross reactive. Under the new government guidelines THC testing levels will be reduced to 50 nanograms. Many more THC false positives can be expected in 1994.
  • Dristan Nasal Spray, Neosynephren, Vicks Nasal Spray, Sudafed, etc. and others containing ephedrine or pnenypropanolamine. Over the counter appetite suppressants which contain propanolamine. Most common nasal decongestants can cause a positive reading for Amphetamines. As the cross reactive list suggests at the back of this booklet, amphetamine false positives are the most common. Recent articles in the Journal of Clinical Chemistry ,Vol. 38 No.12 1992 and Vol. 39 No.3 1993 warn that medications containing chloropromazine, fluspirilene, and others may yield a positive when tested for amphetamines.
  • Vicks Formula 44M containing Dextromethorphan, and Primatene-M containing perylamine as well as the pain reliever Demerol, and prescription anti-depressant Elavil test positive for opiates up to three days. Even Quinine water can also cause a positive reading for opiates.
  • Poppy Seeds such as the ones on a bagel from your favorite deli, etc. The journal of Clinical Chemistry Vol.33 No.6, 1987 reports: "the quantities of poppy seed ingested in this study (25 and 40 g) may be expected to be contained in one or two servings of poppy seed cake. Therefore, poppy seeds represent a potentially serious source of falsely positive results in testing opiate abuse." Clinical Chemistry goes on to conclude: Not only is it difficult to distinguish heroin or morphine abuse from codeine, but dietary poppy seeds can give a strong positive result for urinary opiate of several days duration that is confirmed by GC/MS analysis".
  • Nyquil Nighttime Cold Medicine will test positive for Methadone up to two days.
  • Antibiotics. Certain newly developed antibiotics have cause positive samples urine tests. Ampicillin is suspect. Amoxicillin has caused positives for cocaine.
  • Diazepam tests positive for PCP as well as the ingredient in some cough medicines, Dextromethorophan.
  • Your own enzymes. A small fraction of the population excrete large amounts of certain enzymes in their urine which can produce a positive drug test. Dr. John Morgan of the Dept. of Pharmacology of New York City University writes: "A false positive test could occur in some individuals because they excrete unusually large amounts of endogenons lysozyme or malate dehydrogenase." Dr. Morgan judges that natural enzyme interference may run as high as 10% of positive samples.
  • Black Skin. This is not a joke! Those of African origin, certain Orientals, or pacific Islanders might test positive for marijuana. Dr. James Woodford, a toxicologist associated with Emory University labs hypothesized the pigment melanin which protects the skin from the sun, approximates the molecular structure of the THC metabolite to cross react on the marijuana urine test. Dark skinned Caucasians such as those from the subcontinent of India could also read positive on marijuana tests. The body eliminates some melanin in a dark person's urine sample.
  • Passive marijuana inhalation. If you attend a rock concert or ride in a car where marijuana is smoked nearby, even if you do not partake, the second hand marijuana that you might inhale may give your test a positive result for several days.


Claims of billions of dollars lost in employee productivity are based on guesswork, not real evidence.

Drug abuse in the workplace affects a relatively small percentage of workers. A 1994 National Academy of Sciences report found workplace drug use "ranges from a modest to a moderate extent," and noted that much of reported drug use "may be single incident, perhaps even at events like office parties."

Furthermore, drug tests are not work-related because they do not measure on-the-job impairment. A positive drug test only reveals that a drug was ingested at some time in the past. Nor do they distinguish between occasional and habitual use.

Drug testing is designed to detect and punish conduct that is usually engaged in off-duty and off the employer's premises - that is, in private. Employers who conduct random drug tests on workers who are not suspected of using drugs are policing private behavior that has no impact on job performance.


Alertness and sobriety are, of course, imperative for certain occupations, such as train engineers, airline pilots, truck drivers and others. Yet even in these jobs, random drug testing does not guarantee safety. Firstly, drug-related employee impairment in safety-sensitive jobs is rare. There has never been a commercial airline accident linked to pilot drug use. And even after a 1994 Amtrak accident in which several lives were lost, investigators discovered the train engineer had a well known history of alcohol, not drug, abuse.

Computer-assisted performance tests, which measure hand-eye coordination and response time, are a better way of detecting whether employees are up to the job. NASA, for example, has long used task-performance tests to determine whether astronauts and pilots are unfit for work - whether the cause is substance abuse, fatigue, or physical illness.

Drug tests don't prevent accidents because they don't address the root problems that lead to substance abuse. But good management and counseling can. Employee assistance programs (EAPs) help people facing emotional, health, financial or substance abuse problems that can affect job performance. EAP counselors decide what type of help is needed: staff support, inpatient treatment, AA meetings, and the like. In this context, the goal is rehabilitation and wellness - not punishment.

Employers need to kick the drug test habit.

SOURCES: American Management Association survey, "Workplace Drug Testing and Drug Abuse Policies"; R. DeCresce, Drug Testing in the Workplace (BNA, 1989); Under the Influence? Drugs and the American Workforce, National Academy of Sciences, 1994; J.P. Morgan, "The 'Scientific' Justification for Urine Drug Testing," University of Kansas L.R., 1988.


Privacy - the right to be left alone - is one of our most cherished rights. Yet because so few laws protect our privacy, the ACLU's campaign for privacy in the workplace is very important - particularly in the private sector.

The ACLU is working in the states to help enact legislation to protect workplace privacy rights. We have created a model statute regulating workplace drug testing. In 1996 the ACLU launched a public education campaign to help individuals across the nation become aware of the need for increased workplace privacy rights. Our educational videotape Through the Keyhole: Privacy in the Workplace - An Endangered Right was featured on national television and at union meetings and other gatherings nationwide.

Much more work remains to be done. As of mid 1997, only a handful of states ban testing that is not based on individual suspicion: Montana, Iowa, Vermont, and Rhode Island. Minnesota, Maine and Connecticut permit not-for-cause testing, but only of employees in safety-sensitive positions. These laws also require confirmation testing, lab certification and test result confidentiality.

Hawaii, Louisiana, Maryland, Nebraska, Oregon and Utah regulate drug testing in some fashion; Florida and Kansas protect government employee rights, but not those of private sector workers. Only in California, Massachusetts and New Jersey have the highest courts ruled out some forms of drug testing on state constitutional or statutory grounds. The ACLU is now continuing our efforts to protect workplace privacy rights. You can help.


1) Learn more about the issue. Order a copy of our video Through the Keyhole: Privacy in the Workplace - An Endangered Right and share it with family, friends, and co-workers ($7 plus shipping, call 800-775-ACLU to order.) Feel free to duplicate the tape at will.

2) Get a copy of our 1996 report, Surveillance Incorporated., which documents the increase in various forms of employer surveillance and breaks down privacy laws state by state. This free report is available through our website or our 800-number.

3) Write your elected officials urging them to support workplace privacy legislation..

4) Want to do more? Contact the ACLU's Campaign for Fairness in the Workplace to find out how you can personally help to get legislation passed. Write ACLU Campaign for Fairness in the Workplace, 166 Wall Street, Princeton, NJ 08540, fax (609) 683-1787.


Become a member of the ACLU and help support our efforts to protect the right to privacy. Write us at ACLU - Membership Department, 125 Broad Street, New York, NY 10004


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