False positives

[Agast]

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Anyone seeing prescription adderall and phentermine showing up as ecstacy on a confirmatory urine tox screen? Internet search just pulls up a bunch of drug addicts trying to pass tests.

 

[101N]

No.

 

[Jcm800]

anyone seen lidocaine come up false positive for cocaine?

 

[BobBarker]

hmm.. Patient using uppers caught with more uppers.

 

[Ducttape]

No to both.


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[drusso]

What are the quants? I've not seen Adderall show as Ecstasy, but sometimes as methamphetamine (which is permitted as a trace impurity in the manufacturing process). Ask your lab to do a "peak review" of the ion chromaotogram/spectrogram and see what m/z is actually showing up. You can "conjure" methamphetamine from amphetamine in the ionization process of mass spectroscopy resulting in a FP. Maybe some similar chemistry happens resulting in MDMA.

 

[melancholy]

your LCMS/GCMS confirmatory study triggered by a screen should ferret out methamphetamine, amphetamine, MDMA, etc.

 

[101N]

FYI, methamphetamine - Desoxyn - is a schedule II Rx'd by sleep medicine.

 

[Agast]

What are the quants? I've not seen Adderall show as Ecstasy, but sometimes as methamphetamine (which is permitted as a trace impurity in the manufacturing process). Ask your lab to do a "peak review" of the ion chromaotogram/spectrogram and see what m/z is actually showing up. You can "conjure" methamphetamine from amphetamine in the ionization process of mass spectroscopy resulting in a FP. Maybe some similar chemistry happens resulting in MDMA.

No quants listed. I ended up calling the lab and they said positive for ecstasy is positive for ecstasy.

It's just upsetting because I've taken care of this patient for months, weathered the recent death of a parent, rejoiced over the birth of a grandkid, came up with treatment plans for back and knee issues that need surgery and now that's all meaningless because I can't trust them anymore. I'm usually not sad when I have to fire someone.

 

[Ducttape]

Then don't fire them. Just tell them you can't write for opioids, but will continue to provide other treatment, non- opioid...


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