Diphenhydramine

Nurses Recovery

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Today I learned Benadryl can throw a false positive for methadone. WTH? I take Benadryl almost every day during allergy season, and even sometimes for sleep.

Rapid urine drug screens: diphenhydramine and methadone cross-reactivity. - PubMed - NCBI

My question is this: what would happen if I had to submit because of a shortage or something, and I tested positive? Should I just tell them beforehand what I take? Would they maybe use a more specific test? I have no idea how this stuff works.

Specializes in OR.
If you are not in a nurse monitoring program I can't think it would be too big of a deal. I've known many, many nurses over the years who use Benadryl to sleep very often. If they placed folks in the monitoring program for that there would be many more unfortunate souls out there but the "rehabilitation" industry would be loving the extra profits

Cripes, don't give 'em any ideas.:no: like there aren't already enough ways for these things to inappropriatly slap a label on someone, NOT help them when in need, ruin a career, drive a person in bankruptcy then spit them out when there's no more money to be milked. yeah, I know, bitter much.

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Just an FYI, Benadryl is banned because it is used recreationally...frequently. In high doses, it's a like a hallucinogenic, but truly it can cause delirium rather than a true hallucinogenic experience. It can also cause a dissociative experience at moderate doses, which some people find pleasurable.

If you flagged for methadone, the GC would show it was Benadryl, and whether it is in your system in abusive levels, theoretically. That being said, if you have a script for your doc, you are fine, whether or not it flags as methadone, as long as the drug level is appropriate.

Same goes with Robutussin. It's a hallucinogenic and dissociative at high doses as well. It's more abused than Benadryl, which is why you have to be over 18 to purchase it. It's called DMX recreationally, and it can pop a false positive for PCP.

That's why the programs ban these products. But again, a legit MD script will cover you.

Best of luck.

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Just an FYI, Benadryl is banned because it is used recreationally...frequently. In high doses, it's a like a hallucinogenic, but truly it can cause delirium rather than a true hallucinogenic experience. It can also cause a dissociative experience at moderate doses, which some people find pleasurable.

If you flagged for methadone, the GC would show it was Benadryl, and whether it is in your system in abusive levels, theoretically. That being said, if you have a script for your doc, you are fine, whether or not it flags as methadone, as long as the drug level is appropriate.

Same goes with Robutussin. It's a hallucinogenic and dissociative at high doses as well. It's more abused than Benadryl, which is why you have to be over 18 to purchase it. It's called DMX recreationally, and it can pop a false positive for PCP.

That's why the programs ban these products. But again, a legit MD script will cover you.

Best of luck.

It seems that robitussin is minimally associated with Hallucinations, but robitussin DM would be the problem.

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It seems that robitussin is minimally associated with Hallucinations, but robitussin DM would be the problem.

The Robitussin I was in reference to; the DMX, or dextromethorphan. Dextromethorphan is the substance with abusive properties that is hallucinogenic and dissociative. In high doses, it also hits opioid receptors mildly. That is the plain and original formulary.

Robitussin DM has guaifenesen in addition to the DMX (otherwise known as Robitussin Cough and Cold”) and is not the form you want to abuse. You will puke. Guaifenesen is not fun to OD on, trust me. People who abuse Robitussin tend to avoid the DM version.

Robitussin with only guaifenesen is another formulary version marketed under the brand name of Robitussin”, but it is better known as Mucinex under a different branding company. I am not familiar with guaifenesen having abusive properties...and of course all the Robitussin” combos thereof than can include Sudafed, acetaminophen, antihistamines, etc.. Brand-name plain Robitussin” can be plain quaifenesin or plain dextromethorphan; you have to read the labels. I personally think that is dangerous.

Robitussin without guaifenesen also has 1.4% alcohol; the plain guaifenesen does not.

DMX is quite hallucinogenic and very strongly dissociative. I'm sad to admit that I do know from personal experience, back in the day, when I would Robo-Trip”. When it's mixed with candy or flavoring, it's also known as throwing Skittles”.

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Specializes in OR.

All this is another example of the "net cast too far and too wide" issue of these programs. Watching for the alcohol in Nyquil or the abusive risks of various cold medicines is one thing if you are indeed an alcoholic/addict. For those who are not and are yet caught up in the seemingly xeroxed contracts that are issued, we now have medical professionals that are not allowed to treat the symptoms of their own common cold without "asking permission" from some faceless organization where we are no more than a number in a file folder. My dentist that i see twice a year for a cleaning knows me better that that.

Forgive me for being incredibly naive but even from just Pixie's post above I have learned more than i never wanted to know about the terrible things than can be done with cough syrup.:eek:

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Specializes in ICU; Telephone Triage Nurse.
Yeah It will be over some day & I can't wait. I feel like this program has done nothing to help me at all. I have my dreaded weekly nurse meeting tonight. More money out for nothing but aggravation. Oh well such is life in "assistance" land

I love your screen name! That about summed it up when I was in my decree of censure program in 199(cough, cough ...).

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Specializes in Transitional Nursing.

I believe what they do is submit it for further testing to identify the metabolites and/or Gas chromatography–mass spectrometry, which identifies the substance with 100% accuracy. In random drug screens for employment or to rule out diversion, etc., there are cut offs for this exact reason. It allows for a small amount of a substance that could cause a false positive. Usually employers etc. have to allow the in dept testing but often times treatment programs won't pay for it, so they tell you to avoid the substances than can trigger a false positive.

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I believe what they do is submit it for further testing to identify the metabolites and/or Gas chromatography–mass spectrometry, which identifies the substance with 100% accuracy. In random drug screens for employment or to rule out diversion, etc., there are cut offs for this exact reason. It allows for a small amount of a substance that could cause a false positive. Usually employers etc. have to allow the in dept testing but often times treatment programs won't pay for it, so they tell you to avoid the substances than can trigger a false positive.

My monitoring program routinely does do the GC...but it is at my expense, not theirs. My program book states that Benadryl, sudafed, dextromethorphan, etc. are banned because they consider them mood altering, not because they can throw false positives.

If I hypothetically popped a positive for methadone but denied that I took methadone, I would request a GC, they would perform it, and I would have to foot the bill.

But at least in VA, unless I had an MD script for the offending, banned OTC that caused the false positive, I would still be considered in violation of my contract and face potential disciplinary action either from the BON or from HPMP.

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Specializes in ER.

New research points to Benadryl increasing the risk for Alzheimer's. Don't take it!

Common anticholinergic drugs like Benadryl linked to increased dementia risk - Harvard Health Blog - Harvard Health Publishing

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hmm, I wonder if it is the Benadryl, or the underlying disease process for which it I taken...

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Specializes in PDN; Burn; Phone triage.
hmm, I wonder if it is the Benadryl, or the underlying disease process for which it I taken...

Or the fact that Benadryl is an incredibly common drug (like PPIs which are also apparently going to give me Alzheimer's) orrrr the fact that the study didn't seem to control for other risk factors among Benadryl users...

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